Meropenem

Meropenem Brand Name– Merrem

What is Meropenem

Meropenem is an intravenous semisynthetic carbapenem antibiotic. Although similar to imipenem, meropenem does not require concomitant administration of a renal enzyme inhibitor (e.g., cilastatin).

Meropenem is used for the treatment of complicated intraabdominal infections and skin and skin structure infections in adult and pediatric patients and for bacterial meningitis in children.

The spectrum of activity of meropenem is very similar to imipenem although meropenem is more active against Enterobacteriaceae, Haemophilus influenzae, gonococcus, and Pseudomonas aeruginosa.

Meropenem may also have a lower incidence of adverse drug reactions than imipenem.

Meropenem was approved by the FDA in June 1996.

Indications

1. Acinetobacter sp.
2. Aeromonas hydrophila
3. anthrax
4. appendicitis
5. bacteremia
6. Bacteroides fragilis
7. Bacteroides ovatus
8. Bacteroides thetaiotaomicron
9. Bacteroides uniformis
10. Bacteroides ureolyticus
11. Bacteroides vulgatus
12. Campylobacter jejuni
13. Citrobacter diversus
14. Citrobacter freundii
15. Clostridium difficile
16. Clostridium perfringens
17. community-acquired pneumonia
18. Eggerthella lenta
19. Enterobacter cloacae
20. Enterococcus faecalis
21. Escherichia coli
22. febrile neutropenia
23. Fusobacterium sp.
24. Haemophilus influenzae (beta-lactamase negative)
25. Haemophilus influenzae (beta-lactamase positive)
26. Hafnia alvei
27. intraabdominal infections
28. Klebsiella oxytoca
29. Klebsiella pneumoniae
30. meningitis
31. Moraxella catarrhalis
32. Morganella morganii
33. Neisseria meningitidis
34. nosocomial pneumonia
35. Parabacteroides distasonis
36. Pasteurella multocida
37. Peptostreptococcus sp.
38. peritonitis
39. pneumonia
40. Porphyromonas asaccharolytica
41. Prevotella bivia
42. Prevotella intermedia
43. Prevotella melaninogenica
44. Propionibacterium acnes
45. Proteus mirabilis
46. Proteus vulgaris
47. Pseudomonas aeruginosa
48. Salmonella sp.
49. sepsis
50. Serratia marcescens
51. Shigella sp.
52. skin and skin structure infections
53. Staphylococcus aureus (MSSA)
54. Staphylococcus epidermidis
55. Streptococcus agalactiae (group B streptococci)
56. Streptococcus pneumoniae
57. Streptococcus pyogenes (group A beta-hemolytic streptococci)
58. Viridans streptococci
59. Yersinia enterocolitica

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. agitation
4. agranulocytosis
5. anaphylactoid reactions
6. anemia
7. angioedema
8. anorexia
9. anxiety
10. apnea
11. asthenia
12. azotemia
13. back pain
14. bradycardia
15. candidiasis
16. cardiac arrest
17. chest pain (unspecified)
18. chills
19. cholestasis
20. confusion
21. constipation
22. cough
23. delirium
24. depression
25. diaper dermatitis
26. diarrhea
27. dizziness
28. drowsiness
29. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
30. dyspepsia
31. dyspnea
32. dysuria
33. elevated hepatic enzymes
34. eosinophilia
35. epistaxis
36. erythema multiforme
37. fever
38. flatulence
39. GI bleeding
40. GI obstruction
41. glossitis
42. hallucinations
43. headache
44. heart failure
45. hemolytic anemia
46. hepatic failure
47. hyperbilirubinemia
48. hyperglycemia
49. hypertension
50. hypervolemia
51. hypoglycemia
52. hypokalemia
53. hypotension
54. hypoxia
55. ileus
56. infection
57. injection site reaction
58. insomnia
59. jaundice
60. leukocytosis
61. leukopenia
62. melena
63. myocardial infarction
64. nausea
65. neutropenia
66. paresthesias
67. pelvic pain
68. peripheral edema
69. pharyngitis
70. phlebitis
71. pleural effusion
72. pruritus
73. pseudomembranous colitis
74. pulmonary edema
75. pulmonary embolism
76. rash
77. renal failure (unspecified)
78. seizures
79. sinus tachycardia
80. skin ulcer
81. Stevens-Johnson syndrome
82. superinfection
83. syncope
84. thrombocytopenia
85. thrombocytosis
86. toxic epidermal necrolysis
87. urinary incontinence
88. urticaria
89. vomiting

Monitoring Parameters

• blood glucose
• CBC
• LFTs
• serum creatinine/BUN

Contraindications

• breast-feeding
• carbapenem hypersensitivity
• cephalosporin hypersensitivity
• colitis
• diarrhea
• driving or operating machinery
• geriatric
• GI disease
• head trauma
• heart failure
• inflammatory bowel disease
• neurological disease
• penicillin hypersensitivity
• pregnancy
• pseudomembranous colitis
• renal failure
• renal impairment
• seizure disorder
• seizures
• sodium restriction
• ulcerative colitis

Interactions

• Colchicine; Probenecid
• Oral Contraceptives
• Probenecid
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Valproic Acid, Divalproex Sodium
• Warfarin