Diferencia entre revisiones de «Meropenem»
(Replace manual dosing with dynamic SMW tables (Adult + Pediatric)) |
(Remove disease-specific entries now covered by AntibioticDose (1 sections)) |
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==Adult Dosing== | ==Adult Dosing== | ||
===General=== | |||
*1.5-6g IV daily, divided q8 hours | |||
*First Dose: 0.5-2g IV x 1 | |||
===Indications by Disease=== | ===Indications by Disease=== | ||
{{#ask: [[Has DrugName::Meropenem]] [[Has Population::Adult]] | {{#ask: [[Has DrugName::Meropenem]] [[Has Population::Adult]] | ||
|?Treats disease=Disease | |?Treats disease=Disease | ||
|?Has Dose=Dose | |?Has Dose=Dose | ||
|?Has Context=Context | |?Has Context=Context | ||
|format=table | |format=table | ||
|limit=50 | |limit=50 | ||
|mainlabel=- | |mainlabel=- | ||
|headers=show | |headers=show | ||
|sort=Treats disease | |sort=Treats disease | ||
}} | }} | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===General (≥3 Months)=== | |||
*30-120mg/kg/day IV divided q8 hours | |||
*First Dose: 10-40mg/kg IV x 1 | |||
*Max: 6 g/day | |||
===Indications by Disease=== | ===Indications by Disease=== | ||
{{#ask: [[Has DrugName::Meropenem]] [[Has Population::Pediatric]] | {{#ask: [[Has DrugName::Meropenem]] [[Has Population::Pediatric]] | ||
|?Treats disease=Disease | |?Treats disease=Disease | ||
|?Has Dose=Dose | |?Has Dose=Dose | ||
|?Has Context=Context | |?Has Context=Context | ||
|format=table | |format=table | ||
|limit=50 | |limit=50 | ||
|mainlabel=- | |mainlabel=- | ||
|headers=show | |headers=show | ||
|sort=Treats disease | |sort=Treats disease | ||
}} | }} | ||
Revisión actual - 11:08 20 mar 2026
General
- Type: Carbapenems
- Dosage Forms: IV
- Common Trade Names: Merrem
Adult Dosing
General
- 1.5-6g IV daily, divided q8 hours
- First Dose: 0.5-2g IV x 1
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Ascending cholangitis | 1g IV q8hrs | |
| Ludwig's angina | 1 g IV q8 hrs | Immunocompromised |
| Neutropenic fever | 1g IV q8hrs | Inpatient monotherapy |
| Peritonitis | 1g (20mg/kg) IV q8hrs | Allergy/Prior exposure |
| Pneumonia (main) | 1g q8h | ICU, Risk of Pseudomonas |
| Pneumonia (main) | 1g q8h | HAP, High Risk |
| Pneumonia (main) | 1g q8h | VAP, High Risk |
Pediatric Dosing
General (≥3 Months)
- 30-120mg/kg/day IV divided q8 hours
- First Dose: 10-40mg/kg IV x 1
- Max: 6 g/day
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Ludwig's angina | 20mg/kg IV q8hrs (max 1g) | Pediatric Immunocompromised |
| Neutropenic fever | 20mg/kg IV q8hrs (max 1g) | Pediatric Inpatient |
| Peritonitis | 20mg/kg IV q8hrs (max 1g) | Pediatric |
Special Populations
- Pregnancy: B
- Lactation: Use caution
- Renal Dosing
- Adult
- CrCl 26-50: Give q12h
- CrCl 10-25: Decrease dose 50%, give q12h
- CrCl 10: Decrease dose 50%, give q24h
- HD: Give dose after dialysis
- PD: No supplement
- Pediatric
- CrCl 26-50: Give q12h
- CrCl 10-25: Decrease dose 50%, give q12h
- CrCl 10: Decrease dose 50%, give q24h
- HD: Give dose after dialysis
- PD: No supplement
- Adult
- Hepatic Dosing
- Adult
- No adjustment
- Pediatric
- No adjustment
- Adult
Contraindications
- Allergy to class/drug
- Anaphylactic reaction to beta-lactams
- Caution
- Seizure disorder
- CNS infection or lesion
- Renal impairment
- Recent antibiotic-associated colitis
Adverse Reactions
Serious
- Seizure
- Hypersensitivity reaction
- Anaphylaxis
- Stevens-Johnson Syndrome
- Erythema multiforme
- Toxic epidermal necrolysis
- Drug reaction with eosinophilia and systemic signs
- Superinfection
- C. diff associated diarrhea
- Thrombocytopenia
- Agranulocytosis
- Anemia, hemolytic
- Neutropenia
- Leukopenia
- Delirium
Common
Pharmacology
- Half-life: 1.2h (10h in renal failure)
- Metabolism: Kidney minimally; OAT1 and OAT3 substrate
- Excretion: Urine, active secretion (70% unchanged)
- Mechanism of Action: Inhibits cell wall synthesis
Mechanism of Action
Comments
- Has activity against ESBL organisms
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- ↑ Sanford Guide to Antimicrobial Therapy 2014