Meropenem: Difference between revisions
(Special populations, contraindications, pharmacology) |
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==General== | ==General== | ||
*Type: [[Carbapenems]] | *Type: [[Carbapenems]] | ||
*Dosage Forms: | *Dosage Forms: IV | ||
*Common Trade Names: | *Common Trade Names: Merrem | ||
==Adult Dosing== | ==Adult Dosing== | ||
===General=== | ===General=== | ||
*1.5- | *1.5-6g IV daily, divided q8 hours | ||
*First Dose: 0.5-2g IV x 1 | *First Dose: 0.5-2g IV x 1 | ||
===[[Meningitis]]=== | |||
*2g IV every 8 hours. | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
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==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Anaphylactic reaction to beta-lactams | *[[Anaphylactic reaction]] to beta-lactams | ||
*Caution | *Caution | ||
**Seizure disorder | **[[Seizure disorder]] | ||
**CNS infection or lesion | **[[CNS infection]] or lesion | ||
**Renal impairment | **Renal impairment | ||
**Recent | **Recent antibiotic-associated [[colitis]] | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
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*[[Anaphylaxis]] | *[[Anaphylaxis]] | ||
*[[Stevens-Johnson Syndrome]] | *[[Stevens-Johnson Syndrome]] | ||
*Erythema multiforme | *[[Erythema multiforme]] | ||
*Toxic epidermal necrolysis | *[[Toxic epidermal necrolysis]] | ||
*Drug reaction with eosinophilia and systemic | *Drug reaction with eosinophilia and systemic signs | ||
*Superinfection | *Superinfection | ||
*C. diff associated [[diarrhea]] | *[[C. diff]] associated [[diarrhea]] | ||
*[[Thrombocytopenia]] | *[[Thrombocytopenia]] | ||
*[[Agranulocytosis]] | *[[Agranulocytosis]] | ||
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*[[Neutropenia]] | *[[Neutropenia]] | ||
*[[Leukopenia]] | *[[Leukopenia]] | ||
*Delirium | *[[Delirium]] | ||
===Common=== | ===Common=== | ||
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*Excretion: Urine, active secretion (70% unchanged) | *Excretion: Urine, active secretion (70% unchanged) | ||
*Mechanism of Action: Inhibits cell wall synthesis | *Mechanism of Action: Inhibits cell wall synthesis | ||
==Mechanism of Action== | |||
==Comments== | |||
*Has activity against ESBL organisms | |||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ||
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| ||[[Klebsiella]] sp||'''S''' | | ||[[Klebsiella]] sp||'''S''' | ||
|- | |- | ||
| ||E. coli/Klebsiella ESBL+||'''S''' | | ||E. coli/Klebsiella ESBL+||'''[[Has ESBL::S]]''' | ||
|- | |- | ||
| ||E coli/Klebsiella KPC+||R | | ||E coli/Klebsiella KPC+||R | ||
| Line 203: | Line 211: | ||
*[[Antibiotics (Main)]] | *[[Antibiotics (Main)]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:ID]] | |||
Latest revision as of 04:31, 3 August 2025
General
- Type: Carbapenems
- Dosage Forms: IV
- Common Trade Names: Merrem
Adult Dosing
General
- 1.5-6g IV daily, divided q8 hours
- First Dose: 0.5-2g IV x 1
Meningitis
- 2g IV every 8 hours.
Pediatric Dosing
General (≥3 Months)
- 30-120mg/kg/day IV divided q8 hours
- First Dose: 10-40mg/kg IV x 1
- Max: 6 g/day
Special Populations
- Pregnancy: B
- Lactation: Use caution
- Renal Dosing
- Adult
- CrCl 26-50: Give q12h
- CrCl 10-25: Decrease dose 50%, give q12h
- CrCl 10: Decrease dose 50%, give q24h
- HD: Give dose after dialysis
- PD: No supplement
- Pediatric
- CrCl 26-50: Give q12h
- CrCl 10-25: Decrease dose 50%, give q12h
- CrCl 10: Decrease dose 50%, give q24h
- HD: Give dose after dialysis
- PD: No supplement
- Adult
- Hepatic Dosing
- Adult
- No adjustment
- Pediatric
- No adjustment
- Adult
Contraindications
- Allergy to class/drug
- Anaphylactic reaction to beta-lactams
- Caution
- Seizure disorder
- CNS infection or lesion
- Renal impairment
- Recent antibiotic-associated colitis
Adverse Reactions
Serious
- Seizure
- Hypersensitivity reaction
- Anaphylaxis
- Stevens-Johnson Syndrome
- Erythema multiforme
- Toxic epidermal necrolysis
- Drug reaction with eosinophilia and systemic signs
- Superinfection
- C. diff associated diarrhea
- Thrombocytopenia
- Agranulocytosis
- Anemia, hemolytic
- Neutropenia
- Leukopenia
- Delirium
Common
Pharmacology
- Half-life: 1.2h (10h in renal failure)
- Metabolism: Kidney minimally; OAT1 and OAT3 substrate
- Excretion: Urine, active secretion (70% unchanged)
- Mechanism of Action: Inhibits cell wall synthesis
Mechanism of Action
Comments
- Has activity against ESBL organisms
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- ↑ Sanford Guide to Antimicrobial Therapy 2014