Meropenem

Restricted
C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$$$

Dosing

1-2 g IV q8h

CrCl >50 mL/minCrCl 25 - 50 mL/minCrCl 10-25 mL/minCrCl < 10 mL/min (ESRD not on HD)Dialysis (HD)Dialysis (CRRT)2g IV Q8h2g IV Q12h1g IV Q12h1g IV Q24h500mg IV x1 now then 500mg QPM

Give post HD on HD days1g IV Q8-12h*

*Recommend 1g Q8h for CVVHD ultrafiltration rates exceeding 2L/hr

CrCl >50 mL/minCrCl 25 - 50 mL/minCrCl 10-25 mL/minCrCl < 10 mL/min (ESRD not on HD)Dialysis (HD)Dialysis (CRRT)1 g IV Q8h1g IV Q12h0.5g IV Q12h0.5 g IV Q24h500mg IV x1 now then 500mg QPM

Give post HD on HD days1g IV Q8-12h*

*Recommend 1g Q8h for CVVHD ultrafiltration rates exceeding 2L/hr

Creatinine Clearance >50mL/min/1.73m²Creatinine Clearance 30-49mL/min/1.73m²Creatinine Clearance 10-29mL/min/1.73m²Creatinine Clearance ≤10mL/min/1.73m²20mg/kg/dose Q8H20mg/kg/dose Q12H10mg/kg/dose Q12H10mg/kg/dose Q24H

Creatinine Clearance >50mL/min/1.73m²Creatinine Clearance 30-49mL/min/1.73m²Creatinine Clearance 10-29mL/min/1.73m²Creatinine Clearance ≤10mL/min/1.73m²40mg/kg/dose Q8H40mg/kg/dose Q12H20mg/kg/dose Q12H20mg/kg/dose Q24H

Uncomplicated InfectionMeningitis or Cystic Fibrosis1g Q8H2g Q8H

Clinical deterioration on concurrent/recent antimicrobials or febrile neutropenia and/or overt sepsis in an immunocompromised patient.

General Information

  • Hypersensitivity

  • GI effects

  • C. difficile

  • Seizures (especially with high doses or doses not adjusted for renal function)

Laboratory

  • CBC, CMP weekly

Clinical

  • Hypersensitivity

  • GI effects

  • Seizures (rare)

Valproic acid: Carbapenems decrease valproate levels and may decrease seizure threshold

Antimicrobial class: Carbapenem

Pregnancy category: B

Average serum half life: 1 hour

Biliary penetration: Therapeutic

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic

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