NLM There is no experience in paediatric patients with neutropenia or primary or secondary immunodeficiency. Creatinine Clearance                 Dose                         frequency Keep all medicines away from children. If we perform the same previous estimations for the renal parenchyma, the dose of meropenem 1 g iv can cover with bactericidal effect to bacteria whose MIC-90 is up to 1.75 µg/mL. The clinical and bacteriological efficacies of meropenem in the treatment of 12 patients with urinary tract infection were studied. Nitrofurantoin or fosfomycin may also be used for A 5 minute intravenous bolus injection of Meronem in healthy volunteers results in peak plasma levels of approximately 52 ~g/ml for the 500 mg dose and 112 ~glml for the 1 g dose. In children over 50 kg weight, adult dosage Efficacy and tolerability in infants under 3 months old have not been established; therefore, Meronem is not recommended for use below this age. Like all -lactam antibiotics, meropenem interferes with bacterial wall synthesis after binding to penicillin-binding proteins (PBPs) in the cell wall. United Kingdom. Powder for solution for intravenous injection or infusion. Vc Volume of distribution … 10-25                             one-half unit dose               every 12 hours Meronem may reduce serum valproic acid levels. MEROPENEM. VABP/VAP Ventilator Acquired (Bacterial) Pneumonia . 5% Glucose solution and 0.9% Sodium Chloride Kaye KS, Bhowmick T, Metallidis S, Bleasdale SC, Sagan OS, Stus V, Vazquez J, Zaitsev V, Bidair M, Chorvat E, Dragoescu PO, Fedosiuk E, Horcajada JP, Murta C, Sarychev Y, Stoev V, Morgan E, Fusaro K, Griffith D, Lomovskaya O, Alexander EL, Loutit J, Dudley MN, Giamarellos-Bourboulis EJ. Pregnancy cadaveris, Clostridium sordellii, Clostridium butyricum, Clostridium clostridiiformis, Clostridium innocuum, Clostridium subterminale, Clostridium tertium, Eubacterium lentum, Eubacterium aerofaciens, Fusobacterium mortiferum, Fusobacterium necrophorum, There was no evidence of mutagenic potential in the 5 tests conducted and no evidence of reproductive and teratogenic toxicity in studies at the highest possible doses in rats and monkeys; the no effect dose level of a (small) reduction in F1 body weight in rat was 120 mg/kg. Method of Administration : Get the latest public health information from CDC: Extended-spectrum β-lactamases (ESBLs) are enzymes that confer resistance to most β-lactam antibiotics. There is no experience with the use of Meronem in patients under peritoneal dialysis. UV Ultra Violet spectrometry . Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus equi, Streptococcus bovis, Streptococcus mitis, Streptococcus mitior. It is the same drug class as Imipenem. Vibrio parahaemolyticus, Vibrio vulnificus, Yersinia enterocofitica. In animal studies meropenem has shown nephrotoxic effects, only at high dose levels (500 mg/kg). In addition to cUTI, the Medicines Company, which is the developer of meropenem-vaborbactam, is also exploring the fixed-dose antibiotic combination for carbapenem-resistant Enterobacteriaceae (CRE) infections of blood, lung, urinary tract, and abdominal organs. Eur J Clin Microbiol Infect Dis. Animal studies have not shown any adverse effect on the developing foetus. EPIC was a randomized, double-blind study. Abstract Meropenem (Merrem, Meronem) is a broad-spectrum antibacterial agent of the carbapenem family, indicated as empirical therapy prior to the identification of causative organisms, or for disease caused by single or multiple susceptible bacteria in both adults and children with a … In 8 patients the drug was administered intravenously in a dose of 1 g every 8 hours and in 4 patients with the creatinine clearance below 50 ml/min it was administered in a dose of 1 g every 12 hours (the treatment course of 7 to 10 days). As with other antibiotics, particular caution is recommended in using meropenem as monotherapy in critically ill patients with known or suspected Pseudomonas aeruginosa lower respiratory tract infection. effective plasma concentrations. injection or infusion Meronem 500 mg 1000 mg MERONEM IV Jody A. Charnow Microbial eradication occurred in significantly more patients treated with meropenem-vaborbactam than piperacillin-tazobactam. – Gynaecological Infections, such as endometritis and pelvic – inflammatory disease Management of febrile neutropenic patients . Meropenem is cleared by haemodialysis; if continued treatment with Meronem is necessary, it is recommended that the unit dose (based on the type and severity of infection) is administered at the completion of the haemodialysis procedure to restore therapeutically Meronem is generally well tolerated. HealthDay News—For the treatment of adults with complicated urinary tract infections (cUTIs), a combination of meropenem-vaborbactam (M-V) is non-inferior to piperacillin-tazobactam (P-T), according to a study presented at the annual meeting of the Infectious Diseases Society of America (IDWeek), held in New Orleans. 2 g . اليكا إم لعلاج حالات الالتهابات الجلدية والحكة المصاحبة بعدوى فطرية, Risek for peptic ulcer and gastro oesophageal reflux disease. MEROPENEM. equivalent to anhydrous meropenem 500 mg         1000 mg The FDA has approved Vabomere, an intravenous antibiotic, for the treatment of complicated urinary tract infections (UTIs), including pyelonephritis, in adults.. The sole metabolite of meropenem had a similar profile of toxicity in animal studies. Last updated on Sep 22, 2020. 1 Jeff Loutit, MBChB, of The Medicines Company in San Diego, and … Iakovlev SV, Iakovlev VP, Derevianko II, Kira EF; Meropenem Study Group. The co-administration of Meronem with potentially nephrotoxic drugs should be considered with caution. 500 mg or 1 g . There is no experience in children with altered hepatic or renal function. • Complicated urinary tract infections • Complicated intra-abdominal infections • Intra- and post-partum infections • Complicated skin and soft tissue infections • Acute bacterial meningitis. It is given by injection into a vein. Cheshire, SK10 2NA. T1/2 Half-life . Complicated intra-abdominal infections . – Urinary Tract Infections A 30 minute intravenous infusion of a single dose of Meronem in healthy volunteers results in peak plasma levels of approximately 11 mg/ml for the 250 mg dose, 23 mg/ml for the 500 mg dose and 49 mg/ml for the 1 9 dose. Your email address will not be published. 5% Glucose solution with 0.02% Sodium Bicarbonate Pharmacokinetic studies in patients with liver disease have shown no effects of liver disease on the pharmacokinetics of meropenem. faecalis, Bordetella bronchiseptica, Brucella melitensis, Campylobacter coli, Campylobacter jejuni, Citrobacter freundii, Citrobacter divers us, Citrobacter koseri, Citrobacter amalonaticus, Meronem is compatible with the following infusion fluids: 5% Glucose with 0.15% Potassium Chloride solution some patients.  |  Meropenem, sold under the brandname Merrem among others, is a broad-spectrum antibiotic used to treat a variety of bacterial infections. Urinary concentrations of meropenem in excess of 10 ~glml are maintained for up to 5 hours after the administration of a 500 mg dose. Subtherapeutic levels may be reached in some patients. Pack size : For 76% of the bacteria tested, the MBC:MIC ratios were 2 or less. 1995 Sep;47(3):147-56.  |  500 mg IV every 8 hours in the treatment of pneumonia, UTI, gynaecological infections such as endometritis, skin and skin structure infections. Meronem IV can be given as an intravenous bolus injection over approximately 5 minutes or by intravenous infusion over approximately 15 to 30 minutes using the specific available Dosage adjustments are necessary in subjects with renal impairment. Note: Ertapenem, a new carbapenem doesn’t cover pseudomonas. (mm)                           (mg/L) The structural way was based on protein sequence and active site of the enzymes and classified β-lactamases into 4 classes, A, C and D serine β-lactamases and B metallo-β-lactamases.3 A functional classification correlated the properties of a specific enzyme with the resistance profile of a clinical isolate and included 3 major groups, 1, 2 and 3 with subgroups.3 In Table 1, we summarize the clinically important β-lactam… Table 3 “In vitro” MIC-50 and MIC-90 for most relevant uropathogens. USP United States Pharmacopoeia . Staphylococci-coagulase-negative; including, Staphylococcus epidermidis, Staphylococcus saprophyticus, Staphylococcus capitis, Staphylococcus cohnii, Staphylococcus xylosus, Staphylococcus warneri, Staphylococcus hominis, Staphylococcus simulans, Staphylococcus intermedius, Staphylococcus sciuri, Staphylococcus lugdunensis, Streptococcus pneumoniae (penicillin susceptible and resistant). Pseudomonas pseudomallei, Pseudomonas acidovorans, Salmonella spp., including Salmonella enteritidis/typhi, Serratia marcescens, Serratia liquefaciens, Serratia rubidaea, Shigella sonnei, Shigella flexneri, Shigella boydii, Shigella dysenteriae, Vibrio cholerae, Special warnings and precautions for use : There is some clinical and laboratory evidence of partial cross-allergenicity between other carbapenems and beta-Iactam antibiotics, penicillins and cephalosporins. Enterobacter aerogenes, Enterobacter (Pantoea) agglomerans, Enterobacter cloacae, Enterobacter sakazakii, Escherichia coli, Escherichia hermannii, Gardnerella vaginalis, Haemophilus influenzae (including ~-Iactamase positive and ampicillin resistant strains). Lactation TGA Thermogravimetric Analysis . It is important to consider the diagnosis of pseudomembranous colitis in the case of patients who develop diarrhoea in association with the use of Meronem. section. ACS Dobfar SpA, Italy for AstraZeneca UK Limited, Macclesfield, UTI Urinary tract infection . Severe complicated urinary tract infections were mainly observed in the patients with long-term urolithiasis, subjected to repeated surgical interventions and isolating as a rule polyresistant strains of Pseudomonas aeruginosa and E.agglomerans as the pyelonephritis pathogens at a titre of 5 x 10(5)-5 x 10(8) microbial cells per 1 ml of the urine susceptible to meropenem in 80 to 96 per cent of the cases. Acute bacterial meningitis . Active ingredient: •If there is any question about the indication for meropenem, the prescriber Serious adverse events are rare. Rarely, pseudomembranous colitis has been reported on Meronem as with practically all antibiotics and may vary in severity from slight to life-threatening. Imipenem 500mg q8h Meropenem 500mg q8h** Imipenem 1g q8h Meropenem 500mg q6h** Imipenem 750mg q12h Meropenem 500mg q8h** Imipenem 250mg q6h Meropenem 500mg q8h** •See full protocol details online for pediatric and renal dosage adjustment recommendations. Streptococcus milleri, Streptococcus sanguis, Streptococcus viridans, Streptococcus salivarius, Streptococcus morbillorum, Streptococcus Group G, Streptococcus Group F, Meropenem is detectable at very low concentrations in animal breast milk. Meropenem is a carbapenem antibiotic for parenteral use, that is relatively stable to human dehydropeptidase-1 (DHP-1) and therefore, does not require the addition of an inhibitor of DHP-1. Reconstituted product, constituted as described above, should be used immediately and must be stored for no longer than 24 hours under refrigeration, only if necessary. VAB Vaborbactam . injection or infusion Cefepime (4th Gen Cephalosporin). Meropenem Dosage. Tallarigo C, Comunale L, Baldassarre R, Poletti G. Minerva Urol Nefrol. 500 mg or 1 g . In vitro tests show that meropenem acts synergistically with various antibiotics. Empiric coverage should also include antiE faecalis coverage. As with other antibiotics, overgrowth of non-susceptible organisms may occur and, therefore, continuous monitoring of each patient is necessary. Achromobacter xylosoxidans, Acinetobacter anitratus, Acinetobacter Iwoftii, Acinetobacter baumannii, Aeromonas hydrophila, Aeromonas sorbria, Aeromonas ca viae, A/~igenes National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. By continuing to browse this site you are agreeing to our use of cookies. 500 mg or 1 g . – Septicaemia Meronem IV for intravenous infusion may be constituted with compatible infusion fluids (50 to 200 ml) (see “Incompatibilities and Special precautions for storage”). – Pneumonias and Nosocomial Pneumonias Meronem is contraindicated in patients who have demonstrated hypersensitivity to this product. 1 g . Meronem 500 mg   1000 mg Effect on ability to drive and use machines : No data is available, but it is not anticipated that Meronem will affect the ability to drive and use machines. Wagenlehner FM, Sobel JD, Newell P, et al. Meronem should not be used in breast-feeding women unless the potential benefit justifies the potential risk to the baby. Ertapenem 1 g IV q24H can be used for uncomplicated UTI. [Effectiveness of cefpirome in the treatment of complicated infections of the upper and lower urinary tracts]. Meronem has proved efficacious alone or in combination with other antimic bial agents in the treatment of polymicrobial infections. ESBL-producing bacteria also typically show increased levels of resistance to other agents and therefore treatment options are often limited. Meronem should not be mixed with or added to other drugs. 100 mL (500mg meropenem) vial: powder for reconsitution for intravenous administration 100 mL (1g meropenem) vial: powder for reconsitution for intravenous administration . There is no experience in children with renal impairment. Urinary tract infection (UTI) is the most common bacterial infection. Fusobacterium nucleatum, Fusobacterium varium, Mobiluncus curtisii, Mobiluncus mulieris, Peptostreptococcus anaerobius, Peptostreptococcus micros, Peptostreptococcus saccharolyticus, Peptococcus saccharolyticus, Peptostreptococcus asaccharolyticus, [Urinary tract infections in primary care]. However, there is no absolute pharmacokinetic proportionality with the administered dose both as regards Cmax and AUC.Furthermore, a reduction in plasma clearance from 287 to 205 ml/min for the range of dosage 250 mg to 2 9 has been observed. – Intra-abdominal Infections [Multicenter open randomized trial of meropenem in comparison to ceftazidime and amikacin used in combination in severe hospital infections]. In normal individuals rapid renal elimination will occur; in subjects with renal impairment, haemodialysis will remove meropenem and its metabolite. Use in infections caused by methicillin resistant staphylococci is not recommended. Animal studies indicate that meropenem is well tolerated by the kidney. Intra- and post-partum infections . Standard aseptic technique should be employed during constitution. Meronem may reduce serum valproic acid levels. Meropenem is also used to treat bacterial meningitis (infection that causes inflammation of the tissue that covers the brain and spinal cord). In subjects with normal renal function, meropenem’s elimination half-life is approximately 1 hour. FOR INTRAVENOUS ADMINISTRATION. Usual Adult Dose for: Skin and Structure Infection; Intraabdominal Infection; Meningitis; Nosocomial Pneumonia; Usual Pediatric … Vial for I.V. NIH Complicated urinary tract infections . Gram-negative aerobes: Accidental overdosage could occur during therapy, particularly in patients with renal impairment. Resistant                                  <11                                   > 16. The average breast milk concentration was 0.48 … As the potency and duration of action of Meronem dosed without probenecid are adequate, the co-administration of probenecid with Meronem is not recommended. Severe complicated urinary tract infections were mainly observed in the patients with long-term urolithiasis, subjected to repeated surgical interventions and isolating as a rule polyresistant strains of Pseudomonas aeruginosa and E.agglomerans as the pyelonephritis pathogens at a titre of 5 x 10 (5)-5 x 10 (8) microbial cells per 1 ml of the urine susceptible to meropenem in 80 to 96 per cent of the cases. {{}} This site uses cookies. It has been demonstrated both in vitro and in vivo that meropenem has a The in vitro antibacterial spectrum of meropenem includes the majority of clinically significant Gram-positive and Gram-negative, aerobic and anaerobic strains of bacteria, as shown below: Gram-positive aerobes: similar to those in adults. 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 Haemophilus parainfluenzae, Haemophilus ducreyi, Helicobacter pylori, Neisseria meningitidis, Neisseria gonorrhoeae (including ~-Iactamase positive, penicillin resistant and spectinomycin resistant strains) Hafnia alvei, Klebsiella pneumoniae, Klebsiella aerogenes, Klebsiella ozaenae, Klebsiella oxytoca, Moraxella (Branhamella) catarrhalis, Morganella morganii, Proteus mirabilis, Proteus vulgaris, Proteus penneri, Providencia rettgeri, Providencia stuartii, Providencia alcalifaciens, Pasteurella multocida, Plesiomonas shigelloides, Pseudomonas aeruginosa, Pseudomonas putida, Pseudomonas alcaligenes, Burkholderia (Pseudomonas) cepacia, Pseudomonas fluorescens, Pseudomonas stutzeri, Dosing: Intra-abdominal infections: 1 g IV every 8 hrs Meningitis, bacterial: 2 g IV every 8 hrs Disease state based dosing: Renal failures: See Table 4 Hepatic failures: Dosage adjustment is not required. Trademark A single setof meropenem susceptibility criteria are recommended based on pharmacokinetics and correlation of clinical and microbiological outcomes with zone diameter and minimum inhibitory concentrations (MIC) of the infecting organisms. Derevianko II, Kotliarova GA, Kondrat'eva EM, Khodyreva LA, Siniukhin VN. For uncomplicated enterococcal urinary tract infections, ampicillin or amoxicillin is the empiric drug of choice until further speciation, unless patient has severe penicillin allergy, in which case nitrofurantoin or levofloxacin can be used as an alternative based on susceptibilities. Treatment of patients with bacteraemia that occurs in association with, or is suspected to be associated with, any of the infections listed above. Overview; Side Effects; Dosage; Professional ; Interactions; More; Applies to the following strengths: 500 mg; 1000 mg; 500 mg/ 50 mL-NaCl 0.9%; 1000 mg/ 50 mL-NaCl 0.9%. – Empiric treatment, for presumed infections in adult patients with febrile neutropenia, used as monotherapy or in combination with anti-viral or anti-fungal agents. All carbapenems are resistant to Beta-lactamases, including Extended Spectrum Bata-Lactamases (ESBL). This provides an approximate Meronem for IV injection and infusion includes the excipient anhydrous sodium carbonate. [Multicenter comparative study of meropenem vs. imipenem in the intramuscular treatment of hospital infections of the urinary tract]. Although studies indicate that a toxin produced by Clostridium difficile is one of the main causes of antibiotic-associated colitis, other causes should be considered. The dosage and duration of therapy shall be established depending on type and severity of infection and the condition of the patient. Adverse events rarely lead to cessation of treatment. Meropenem may also be used for purposes not listed in this medication guide. Vial for I.V. pneumosintes, Bacteroides coagulans, Bacteroides uniformis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides eggerthii, Bacteroides capsillosis, Prevotella buccalis, Prevotella corporis, Bacteroides gracilis, Prevotella melaninogenica, Prevotella intermedia, Prevotella bivia, Prevotella splanchnicus, Prevotella oralis, Prevotella disiens, Prevotella rumenicola, Bacteroides ureolyticus, Prevotella oris, Prevotella buccae, Prevotella denticola, Bacteroides levii, Porphyromonas asaccharolytica, Bifidobacterium spp., Bilophila wadsworthia, Clostridium perfringens, Clostridium bifermentans, Clostridium ramosum, Clostridium sporogenes, Clostridium There was an increased incidence of abortions at 500 mg/kg in a preliminary study in monkeys. Clin Infect Dis 2016; 63:754. In repeat dose studies (up to 6 months) only minor effects were seen including a small decrease in red cell parameters and an increase in liver weight in dogs treated with doses of 500 mg/kg. Dosage in Adults with Hepatic Insufficiency : No dosage adjustment is necessary in patients with hepatic insufficiency (see” Special warnings and precautions for use”). Meropenem penetrates well into most body fluids and tissues including cerebrospinal fluid Meropenem is stable in susceptibility tests and these tests can be performed using normal routine methods. Anaerobic bacteria: Actinomyces odontolyticus, Actinomyces meyeri, Bacteroides-Prevotella-Porphyromonas spp., Bacteroides fragilis, Bacteroides vulgatus, Bacteroides variabilis, Bacteroides of patients with bacterial meningitis, achieving concentrations in excess of those required to inhibit most bacteria. In meningitis the recommended dosage is 2 g every 8 hours. Streptococci (pneumoniae/ pyogenes/ viridans group) Enterococci (Group D strep) Staph epidermidis (coagulase negative) Staph aureus (Methicillin sensitive) The potential effect of Meronem on the protein binding of other drugs or metabolism has not been studied. Meropenem was used in the monotherapy. Dosage Schedule for Adults with Impaired Renal Function : Dosage should be reduced in patients with creatinine clearance less than 51 ml/min, as scheduled below. concentration of 50 mg/ml. All vials are for single use only. Interactions with other medicinal products and other forms of interaction : Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal excretion, with the effect of increasing the elimination half-life and plasma concentration of meropenem. Minimum bactericidal concentrations (M BC) are commonly the same as the minimum inhibitory concentrations (MIC). Therefore, antibiotics should be prescribed with care for individuals with a history of gastr intestinal complaints, particularly colitis. There was no evidence of increased sensitivity to meropenem in juveniles compared to adult animals. Torres A, Zhong N, Pachl J, et al. The safety of Meronem in human pregnancy has not been evaluated. Pharmacokinetic studies in patients with renal insufficiency have shown the plasma clearance of meropenem correlates with creatinine clearance. Ceftazidime-avibactam Versus Doripenem for the Treatment of Complicated Urinary Tract Infections, Including Acute Pyelonephritis: RECAPTURE, a Phase 3 Randomized Trial Program. Meronem IV is presented as a sterile white powder containing meropenem 500 mg or 1g as the trihydrate blended with anhydrous sodium carbonate for constitution. – Skin and Skin Structure Infections 5% Glucose with 0.225% Sodium Chloride solution Please enable it to take advantage of the complete set of features! Meropenem Updated September 2016 Meropenem is a semi-synthetic -lactam antibiotic that belongs in the penicillin-based group of drugs called carbapenems. Approximately 70% of the administered dose is recovered as unchanged meropenem in the urine over 12 hours, after which little further urinary excretion is detectable. The only adverse effect observed in animal reproductive studies was an increased incidence of abortions in monkeys at 13 times the expected exposure in man. Limited post-marketing experience indicates that adverse events following over dosage are consistent with the adverse event profile described in the undesirable effects Beta-lactamases are classified either by their structure or by their functional properties. Bacillus spp., Corynebacterium diphtheriae, Enterococcus faecalis, Enterococcus fiquifaciens, Enterococcus avium, Listeria monocytogenes, Lactobacillus spp Nocardia asteroides, Staphylococcus aureus (penicillinase negative and positive),

meropenem coverage uti

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