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Meropenem

Therapeutic Category  Antibiotic Pharmacologic class:  Carbapenem Use\ Indications Intra-abdominal infections (complicated appendicitis and peritonitis) caused by viridans group streptococci, E. coli, K. pneumoniae, P. aeruginosa, B. fragilis, B. thetaiotaomicron, and Peptostreptococcus sp; also indicated for bacterial meningitis in pediatric patients >3 months of age caused by S. pneumoniae, H. influenzae, and N. meningitidis; meropenem has also been used to treat soft tissue infections, febrile neutropenia, and urinary tract infections Pharmacological Effects Inhibits bacterial cell wall synthesis by binding to several of the penicillin-binding proteins, which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis; bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested Adverse Reaction      Central nervous system: Headache Dermatologic: Rash, pruritus Gastrointestinal: Diarrhea, nausea/vomiting, constipation Local: Pain at injection site, phlebitis, thrombophlebitis Respiratory: Apnea

Precautions/Warnings/Contraindication Pseudomembranous colitis and hypersensitivity reactions have occurred and often require immediate drug discontinuation; thrombocytopenia has been reported in patients with significant renal dysfunction; seizures have occurred in patients with underlying neurologic disorders. safety and efficacy have not been established for children <3 months of age; superinfection possible with long courses of therapy Pregnancy category: B Interactions:  Increased effect: Probenecid competes with meropenem for active tubular secretion and inhibits the renal excretion of meropenem Dosing Adults: 1 g every 8 hours Dosing adjustment in renal impairment: Brand Available:  Meronem® 1000mg I.V  Meronem® 500mg I.V