Home Drug Guide Meropenem

Drug Guide

Generic Name

Meropenem

Brand Names Merrem IV, Meropenem and Sodium Chloride in Duplex Container

Classification

Therapeutic: Antibiotic, Carbapenem

Pharmacological: Beta-lactam antibiotic (Carbapenem)

FDA Approved Indications

Infections caused by susceptible bacteria, including meningitis, intra-abdominal infections, pneumonia, skin and soft tissue infections, urinary tract infections

Mechanism of Action

Meropenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death, especially in Gram-positive and Gram-negative bacteria.

Dosage and Administration

Adult: Typically 1 g every 8 hours IV infusion over 15-30 minutes; dosage may be adjusted based on severity and site of infection.

Pediatric: Dosing based on weight and age; generally 10-20 mg/kg every 8 hours IV infusion.

Geriatric: Adjust dosage based on renal function; no specific age-based dose adjustments but increased caution in renal impairment.

Renal Impairment: Dose reduction may be necessary depending on creatinine clearance; refer to specific guidelines.

Hepatic Impairment: No specific dose adjustment required.

Pharmacokinetics

Absorption: Primarily administered IV; not absorbed orally.

Distribution: Widely distributed in body tissues and fluids, including cerebrospinal fluid (CSF) when meninges are inflamed.

Metabolism: Not significantly metabolized.

Excretion: Renal excretion through glomerular filtration and tubular secretion.

Half Life: Approximately 1 hour in individuals with normal renal function.

Contraindications

Known hypersensitivity to meropenem, other carbapenems, or beta-lactam antibiotics.

Precautions

Use with caution in patients with history of hypersensitivity to penicillins or cephalosporins; assess for cross-reactivity.
Monitor renal function during therapy.

Adverse Reactions - Common

Nausea (Common)
Vomiting (Common)
Diarrhea (Common)
Rash (Less common)

Adverse Reactions - Serious

Severe hypersensitivity reactions including anaphylaxis (Rare)
Clostridioides difficile-associated diarrhea (Rare)
Seizures, especially in patients with CNS disorders or renal impairment (Very rare)

Drug-Drug Interactions

Valproic acid - reduces valproic acid levels, increasing risk of seizures.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of allergic reactions, superinfection, renal function, and gastrointestinal symptoms. Evaluate infection response.

Diagnoses:

Risk for infection related to antibiotic therapy.
Knowledge deficit regarding medication use.

Implementation: Administer IV as prescribed, observe for adverse reactions, monitor renal function, and educate patient about potential side effects.

Evaluation: Assess resolution of infection, monitor for adverse effects, and ensure patient tolerates therapy.

Patient/Family Teaching

Complete full course of therapy.
Report any signs of allergic reactions or severe diarrhea.
Notify healthcare provider if rash, difficulty breathing, or seizure occurs.

Special Considerations

Black Box Warnings:

Seizure risk in predisposed patients, such as those with CNS pathology or renal impairment.

Genetic Factors: N/A

Lab Test Interference: May cause false positive results for urinary glucose with certain tests.

Overdose Management

Signs/Symptoms: Potential neurological symptoms such as seizures, or other adverse reactions.

Treatment: Supportive care, maintain airway and breathing, consider hemodialysis in severe cases.

Storage and Handling

Storage: Store at 20°C to 25°C (68°F to 77°F), protected from light.

Stability: Stable for 24 hours when reconstituted at room temperature; follow manufacturer guidelines for specific reconstitution and infusion.