Meropenem
Meropenem (Merrem IV)
Meropenem
( mer-oh- PEN-em)
Pregnancy Category: B Merrem IV (Rx)

Classification: Antibiotic, miscellaneous

See Also: See also Anti-Infectives .

Action/Kinetics: Broad-spectrum carbapenem antibiotic. Acts by inhibiting cell wall synthesis in gram-positive and gram-negative bacteria. t 1/2, elimination: About 1 hr. Both unchanged drug (65% to 83%) and the inactive metabolite (20% to 32%) are excreted through the urine. Adjust dosage in impaired renal function.

Uses: Complicated appendicitis and peritonitis caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Bacteroides fragilis, Bacteroides thetaiotaomicron, Peptostreptococcus species, and viridans group streptococci. Bacterial meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (ß-lactamase- and non-ß-lactamase-producing strains), and Neisseria meningitidis.

Contraindications: Hypersensitivity to meropenem or other drugs in the same class. Those who have had anaphylactic reactions to ß-lactams.

Special Concerns: Use with caution during lactation. Safety and efficacy have not been determined for children less than 3 months of age.

Side Effects: GI: Diarrhea, N&V;, constipation, abdominal pain, GI hemorrhage pseudomembranous colitis, abdominal pain, melena, oral moniliasis, anorexia, cholestatic jaundice, jaundice, flatulence, ileus. CNS: Insomnia, agitation, headache, delirium, confusion, dizziness, nervousness, paresthesia, hallucinations, somnolence, anxiety, depression, seizures. CV: Heart failure, cardiac arrest, MI, pulmonary embolus tachycardia, hypertension, bradycardia, hypotension, syncope. Dermatologic: Rash, pruritus, urticaria, sweating. Body as a whole: Pain, chest pain, sepsis, shock, hepatic failure fever, abdominal enlargement, back pain. GU: Dysuria, kidney failure, presence of urine RBCs. Respiratory: Respiratory disorder, dyspnea. At injection site: Inflammation, phlebitis, thrombophlebitis, pain, edema. Miscellaneous: Anemia, peripheral edema, hypoxia, epistaxis, hemoperitoneum.
In children, the drug may cause diarrhea, rash, and vomiting when used for bacterial infections. Also, when used for meningitis in children, rash (diaper area moniliasis), diarrhea, oral moniliasis, and glossitis have been noted.

Laboratory Test Alterations: Eosinophils, ALT, AST, alkaline phosphatase, LDH, bilirubin, creatinine, BUN. Hemoglobin, hematocrit, WBCs. or platelets. Prolonged or shortened PT, PTT. Positive direct or indirect Coombs' test.

How Supplied: Powder for injection: 500 mg, 1 g

Dosage
?IV Bacterial infections, meningitis.
Adults: 1 g IV q 8 hr given over 15-30 min or as an IV bolus injection (5-20 mL) over 3-5 min. In clients with impaired renal function, the dose is reduced as follows: C _CR 26-50 mL/min, 1 g q 12 hr; C _CR 10-25 mL/min, one-half the recommended dose q 12 hr; C _CR less than 10 mL/min, one-half the recommended dose q 24 hr. Children, 3 months or older: 20 or 40 mg/kg (depending on the type of infection) q 8 hr, up to a maximum of 2 g q 8 hr. For pediatric clients weighing 50 kg or more, administer 1 g q 8 hr for intra-abdominal infections and 2 g q 8 hr for meningitis given over 15-30 min or as an IV bolus injection (5-20 mL) over 3-5 min.