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Meropenem

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Meropenem, Merrem

  • See Also
  1. Meropenem Vaborbactam
  2. Carbapenem
  • Indications
  1. See Carbapenem
  2. Conditions
    1. Complicated Skin and Soft Tissue Infections
    2. Intraabdominal Infections (Appendicitis, peritonitis)
    3. Meningitis (over age 3 months)
      1. Meropenem is the only Carbapenem FDA approved for Meningitis
  • Mechanism
  1. See Carbapenem
  • Dosing
  1. Adult (and child weighing >50 kg)
    1. High Dose: 2000 mg IV every 8 hours
      1. Indicated in Meningitis (not FDA approved)
    2. Medium Dose: 1000 mg IV every 8 hours
      1. Indicated in complicated intra-abdominal and Pseudomonas infections
      2. Also used in Hospital Acquired Pneumonia, complicated UTI, Malignant Otitis Externa (not FDA approved)
    3. Low Dose: 500 mg IV every 8 hours
      1. Indicated in Skin and Soft Tissue Infections
    4. Adjust dose in impaired Renal Function
      1. CrCl 10 to 25 ml/min: Give indicated dose every 12 hours
      2. CrCl 26 to 50 ml/min: Give 50% of indicated dose every 12 hours
      3. CrCl <10 ml/min: Give 50% of indicated dose every 24 hours
  2. Child over age 3 months (and weight<50 kg)
    1. High Dose: 40 mg/kg IV every 8 hours
      1. Indicated in Meningitis
    2. Medium Dose: 20 mg/kg IV every 8 hours
      1. Indicated in complicated intra-abdominal and Pseudomonas infections
    3. Low Dose: 10 mg/kg IV every 8 hours
      1. Indicated in Skin and Soft Tissue Infections
  3. Infant age 2 weeks to 3 months (for complicated intra-abdominal infection)
    1. Gestational age <32 weeks: 20 mg/kg IV every 8 hours
    2. Gestational age >32 weeks: 30 mg/kg IV every 8 hours
  4. Infant age <2 weeks (for complicated intra-abdominal infection)
    1. Gestational age <32 weeks: 20 mg/kg IV every 12 hours
    2. Gestational age >32 weeks: 20 mg/kg IV every 8 hours
  • Drug Interactions
  1. See Carbapenem
  • Adverse Effects
  1. See Carbapenem
  2. Seizures
    1. Unlike other Carbapenems, does not appear to significantly increase Seizure risk in Meningitis
    2. Norrby (1999) Scand J Inf Dis 31(1):3-10 +PMID: 10381210 [PubMed]
  3. Thrombocytopenia
    1. May oocur with Meropenem (Merrem) in patients with renal dysfunction
  • Safety
  1. Unknown safety in pregnancy and Lactation
  • Resources
  1. Meropenem (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3b952a55-6ef7-45c8-be21-16eefe37ec2e
  • References
  1. LiverTox (2017), accessed online 1/2/2023
    1. https://www.ncbi.nlm.nih.gov/books/NBK548705/
  2. Hamilton (2020) Tarascon Pharmacopeia
  3. (2012) Presc Lett, Resource #231205, Comparison of Carbapenem Antibiotics
  4. Zhanel (2007) Drugs: 67(7): 1027-52 [PubMed]