Antimicrobials
Meropenem

Meropenem

Spectrum of Activity

Stewardship Considerations

General Information

10 mg/kg IV/SC/IM q12h

IV dosing is not well understood and a wide range of doses has been suggested. Higher end of the dose is likely indicated for Pseudomonas infections. 

8-12 mg/kg SC q8-12h

8-24 mg/kg IV q8h

Loading dose of 0.37 mg/kg IV followed by 0.38 mg/kg/hr IV CRI. This has been shown to achieve stable concentration of 1 ug/ml, a level that may be somewhat low, particularly for Pseudomonas.

Injectable

  • 500 mg vial
  • Predominantly indicated for treatment of ESBL-producing Gram negatives or multidrug resistant Pseudomonas infections, particularly when amikacin is contraindicated
  • Should not be used empirically unless there is strong evidence supporting presence of ESBLs or MDR Pseudomonas
    • Empirical use must be accompanied by culture to attempt to quickly de-escalate
  • Time-dependent
  • Parenteral administration
  • Well distributed to most tissues, including CSF
  • Rapid renal clearance after IV bolus dosing necessitates higher IV doses or use of IV CRI

Usually well tolerated.

  • Synergistic activity with aminoglycosides against some isolates of Pseudomonas aeruginosa
  • Probenecid may increase serum concentrations

No approved veterinary product in Canada.

Does not work if given by mouth.

Plumb DC. Meropenem. Plumb’s Veterinary Drugs. Updated August 2017.