Meropenem (Merrem)
Christopher M. Bland, Pharm.D., FCCP, FIDSA, BCPS

Meropenem – Merrem®

Drug Class – Carbapenem antibiotic (Broad-spectrum)

Mechanism of Action – Binds to penicillin binding proteins to inhibit cell wall synthesis resulting in bactericidal effect

Dosage Forms – Vial for Injection (500mg and 1gm)

Dosing – 500mg or 1gm IV q8h (Adults); 10-40mg/kg IV q8-12h (Pediatrics)

Prolonged infusions sometimes utilized off-label for multidrug-resistant pathogens

Ranges are due to different recommendations by indication

Indications

  1. 1.Complicated skin and skin structure infections (3 months of age and older) 

  2. 2.Complicated intra-abdominal infections (adults and pediatrics) 

  3. 3.Bacterial meningitis (3 months of age and older) 

 

Meropenem – Merrem®

Dosage adjustment

  • •Required in renal impairment 

    • •50ml/min or less 

  • •NOT required in hepatic impairment 

Contraindications

  • •Known hypersensitivity to meropenem or anaphylaxis to beta-lactams 

Warnings

  • •Allergic reactions 

  • •Seizures 

  • •Thrombocytopenia (renal-insufficient patients) 

  • •C. difficile-associated diarrhea 

Pregnancy

  • •Insufficient data 

  • •Excreted in breast milk 

 

Meropenem – Merrem®

Drug Interactions

  • •Significant decreases in valproic acid concentrations 

  • •Probenecid increases meropenem concentrations 

  • •Avoid these combinations 

Adverse Effects

  • •Seizures 

  • •Antibiotic-associated diarrhea including C. difficile 

  • •Common CNS and GI complaints  

  • •Rash 

Monitoring Parameters

  • •Signs and symptoms of infection 

  • •Diarrhea 

    • •C. difficile can occur months after stopping therapy 

Therapeutic Pearls

  • •Drug of choice to treat severe ESBL E. coli or K. pneumoniae infections 

  • •Valproic Acid= Depakote for drug interaction 

  • •Can use for Depakote overdoses off-label 

  • •Does not treat MRSA or S. maltophilia 

 

Tips:

The control bar will always show on the first slide.  After the first slide, move your mouse to the bottom of the slide for it to reappear.
  • Slide 1/4
    0:00/9:31
  • 1/4
  • 0:00/9:31
Error loading audio. Check your Internet connection.
Error loading audio. Check your Internet connection.
Error loading audio. Check your Internet connection.
Error loading audio. Check your Internet connection.