Classifications: carbapenem antibiotic; Therapeutic: carbapenem antibiotic
Pregnancy Category: B
500 mg, 1 g injection
Broad-spectrum carbapenem antibiotic that inhibits the cell wall synthesis of gram-positive and gram-negative bacteria by
its strong affinity for penicillin-binding proteins of bacterial cell wall.
Effective against both gram-positive and gram-negative bacteria. High resistance to most bacterial beta-lactamases.
Complicated appendicitis and peritonitis, bacterial meningitis caused by susceptible bacteria, complicated skin infections,
intraabdominal infections, skin/soft tissue infections.
Hypersensitivity to meropenem, other carbapenem antibiotics including imipenem, penicillins, cephalosporins, or other beta-lactams.
Safety and effectiveness in infants <3 mo not established.
History of asthma or allergies, renal impairment, renal disease; epileptics, history of neurologic disorders, older adult,
pregnancy (category B). Safety and effectiveness in infants <3 mo not established.
Route & Dosage
Adult/Child (>50 kg): IV 1 g q8h
Child (≥3 mo, <50 kg): IV 20 mg/kg q8h (max: 1 g q8h)
Adult/Child (>50 kg): IV 2 g q8h
Child (≥3 mo, <50 kg): IV 40 mg/kg q8h (max: 2 g q8h)
Complicated Skin Infection
Adult/Child (>50 kg): IV 500 mg q8h
Child (>3 mo, <50 kg): IV 10 mg/kg q8h (max: 500 mg q8h)
Clcr 2650 mL/min: q12h; 1025 mL/min: ? dose q12h; <10 mL/min: ? dose q24h
- Note: Dosage reduction is recommended for older adults.
PREPARE: Direct: Reconstitute the 500-mg or 1-g vial, respectively, by adding 10 or 20 mL sterile water for injection to yield approximately
50 mg/mL. Shake to dissolve and let stand until clear. IV Infusion: Further dilute in 50250 mL of D5W, NS, or D5/NS.
ADMINISTER: Direct: Give doses of 520 mL over 35 min. IV Infusion: Give over 1530 min.
INCOMPATIBILITIES Solution/additive: D5W, Ringer's lactate, mannitol, amphotericin B, metronidazole, multivitamins, sodium bicarbonate. Y-site: Amphotericin B, diazepam, doxycycline, metronidazole, ondansetron, zidovudine.
- Store undiluted at 15°30° C (59°86° F), diluted IV solutions should generally be used within
1 h of preparation.
Adverse Effects (≥1%) GI:
Diarrhea, nausea, vomiting, constipation
Inflammation at injection site, phlebitis, thrombophlebitis. CNS:
Rash, pruritus, diaper rash. Body as a Whole:
Apnea, oral moniliasis, sepsis, shock. Hematologic:
delays meropenem excretion; may decrease valproic acid
Attains high concentrations in bile, bronchial secretions, cerebrospinal fluid. Metabolism:
Renal and extrarenal metabolism via dipeptidases or nonspecific degradation. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Lab tests: Perform C&S tests prior to therapy. Monitor periodically liver and kidney function.
- Determine history of hypersensitivity reactions to other beta-lactams, cephalosporins, penicillins, or other drugs.
- Discontinue drug and immediately report S&S of hypersensitivity (see Appendix F).
- Report S&S of superinfection or pseudomembranous colitis (see Appendix F).
- Monitor for seizures especially in older adults and those with renal insufficiency.
Patient & Family Education
- Learn S&S of hypersensitivity, superinfection, and pseudomembranous colitis; report any of these to physician promptly.