Meropenem

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$20.8/day

Dosing

Standard Dose
500mg IV q6h or 1g IV q8h

Meningitis
2g IV q8h

CF Exacerbation
2g IV q8h

General Information

Acceptable Uses

Documented infections due to organisms producing inducible β-lactamases or Extended-Spectrum β-lactamases (ESBL) resistant to alternate agents.

Empiric Treatment of life-threatening infections where multi-drug resistant organisms suspected (i.e. severe sepsis, neutropenic patient with absolute neutrophil count < 0.5)

Therapy of P. aeruginosa infections where other agents cannot be used due to allergy or toxicity

Unacceptable Uses

Therapy of documented or suspected infections due to MRSA, Enterococcus spp., Stenotrophomonas maltophilia, Chlamydia spp. and Mycoplasma spp.

Treatment of infections due to organisms susceptible to less costly and/or narrower-spectrum agents

Common Usage

Therapy of serious, often nosocomial infections involving resistant gram negative organisms

Adverse Effects

  •  Immediate and delayed-type allergy

  •  GI disturbance

  •  Cytopenias, positive Coombs

  •  Liver enzyme abnormalities

Major Interactions

  • Carbapenems may cause rapid and profound decrease in valproic acid levels.
  • Increasing valproic acid dosage is often NOT sufficient to overcome this interaction.
  • Avoid this combination if at all possible.

Additional Information

IV Administration
Dilute in 100 mL D5W or NS and administer over 30 min

EH Prescribing Restrictions
None (Pharmacist review of therapy)

Community IV Formulary (Metro Region)
Yes

Pharmacology

Antimicrobial class: Carbapenem

Pregnancy category: B

Average serum half life: 1 hour

Biliary penetration: Therapeutic

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic