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
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