Indications
Meropenem IV is indicated for treatment in adults and children for the following infections caused by single or multiple bacteria sensitive to meropenem.
- Pneumonia and Nosocomial Pneumonia
- Urinary Tract Infections
- Intra-abdominal Infections
- Gynaecological Infections, such as endometritis and pelvic inflammatory disease
- Skin and Skin Structure Infections
- Meningitis
- Septicaemia
Empiric treatment, for presumed infections in adult patients with febrile neutropenia, used as monotherapy or in combination with anti-viral or anti-fungal agents.
Pharmacology
Dosage & Administration
As with other antibiotics, caution may be required in using Meropenem as monotherapy in critically ill patients with known or suspected Pseudomonas aeruginosa lower respiratory tract infection. Regular sensitivity testing is recommended when treating Pseudomonas aeruginosa infection. Meropenem should be given as an intravenous bolus injection over approximately 3-5 minutes or by intravenous infusion over approximately 15 to 30 minutes using the specific available presentations.
Adults-
The dosage and duration of therapy should be established depending on type and severity of infection and the condition of the patient. The recommended daily dosage of adult is as follows:
- Pneumonias, Urinary tract infections, gynaecological infections such as endometritis and pelvic inflammatory disease; skin and skin structure infections: Meropenem 500 mg IV every 8 hours
- Nosocomial pneumonias, peritonitis, presumed infections in neutropenic patients and septicaemia: Meropenem 1 g IV every 8 hours
- Meningitis: Meropenem 2 g IV every 8 hours
- Cystic fibrosis: Meropenem IV up to 2 g every 8 hours
Use in children:
- Children 0 to 3 months: Efficacy and tolerability in children under 3 months old have not been established; therefore Meropenem is not recommended.
- For children over 3 months to 12 years of age: The recommended dose of Meropenem IV is 10 to 20 mg/kg every 8 hours depending on type and severity of infection, susceptibility of the pathogen and the condition of the patient.
- For children aged 4 to 18 years with cystic fibrosis: The doses ranging of Meropenem IV is 25 to 40 mg/kg every 8 hours.
- In children 50 kg weight: Adult dosage should be used.
- In meningitis: The recommended dose of Meropenem IV is 40 mg/kg every 8 hours.
- There is no experience in children with hepatic or renal impairment.
Elderly patients: No dosage adjustment is required for the elderly with normal renal function or creatinine clearance values above 50 ml/min.
Interaction
Contraindications
Side Effects
Pregnancy & Lactation
Precautions
Overdose Effects
Use in Special Population
Renal Impairment:
- CrCl 10-25: Half the usual dose 12 hrly.
- CrCl 26-50: Usual dose 12 hrly.
Meropenem is cleared by haemodialysis; if continued treatment with Meropenem is necessary, it is recommended that the unit dose (based on the type and severity of infection) is administered at the completion of the haemodialysis procedure to restore therapeutically effective plasma concentrations. There is no experience with the use of Meropenem in patients under peritoneal dialysis.
Hepatic Impairment:Â No dosage adjustment needed.
Reconstitutions
The content of one vial is to be dissolved in 10 ml water for injection for Meropenem 500 mg IV injection and 20 ml water for injection for Meropenem 1 gm IV injection.
Preparation for injection:
Bolus: Meropenem 500 mg IV injection vials should be constituted with 10 ml sterile water for injections /Meropenem 1g IV injection vials should be constituted with 20 ml sterile water for injections (5 ml per 250 mg meropenem). This provides an approximate concentration of 50 mg/ml. Injection for bolus administration, may be stored for up to 2 hours at controlled room temperature 25°C or for up to 12 hours at 4°C.
Infusion: Meropenem (500 mg and 1 gm) IV injection vials may be directly constituted with a compatible infusion fluid (50 to 200 ml). Alternatively, an injection vial may be constituted, then the resulting solution added to an IV container and further diluted with an appropriate infusion fluid, as needed.
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