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2024-11-18T01:25:49Z

Created page with "Category: Drugs Category: Carbapenem '''Oral Antibiotics''' '''Drug class: Carbapenem'''; beta-lactam antibio..."

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[[Category: Drugs]][[Category: Carbapenem]]

[[:Category: Antibiotics | '''Oral Antibiotics''']]

'''Drug class: [[:Category: Carbapenem | Carbapenem]]'''; beta-lactam antibiotics, a broad-spectrum antibiotic belonging to the carbapenem.

'''Meropenem (MERONEM)'''（中文：[[美羅培南]]）
==Common Strengths==
*500 mg
*1 g

==Drug Trade Names==
*Meronem

==Drug Usage==
It is effective against both Gram-positive and Gram-negative bacteria.

Meropenem is indicated for:
*Complicated skin and skin structure infections
*Complicated intra-abdominal infections
*Bacterial meningitis (in children aged 3 months and older)
*Other serious infections such as pneumonia and sepsis

==Mechanism of Action==
Meropenem exerts its bactericidal effect by inhibiting bacterial cell wall peptidoglycan synthesis. It binds to penicillin-binding proteins (PBPs), disrupting he formation of the bacterial cell wall, which ultimately leads to cell death. Unlike many other beta-lactam antibiotics, meropenem is resistant to degradation by various beta-lactamases produced by bacteria.

==Route of Administration==
Meropenem is administered intravenously (IV), either as an infusion or a bolus injection.

==Dosages==
*Normal Adults:
**500 mg every 8 hours for complicated skin infections
**1 g every 8 hours for intra-abdominal infections
*Renal Impairment: Dosage adjustments are necessary based on creatinine clearance:
**For eGFR <51 mL/min, reduce the dose accordingly, typically starting at lower doses and increasing based on clinical response.
*Children:
**Dosing is weight-based, typically ranging from 10 mg/kg to 40 mg/kg every 8 hours depending on the infection type.

==Side Effects==
{| class="wikitable"
!style="text-align: left"| Frequency
!Adverse reactions
|-
| rowspan="5" | '''Common Side Effects
| Nausea
|-
| Diarrhea
|-
| Headache
|-
| Rash
|-
| Injection site pain
|-
| rowspan="3" | '''Serious Side Effects
| Seizures
|-
| Clostridium-difficile infectio
|-
| Anaphylaxis (severe allergic reaction)
|}

Patients with a history of allergies to beta-lactam antibiotics (e.g. penicillin) may be at higher risk for allergic reactions.

Meropenem may pose risks for patients with certain conditions, including those with a history of seizures or renal impairment. It can also lead to Clostridium difficile-associated diarrhea, which may occur during or after treatment.

==Pharmacokinetics==
Meropenem has a rapid onset of action, typically within 15 to 30 minutes after administration.

Its duration of action can vary but generally lasts about 6 to 8 hours, necessitating frequent dosing.

==Drug Precautions==
'''Pregnancy

Meropenem appears to be safe during pregnancy; however, it should only be used if clearly needed.

'''Breastfeeding

Limited data suggest that meropenem may be excreted in breast milk; caution is advised.

'''Children and Elderly

Safety has been established in children over 3 months. In elderly patients, renal function should be monitored closely due to potential age-related decline.

'''Monitoring Items

Regular monitoring of renal function and signs of infection or adverse reactions is recommended during treatment.

'''Drug Interactions
*Valproic Acid [Epilim]: Meropenem significantly reduces the plasma concentrations of valproic acid , which can lead to a relapse of seizures in patients who are on antiepileptic therapy. Studies have shown an average drop of about 66% in valproate levels within 24 hours of co-administration, making this interaction clinically significant and warranting avoidance of concurrent use.
*Probenecid: This medication can increase the levels of meropenem by inhibiting its renal clearance, potentially leading to enhanced side effects such as nausea and headache.
*Meropenem has mild interactions with several vitamins (e.g. biotin, thiamine) and medications like balsalazide and pyridoxine.

==FAQ==
'''How Should I Take the Meropenem?

Meropenem is not available in tablet form; it is administered intravenously under medical supervioson.

'''What Should I Avoid While Taking?
*Avoid using Epilim [Valproic acid] concurrently with meropenem, as meropenem can significantly reduce their plasma concentrations, potentially leading to seizure relapses.
*There is a moderate interaction between alcohol and meropenem. It is generally recommended to avoid alcohol during treatment with antibiotics to prevent any potential complications.
*Seizure Disorders: Patients with a history of seizures should use caution, as meropenem may increase the risk of seizures, particularly in those who are also taking medications like valproate.
*Avoid meropenem if you have a known allergy to it or other similar antibiotics (e.g., ertapenem, penicillin). Serious allergic reactions can occur.

Meropenem - Revision history

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