MEROPENEM

Carbapenem. Broad-spectrum beta-lactam antibacterial active against many Gram-positive and Gram-negative bacteria and anaerobes. It also has good activity against Pseudomonas aeruginosa

Dosage Forms

Powder for reconstitution for injection

500 mg

Uses

  • Severe hospital-acquired infections
  • Septicaemia
  • Severe pneumonia (hospital and ventilator-associated)
  • Broncho-pulmonary infections in cystic fibrosis
  • Complicated intra-abdominal infections
  • Intra- and post-partum infections
  • Complicated skin and soft-tissue infections
  • Complicated urinary tract infections
  • Acute bacterial meningitis

Dose and Duration

Aerobic and anaerobic Gram-positive and Gram-negative infections, hospital-acquired septicaemia

By IV injection over 5 minutes or by IV infusion

Adult and child > 12 years or 50 kg: 0.5–1 g every 8 hours

Child 3 months–12 years or <50 kg: 10–20 mg/kg every 8 hours

Neonate 7–28 days: 20 mg/kg every 8 hours. Double dose in severe infection

Neonate under 7 days: 20 mg/kg every 12 hours. Double dose in severe infection

In renal impairmentGive dose as in table below

eGFR (ml/minute/1.73 m²) Dose
26–50 Normal dose every 12 hours
10–25 ½ normal dose every 12 hours
<10 ½ normal dose every 24 hours
Bronchopulmonary infection in cystic fibrosis, meningitis

By IV infusion,

Adult and child over 12 years or 50 kg: 2 g every 8 hours

Child 1 month–12 years or <50 kg: 40 mg/kg every 8 hours

Neonate 7–28 days: 40 mg/kg every 8 hours

Neonate under 7 days: 40 mg/kg every 12 hours

Endocarditis (in combination with another antibacterial)

Adult over 18 year: 2 g every 8 hours

Preparation

  • Dilute meropenem infusion dose in glucose 5% or sodium chloride 0.9% to a final concentration of 1–20 mg/ml. Give over 15–30 minutes

Contraindications

  • History of immediate hypersensitivity reaction to beta-lactam antibacterials
  • Hypersensitivity to meropenem or other carbapenems

Side Effects

  • Nausea, vomiting, diarrhoea, abdominal pain
  • Headache
  • Thrombocythaemia
  • Increased liver function tests
  • Rash, pruritus, Stevens-Johnson syndrome
  • Injection site inflammation, pain

Interactions

  • Valproate: (reduced plasma concentration of valproate)

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • Use with caution in patients with sensitivity to beta-lactam antibacterials
  • Monitor liver function if used in hepatic impairment
  • Only use in pregnancy if benefit outweighs risk.