KEY POINTS
- Meropenem (Merrem) is an injectable carbapenem and beta-lactam antibiotic that interferes with bacterial cell wall synthesis in sensitive organisms
- Has activity versus a wide array of organisms, including multi-drug resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae
- DOES NOT cover MRSA or VRE
- Carbapenems like meropenem are generally considered the drugs of choice for ESBL-producing organisms (aka ESBL positive organisms)
- ESBL = extended-spectrum beta-lactmase
- Reserve this “big gun” antibiotic until you absolutely have to use it
- Can be used for many infection types – pneumonia, skin & soft tissue infection, bloodstream infection, etc
- Most likely to see this drug used as empiric therapy in an ICU setting, but when more information is known, try to de-escalate to more narrow therapy
- Doses in normal kidney function can range form 500mg Q8H for UTI to 2gm Q8H for meningitis
- Adjust doses for renal function
- Can be given via extended-infusion to prolong the time > MIC, but product stability can be an issue
- Patients who are allergic to penicillins or cephalosporins may also be allergic to carbapenems
- Generally speaking cross-reactivity is low, be more concerned in patients with a history of severe allergic reaction
- Beware seizures and hypersensitivity
RESOURCES
