MEROPENEM

1. Chemical Class: CARBAPENEM

2. Therapeutic CLASS Antibiotic (ANTIBACTERIAL)

3. Pharmacological class: Bacterial cell wall synthesis inhibitors

Pharmacokinetics:
Directions for administration Intravenous injection to be administered over 5 minutes.
Distribution: Distribution the plasma protein binding of meropenem is approximately 2%
Elimination The drug is eliminated both by metabolism and excretion.
Mode of Action Meropenem exerts its bactericidal activity by inhibiting bacterial cell wall synthesis in Gram-
positive and Gram-negative bacteria through binding to penicillin-binding proteins (PBPs). Meropenem binds to
PBPs 2, 3 and 4 of Escherichia coli and Pseudomonas aeruginosa; and PBPs 1, 2 and 4 of Staphylococcus
aureus.
Indications:
For the treatment of the following infections in adults and children over 3 months of age:
1. Severe Pneumonia including hospital-acquired and ventilator-associated pneumonia
2. Broncho-pulmonary infections in cystic fibrosis
3. Complicated urinary tract infections
4. Complicated intra-abdominal infections
5. Intra- and post-partum infections
6. Acute bacterial meningitis
7. Complicated skin and soft tissue infections
8. endocarditis
9. Septicemia
10. Management of febrile neutropenia

ADVERSE REACTIONS Following adverse reactions have been reported during treatment with meropenem:
common or very common Abdominal pain. diarrhea. headache. inflammation. nausea. skin reactions.
thrombocytosis. vomiting
Uncommon Agranulocytosis. antibiotic associated colitis. eosinophilia. hemolytic anemia. increased risk of
infection. leucopenia. neutropenia. paranesthesia. Severe cutaneous adverse reactions (SCARs) [ Severe cutaneous
adverse reaction (SCAR) is life-threatening. It consists of Stevens-Johnson syndrome/toxic epidermal necrolysis
(SJS/TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous
pustulosis (AGEP), and generalized bullous fixed drug eruptions (GBFDE)].. thrombocytopenia. thrombophlebitis
Rare Seizure
CONTRAINDICATIONS Meropenem is contraindicated in patients:
1- With known hypersensitivity to meropenem or to any excipient of the product. –
 2- Hypersensitive to any other carbapenem antibacterial agent.
3- Hypersensitivity reaction (e.g., acute anaphylactic shock) to any other type of β-lactams antibacterial
agent (e.g., Penicillin and Cephalosporins).

PRECAUTIONS:
1. PREGNANCY Use only if potential benefit outweighs risk—no information available.
2. BREAST FEEDING Unlikely to be absorbed (however, manufacturer advises avoid).
3. MONITORING REQUIREMENTS Manufacturer advises monitor liver function—risk of hepatotoxicity.
DRUG INTERACTIONS
Probenecid Co-administration of Meropenem I.V. with probenecid inhibits renal excretion of meropenem.
Valproic Acid Co-administration of Meropenem I.V. with valproic acid or divalproex sodium reduces the
serum concentration of valproic acid potentially increasing the risk of breakthrough seizures.
Oral Anti-coagulants (e.g., Warfarin)
Simultaneous administration of antibiotics with warfarin may augment its anti-coagulant effects. It is
recommended that the INR should be monitored frequently during and shortly after co-administration of
antibiotics with an oral anti-coagulant agent.
DOSAGE AND ADMINISTRATION
 • Renal Dosing

•
• Dosage for adult patient with hepatic impairment:
o Adult No adjustment

BRAND NAME AND COMPANY

SRNO BRAND COMPANY
1 MERREM PFIZER PHARMA
2 MEROGET GETZ PHARMA
3 MERONEM ICI PAKISTAN LTD
4 PENRO BOSCH
PHARMACEUTICALS
5 XEPIME MACTER
INTERNATIONAL
REFERENCES:
1- CURRENT Medical Diagnosis & Treatment 2020.
2- Martindale_ The Complete Drug Reference-Pharmaceutical Press.
3- BNF 80 (British National Formulary) September 2020-March 2021 (2020, Pharmaceutical Press)
4- The Sanford Guide to Antimicrobial Therapy 2018 (2018, Antimicrobial Therapy Inc).