Antimicrobials
Meropenem

Meropenem

Restricted
C difficile risk
Medium
Oral Bioavailability
N/A
Cost
IV: $$$

Spectrum Of Activity

Dosing

Dosing by Post-Natal Age

0-7 days>7 days20 mg/kg/dose IV q12h20 mg/kg/dose IV q8h

40 mg/kg/dose IV q8h

Including Haematology/Oncology and HPCT patients with fever20 mg/kg/dose IV q8h Dose limit: 1 g/dose; 3 g/day

Meningitis, Cystic Fibrosis respiratory tract infection40mg/kg/dose IV q8h Dose limit: 2 g/dose; 6 g/day

MildModerateSevereDialysisStandard dose, given q12h50% dose given q12h50% dose given q24hDose after dialysis

An Automatic Stop Date of 72 hours is in placeProlonged therapy requires ID or Antimicrobial Stewardship approval

Patients with severe infections (eg, meningitis, brain abscess, pneumonia, sepsis) caused by bacteria with proven resistance to all other antibioticsAcute exacerbation of pulmonary disease in patients with cystic fibrosis who are colonized with multi-drug resistant P. aeruginosa or B. cepacia

Haematology/Oncology and HPCT patients with fever who deteriorate or have identified risk factors

Prevention of emerging resistant organismsHigh costConsider piperacillin-tazobactam, tobramycin, ciprofloxacin, or ceftriaxone/ceftazidime instead

General Information

  • Highly restricted

  • Severe infections including meningitis, unstable neutropenic patients with fever, and for definitive therapy of infections caused by resistant pathogens

Not funded

  • Periodic renal, hepatic, and hematologic function tests

  • Observe for changes in bowel frequency

  • Monitor for signs of anaphylaxis during first dose

  • Meropenem will decrease valproic acid plasma levels. Monitor valproic acid levels and consider alternate anticonvulsants

  • Incompatible with IV ciprofloxacin. Administer drugs at least 2 hours apart and flush line well between infusions

  • Check for drug interactions prior to use