Meropenem

Abstract

Meropenem (Merrem, Meronem) is a broad-spectrum antibacterial agent of the carbapenem family, indicated as empirical therapy prior to the identification of causative organisms, or for disease caused by single or multiple susceptible bacteria in both adults and children with a broad range of serious infections. Meropenem is approved for use in complicated intra-abdominal infection (cIAI), complicated skin and skin structure infection (cSSSI) and bacterial meningitis (in paediatric patients aged > or = 3 months) in the US, and in most other countries for nosocomial pneumonia, cIAI, septicaemia, febrile neutropenia, cSSSI, bacterial meningitis, complicated urinary tract infection (UTI), obstetric and gynaecological infections, in cystic fibrosis patients with pulmonary exacerbations, and for the treatment of severe community-acquired pneumonia (CAP). Meropenem has a broad spectrum of in vitro activity against Gram-positive and Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae. It has similar efficacy to comparator antibacterial agents, including: imipenem/cilastatin in cIAI, cSSSI, febrile neutropenia, complicated UTI, obstetric or gynaecological infections and severe CAP; clindamycin plus tobramycin or gentamicin in cIAI or obstetric/gynaecological infections; cefotaxime plus metronidazole in cIAI; cefepime and ceftazidime plus amikacin in septicaemia or febrile neutropenia; and ceftazidime, clarithromycin plus ceftriaxone or amikacin in severe CAP. Meropenem has also shown similar efficacy to cefotaxime in paediatric and adult patients with bacterial meningitis, and to ceftazidime when both agents were administered with or without tobramycin in patients with cystic fibrosis experiencing acute pulmonary exacerbations. Meropenem showed greater efficacy than ceftazidime or piperacillin/tazobactam in febrile neutropenia, and greater efficacy than ceftazidime plus amikacin or tobramycin in patients with nosocomial pneumonia. Meropenem is well tolerated and has the advantage of being suitable for administration as an intravenous bolus or infusion. Its low propensity for inducing seizures means that it is suitable for treating bacterial meningitis and is the only carbapenem approved in this indication. Thus, meropenem continues to be an important option for the empirical treatment of serious bacterial infections in hospitalized patients.

Comparison of the Accuracy and Precision of Pharmacokinetic Equations To Predict Free Meropenem Concentrations in Critically Ill Patients

“…Meropenem is predominantly excreted via the kid- neys and, consequently, clearance of the drug is significantly affected by renal impairment (22). In this study, to avoid a discrepancy between the renal function and the measured serum creatinine concentration, a value less than the lower limit of normal (established at 0.4 mg/dl) was rounded up to 0.4 mg/dl and was defined as a modified serum creatinine concentration.…”

Retrospective analysis of clinical profile prognostic factors and outcomes of 19 patients of emphysematous pyelonephritis

“…Also, with the availability of powerful antibiotics against extended spectrum beta lactamase-producing organisms, the chances of early control of bacteremia are higher. We used Carbapenems and fourth-generation cephalosporins in most of our patients, both of which are a class of extended spectrum antibiotics that are very effective against coliforms [25,26]. We feel that the disease not only needs to be picked up early but also be hit hard at the onset.…”

Effect of Obesity on the Population Pharmacokinetics of Meropenem in Critically Ill Patients

“…Meropenem is a broad-spectrum antimicrobial of the carbapenem class which is frequently used as empirical or directed therapy in critically ill patients (14). Meropenem shows time-dependent antibacterial activity.…”