Adult Dosing
Skin and skin structure infections
- 500 mg IV infusion q8 hrs
Intra-abdominal infections
Bacterial meningitis
Note:
- Give meropenem as intravenous infusion over approximately 15-30 minutes or as an intravenous bolus injection (5-20 mL) over approximately 3-5 minutes
Pediatric Dosing
Skin and skin structure infections (>3 yrs)
- 10 mg/kg q8 hrs; Max: 500 mg q8 hrs
Intra-abdominal infections (>3 yrs)
- 20 mg/kg q8 hrs; Max: 1 g q8 hrs
Bacterial Meningitis (>3 yrs)
- 40 mg/kg q8 hrs; Max: 2 g q8 hrs
Note:
- Give meropenem as intravenous infusion over approximately 15-30 minutes or as an intravenous bolus injection (5-20 mL) over approximately 3-5 minutes
[Outline]
Renal Dose Adjustment (Based on CrCl)
- >50 mL/min: Recommended dose q8 hrs
- 25-50 mL/min: Recommended dose q12 hrs
- 10-25 mL/min: 50% of recommended dose q12 hrs
- <10 mL/min: 50% of recommended dose q24 hrs
- Hemodialysis: Not defined
Hepatic Dose Adjustment
- Hepatic impairment: No dose adjustments
- Serious and occasionally fatal hypersensitivity (anaphylactic) reactions can occur in patients receiving beta-lactams therapy, particularly in patients with the history of sensitivity to multiple allergens, or history of penicillin hypersensitivity. Hence before initiating the therapy with meropenem, make careful inquiry about previous hypersensitivity reactions. Discontinue the therapy and provide immediate emergency treatment with epinephrine, oxygen, intravenous steroid and airway management as indicated, if allergic reactions occurs
- Meropenem can cause seizures and other CNS adverse reactions, such as confusional states and myoclonic activity
- Patients with CNS disorders or with bacterial meningitis, or compromised renal function are at higher risk
- Closely follow the dosing guideline especially in patients with known predisposing factors to convulsive activity. Continue with anticonvulsant therapy in patients with known seizure disorders and if CNS symptoms occurs evaluated the patients neurologically and placed on anti-convulsant therapy if not already instituted
- Co-administration of meropenem and valproic acid or divalproex sodium results in a reduction in valproic acid concentrations below the therapeutic range. Use alternate antibacterial agent in patients whose seizures are well controlled on valproic acid or divalproex sodium, if administration of meropenem is necessary, consider supplemental anticonvulsant therapy
- Clostridium difficile associated diarrhea (CDAD) ranging from mild diarrhea to fatal colitis occurs with meropenem therapy as antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile
- C. difficile produces toxins A and B which contribute to CDAD. Hypertoxin producing strains causes increased morbidity and mortality since these infections can be refractory to antibiotic therapy and may require colectomy. Careful medical examination is necessary since CDAD may occur >2 months after administration of drug
- If CDAD is suspected/confirmed discontinue the treatment, provide fluid, electrolyte, and protein supplementation along with antibiotics for C. difficile, surgical evaluation as clinically needed
- To reduce the development of drug resistant bacteria and maintain the effectiveness of meropenem, use only to treat/prevent infections that are proven or strongly suspected to be caused by susceptible bacteria
- Prolong use of meropenem can result in overgrowth of nonsusceptible organisms, provide appropriate treatment if superinfection occurs during therapy
- Monitor organ system functions, including renal, hepatic, and hematopoietic periodically during prolonged therapy
- Patients receiving the therapy on an outpatient basis may develop seizures, headaches and/or paresthesias that could interfere with mental alertness and/or cause motor impairment
Cautions: Use with caution in
- Renal impairment
- History of seizure disorder
- CNS disorder
Merrem, Merrem IV interacts with :
Pregnancy Category:B
Breastfeeding: Safety unknown; however beta-lactams are generally not expected to cause adverse effects in breastfed infants. Disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush, has been reported occasionally with beta-lactams, but these effects have not been evaluated adequately. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 29 March 2011). Manufacturer advises caution.
Pricing data from www.DrugStore.com in U.S.A.
- Merrem 1 GM SOLR [Vial] (ASTRAZENECA)
1 gm = $79.56
5 gm = $386.17 - Merrem 500 MG SOLR [Vial] (ASTRAZENECA)
1 mg = $39.99
10 mg = $365.99 - Meropenem 500 MG SOLR [Vial] (SANDOZ)
1 mg = $29.99
3 mg = $79.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
