[1] Those who are allergic to other β-lactam antibiotics are more likely to be allergic to meropenem as well. Prescribing Meropenem in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Meropenem for injection is indicated for the treatment of complicated skin and skin structure infections (cSSSI) due to Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pyogenes, Streptococcus agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, and Peptostreptococcus species . Mechanism of Action: Meropenem is a structural analog of impipenem that is resistant to cleavage by renal dehydropeptidase I. Staphylococcus aureus (methicillin-susceptible isolates only) Meropenem does not have in vitro activity against methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE). Meropenem exerts its action by penetrating bacterial cells readily and interfering with the synthesis of vital cell wall components, which leads to cell death. Adult patients with complicated skin and skin structure infections including complicated cellulitis, complex abscesses, perirectal abscesses, and skin infections requiring intravenous antimicrobials, hospitalization, and surgical intervention were enrolled in a randomized, multi-center, international, double-blind trial. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Seizures and other adverse CNS experiences have been reported during treatment with Meropenem. The study included 510 patients randomized to Meropenem and 527 patients randomized to imipenem-cilastatin. 2 g IV every 8 hours is recommended by clinical practice guidelines as a treatment option for empiric or documented meningitis. Each 500 mg Meropenem for injection vial will deliver 500 mg Meropenem and 45.1 mg of sodium as sodium carbonate (1.96 mEq) [see Dosage and Administration (2.4)]. Chemistry and Mechanism of Action Meropenem. The no-observed-adverse-effect-level (NOAEL) for fetal toxicity in this study was considered to be the high dose of 750 mg/kg/day (equivalent to approximately 2.4 times the MRHD of 1 gram every 8 hours based on body surface area comparison). Meropenem has been reported to be excreted in human milk. Gram-positive bacteria If focal tremors, myoclonus, or seizures occur, evaluate neurologically, placed on anti-convulsant therapy if not already instituted, and re-examine the dosage of Meropenem to determine whether it should be decreased or discontinued. The Meropenem group had a statistically higher number of patients with transient elevation of liver enzymes. A pharmacokinetic study with Meropenem in patients with hepatic impairment has shown no effects of liver disease on the pharmacokinetics of Meropenem. Meropenem penetrates the cell wall of most gram-positive and gram-negative bacteria to bind penicillin-binding-protein (PBP) targets. Mechanism Of Action. [5] Meropenem is frequently given in the treatment of febrile neutropenia. It inhibits bacterial cell wall synthesis like other β-lactam antibiotics. Bacteroides vulgatus Distribution. It inhibits cell wall synthesis by binding to several penicillin-binding proteins, resulting in defective cell walls & osmotically unstable organisms susceptible to cell lysis. The dry powder should be stored at controlled room temperature 20º to 25ºC (68º to 77ºF) [see USP]. The bactericidal action of meropenem results from the inhibition of cell wall synthesis. Absorption. Deaths in 5 patients were assessed as possibly related to Meropenem; 36 (1.2%) patients had Meropenem discontinued because of adverse events. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University.. If you are taking any of these drugs: Divalproex or valproic acid. In patients with renal impairment, thrombocytopenia has been observed but no clinical bleeding reported [see Dosage and Administration (2.2), Adverse Reactions (6.1), Use In Specific Populations (8.5), (8.6), Clinical Pharmacology (12.3)]. Close adherence to the recommended dosage regimens is urged, especially in patients with known factors that predispose to convulsive activity. [1] Some of these include meningitis, intra-abdominal infection, pneumonia, sepsis, and anthrax. The valproic acid concentrations may drop below the therapeutic range as a result of this interaction, therefore increasing the risk of breakthrough seizures. [10] Many of these adverse effects were observed in severely ill individuals already taking many medications including vancomycin. Dosing must be adjusted for altered kidney function and for haemofiltration. During clinical investigations, 2904 immunocompetent adult patients were treated for non-CNS infections with Meropenem (500 mg or 1 gram every 8 hours). Neisseria meningitidis All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. If you are allergic to meropenem; any part of meropenem; or any other drugs, foods, or substances. Morganella morganii is indicated for the treatment of complicated skin and skin structure infections (cSSSI) due to Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pyogenes, Streptococcus agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, and Peptostreptococcus species. The walls are necessary to protect bacteria from their environment and to keep the contents of the bacterial cell together. Sequelae were the most common reason patients were assessed as clinically not cured. The values represent the number of patients clinically cured/number of clinically evaluable patients at the post-treatment follow-up visit, with the percent cure in parentheses (Fully Evaluable analysis set).