Hepatic impairment. The safety profile of meropenem in the elderly (aged > 65 years, n=843) and/or renally impaired (creatinine clearance < 51 ml/min, n=436) was assessed by evaluating data from 26 phase III studies which compared the use of meropenem (0.5 or 1.0 g, i.v. [35489] [63245] One trial of 47 patients with a mean age of 2 years (range, 4 days to 20 years) examined meropenem 20 mg/kg/dose (or up to 40 mg/kg/dose for CNS or critical infections) IV every 8 hours for a variety of infections. amoxicillin, Keflex, doxycycline, triamcinolone, metronidazole, azithromycin, ciprofloxacin, clindamycin, Augmentin, Flagyl. -Concentration of solution for IV bolus: Up to 50 mg/mL Meropenem is cleared by haemodialysis and haemofiltration. Maximum dose: 500 mg/dose Elimination half life (T 1/2): Table 3. Acts by interfering with bacterial cell wall … MERREM IV should be given as intravenous infusion over 30 minutes. -Infants 32 weeks or older GA and PNA less than 2 weeks: 20 mg/kg IV every 8 hours Some of these include meningitis, intra-abdominal infection, pneumonia, sepsis, and anthrax. Indication : • Wide spectrum antibiotic used to treat both Gram-positive and Gram-negative infections including pseudomonas spp. Re-constitute injection vials (500 mg and 1 gram) with sterile Water for Injection (see table 4 below). Comments: The required dose should be administered after completion of the haemodialysis cycle. -Constituted solution for IV bolus: If unable to use freshly prepared solution immediately, may store up to 3 hours at up to 25C (77F) or for 13 hours at up to 5C (41F) NDA 50-706/S-022 Page 4 concentrations of meropenem in excess of … Meropenem undergoes both filtration and tubular secretion. A 20 mg/kg dose of meropenem results in peak serum concentrations of about 50 μg/mL. Doses of 1 gram may also be administered as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes. • For I.V. MERREM IV should be administered by intravenous infusion over approximately 15 minutes to 30 minutes. Once-daily administration of gentamicin is safe and effective for most patients. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Comments: TDM-monograph Meropenem October 2015, CONCEPT version Page 4 of 5 meropenem 500 mg every 8 hours, or 1 gram every 6 hours in patients with normal renal function. General: Solutions prepared for infusion (MERREM IV concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Dextrose Injection 5% should be used immediately. Weight (kg) × (140 - age) Directions for administration For continuous intravenous infusion , manufacturer advises reconstitute each 1 g (as meropenem) vial to produce a 0.05 g (as meropenem)/mL solution with 20 mL Sodium Chloride 0.9%. Administration advice: Should you take probiotics with antibiotics. Table 1: Recommended MERREM IV Dosage Schedule for Adult Patients with Renal Impairment, Table 2: Recommended MERREM IV Dosage Schedule for Pediatric Patients 3 Months of Age and Older with Normal Renal Function, Table 3: Recommended MERREM IV Dosage Schedule for Pediatric Patients Less than 3 Months of Age with Complicated Intra-abdominal Infections and Normal Renal Function, Table 4: Volume of Sterile Water for Injection for Reconstitution of Injection Vials, We comply with the HONcode standard for trustworthy health information -, Recommended dose (500 mg cSSSI and 1 gram Intra-abdominal). 72 × serum creatinine (mg/dL). Higher doses (40 mg/kg/dose IV every 8 hours) have been used in patients with severe infections. 3 months or older: 20 mg/kg IV every 8 hours It is resistant to some forms of extended-spectrum beta-lactamase. Administer MERREM IV as an intravenous infusion over approximately 15 minutes to 30 minutes or as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes. Reconstitution/preparation techniques: -Concentration of solution for IV infusion: Ranges from 1 to 20 mg/mL Maximum dose: 1 g/dose Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, Klebsiella pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species, Infectious Diseases Society of America (IDSA) recommendations: 2 g IV every 8 hours for 7 to 21 days -Complicated infections due to P aeruginosa: 20 mg/kg IV every 8 hours No dose adjustment is necessary in patients with hepatic impairment (see section 4.4). When only serum creatinine is available, the following formula (Cockcroft and Gault equation)1 may be used to estimate creatinine clearance. It is given by injection into a vein.. Common side effects include nausea, diarrhea, constipation, headache, rash, and pain at the site of injection. Hepatic impairment. -Hematologic: Hematopoietic organ system functions (periodically during prolonged therapy) CrCl less than 10 mL/min: One-half recommended dose every 24 hours Economic benefit of a meropenem dosage strategy based on pharmacodynamic concepts. Last updated on Jul 26, 2019. References. Consider IVIg. -Do not freeze IV solutions. Publishers of the British National Formulary. Reference(s) National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. Antibiotics & Drinking Alcohol - Is it Safe? Infants and children: 40 mg/kg IV every 8 hours This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. No dose adjustment is necessary in patients with hepatic impairment (see section 4.4). Dosing Modifications Renal impairment. <10 one-half unit dose every 24 hours Meropenem is cleared by haemodialysis. HML restricted (accepted in SSH and CHCH and shared care centres on National Febrile Neutropenia protocol). Typhoid Fever (Off-label) 15-20 mg/kg/day PO divided q12hr for 7-14 days. If continued treatment with MEROPENEM RANBAXY for Injection is necessary, the unit dose (based on the type and severity of infection) is recommended at the completion of the haemodialysis … There is no accumulation of repeated doses of meropenem 500 mg every 8 hours, or 1 gram every 6 hours in patients with normal renal function. (See dosing table below.). American Thoracic Society, IDSA recommendations: 1 g IV every 8 hours Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Available for Android and iOS devices. Medically reviewed by Drugs.com. -Do not operate machinery or motorized vehicles until it is reasonable well established that this drug is well tolerated. Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Generic name: MEROPENEM 1g in 30mLDosage form: injection. -Compatibility with other drugs not established; this drug should not be mixed with or physically added to solutions containing other drugs. resistant to other antibiotics. Meropenem clearance increases with gestational age and chronologic age as the kidneys mature. Source: Kuti JL, et al. 8 hours (maximum dose is 2 grams every 8 hours), depending on the type of infection (cSSSI, cIAI, intra-abdominal infection or meningitis). BNF Publications. Maximum dose: 2 g/dose Uses: As a single agent therapy for the treatment of bacterial meningitis due to S pneumoniae, Haemophilus influenzae, Neisseria meningitidis Abstract & Commentary . -Compatible for IV bolus: Sterile Water for Injection Meropenem. -Recommended as an alternative therapy, Adults: Complicated skin and skin structure infections, Infants less than 32 weeks GA and PNA less than 2 weeks, Infants less than 32 weeks GA and PNA 2 weeks and older, Infants 32 weeks and older GA and PNA less than 2 weeks, Infants 32 weeks and older GA and PNA 2 weeks and older, For pediatric patients 3 months of age and older, the MERREM IV dose is 10 mg/kg, 20 mg/kg or 40 mg/kg every 8 hours (maximum dose is 2 grams every 8 hours), depending on the type of infection (cSSSI, cIAI, intra-abdominal infection or meningitis). NOTE: space oral dose two hours before or six hours after calcium, magnesium and iron. British National Formulary - BNF (Add filter) 15 October 2020 Indications, dose, contra-indications, side-effects, interactions, cautions, warnings and other safety information for MEROPENEM WITH VABORBACTAM. Alternatively, an injection vial may be re-constituted, then the resulting solution added to an intravenous container and further diluted with an appropriate infusion fluid. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. amoxicillin, Keflex, doxycycline, triamcinolone, metronidazole, azithromycin, ciprofloxacin, clindamycin, Augmentin, Flagyl. It is available for oral use. Do not use flexible container in series connections. -This drug is useful as presumptive therapy in the indicated condition before causative organism is identified due to broad spectrum of bactericidal activity. -Infants less than 32 weeks GA and PNA 2 weeks or older: 20 mg/kg IV every 8 hours -Solution for IV infusion when constituted with Dextrose Injection 5%: Freshly prepared solution should be used immediately. Meropenem is cleared by haemodialysis and haemofiltration. -For IV bolus: Constitute injection vials with sterile Water for Injection; shake to dissolve then let stand until clear. Injection vials (500 mg and 1 gram) may be directly re-constituted with a compatible infusion fluid. • If seizures occur during meropenem therapy, decrease dosage or discontinue meropenem. Monitoring: Use normal dose every 12 hours if eGFR 26–50 mL/minute/1.73 m 2. We comply with the HONcode standard for trustworthy health information -. Use half normal dose every 24 hours if eGFR less than 10 mL/minute/1.73 m 2. • For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. Meropenem readily penetrates the cell wall of most Gram-positive and Gram-negative bacteria to reach penicillin-binding- protein (PBP) targets. Four hundred forty-six patients (397 pediatric patients 3 months to less than 17 years of age) were enrolled in 4 separate clinical trials and randomized to treatment with meropenem (n=225) at a dose of 40 mg/kg every 8 hours or a comparator drug, i.e., cefotaxime (n=187) or ceftriaxone (n=34), at the approved dosing regimens. Comments: Available for Android and iOS devices. -Shortening the duration of therapy may reduce the risk of superinfections with resistant organisms. Solutions prepared for infusion (MERREM IV concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Sodium Chloride Injection 0.9% may be stored for 1 hour at up to 25°C (77°F) or 15 hours at up to 5°C (41°F). -General: Organ system functions (periodically during prolonged therapy) -Solution for IV infusion when constituted with Sodium Chloride Injection 0.9%: If unable to use freshly prepared solution immediately, may store for 1 hour at up to 25C (77F) or 15 hours at up to 5C (41F) Storage requirements: There is limited safety data available to support the administration of a 40 mg/kg (up to a maximum of 2 grams) bolus dose. -Effective in eliminating concurrent bacteremia associated with bacterial meningitis. The recommended dose of MERREM IV is 500 mg given every 8 hours for skin and skin structure infections and 1 gram given every 8 hours for intra-abdominal infections. -Hepatic: Hepatic organ system functions (periodically during prolonged therapy) Meropenem exhibits dose-proportional linear PK properties with dosages of meropenem from 10 to 40 mg/kg. When treating complicated skin and skin structure infections caused by P. aeruginosa, a dose of 1 gram every 8 hours is recommended. Applies to the following strengths: 500 mg; 1000 mg; 500 mg/ 50 mL-NaCl 0.9%; 1000 mg/ 50 mL-NaCl 0.9%, 500 mg IV every 8 hours Detailed Meropenem dosage information for adults and children. -If multidrug-resistant organisms suspected, initial empiric treatment with broad-spectrum coverage (according to the hospital's and/or ICU's antibiogram) is recommended. There is inadequate information regarding the use of MERREM IV in patients on hemodialysis or peritoneal dialysis. See dosing table 3 below. Dosage should be reduced in patients with creatinine clearance of 50 mL/min or less. -Infants 32 weeks or older GA and PNA 2 weeks or older: 30 mg/kg IV every 8 hours Plasma concentrations of meropenem for neonates, infants and children after a single dose of 20 or 40 mg/kg (Ped Infec Dis J 1997; 16:263-8) CSF concentrations are approximately 15% of the simultaneous serum concentrations during the first 1 to 4 h after IV infusion during the first 24 to 48 h of therapy in children with meningitis There are no established dose recommendations for patients receiving peritoneal dialysis. Urinary . -Complicated infections due to Pseudomonas aeruginosa: 1 g IV every 8 hours Patient advice: -Avoid missing doses and complete the entire course of therapy. Solutions of intravenous MERREM IV should not be frozen. -Compatible for IV infusion: Sodium Chloride Injection 0.9%, Dextrose Injection 5% Meropenem dose bnf Usage of meropenem Download Here Free HealthCareMagic App to Ask a Doctor. MERREM IV injection vials re-constituted with sterile Water for Injection for bolus administration (up to 50 mg/mL of MERREM IV) may be stored for up to 3 hours at up to 25°C (77°F) or for 13 hours at up to 5°C (41°F). -Recommended as an alternative therapy. Vancomycin 15 mg/kg (500 mg) IV 6H and Meropenem 20 mg/kg (1 g) IV 8H and Clindamycin 15 mg/kg (600 mg) IV 8H. Includes dosages for Skin and Structure Infection, Intraabdominal Infection, Nosocomial Pneumonia and more; plus renal, liver and dialysis adjustments. Uses: As a single agent therapy for the treatment of complicated skin and skin structure infections due to Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pyogenes, S agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), P aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, Peptostreptococcus species, 1 g IV every 8 hours Shake to dissolve and let stand until clear. Approximately 70% (50% to 75%) of a meropenem dose administered intravenously is recovered unchanged in the urine over 12 hours 1. Last updated on Sep 22, 2020. -Renal: Renal organ system functions (periodically during prolonged therapy); renal function in elderly patients Use normal dose every 12 hours if estimated glomerular filtration rate 26–50 mL/minute/1.73 m 2.. Use half normal dose every 12 hours if estimated glomerular filtration rate 10–25 mL/minute/1.73 m 2.. Use half normal dose every 24 hours if estimated glomerular filtration rate less than 10 mL/minute/1.73 m 2. Approximately 70% (50% to 75%) of a meropenem dose administered intravenously is recovered unchanged in the urine over 12 hours 1. Pediatric patients: Data not available. -Efficacy as monotherapy in the treatment of meningitis due to penicillin nonsusceptible isolates of S pneumoniae has not been established. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. CrCl >60 mL/min: No dosage adjustment necessary; CrCl 21-60 mL/min: 260 mg/day PO; CrCl ≤20 mL/min or continuous peritoneal dialysis : 200 mg/day PO; Dosing Considerations However, re-constituted solutions of MERREM IV maintain satisfactory potency under the conditions described below. Meropenem / vaborbactam is also indicated for the treatment of infections due to aerobic Gram-negative organisms in adults with limited treatment options. Pediatric Patients 3 Months of Age and Older, Pediatric Patients Less Than 3 Months of Age. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University.. every 8 h) with other antimicrobial agents … CrCl greater than 25 to 50 mL/min: Recommended dose every 12 hours IDSA recommendations: -Dry powder: Store at controlled room temperature 20C to 25C (68F to 77F) Meropenem, sold under the brandname Merrem among others, is a broad-spectrum antibiotic used to treat a variety of bacterial infections. Adult: In cases of severe pneumonia, complicated UTI, complicated intra-abdominal infections, complicated skin and skin structure infections, gynaecological infections: 0.5-1 g 8 hourly via infusion over approx 15-30 minutes or via bolus inj over approx 3-5 minutes. Data sources include IBM Watson Micromedex (updated 2 Nov 2020), Cerner Multum™ (updated 2 Nov 2020), ASHP (updated 23 Oct 2020) and others. -Culture and susceptibility information should be considered when selecting treatment or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy. -Pediatric patients younger than 3 months: Administer as IV infusion over 30 minutes. Freshly prepared solutions of MERREM IV should be used. MERREM IV should not be mixed with or physically added to solutions containing other drugs. See. There are no established dose recommendations for patients receiving peritoneal dialysis. Hemodialysis, peritoneal dialysis: Data not available. Medically reviewed by Drugs.com. Approximately 70% of the intravenously administered dose is recovered as unchanged meropenem in the urine over 12 hours, after which little further urinary excretion is detectable. Applying Pharmacokinetic and Pharmacodynamic Principles to Meropenem . bolus, add 10 ml of sterile water for injection to 500 mg/20 ml vial size or 20 ml to 1 g/30 ml vial size to provide 50 mg/ml. Hold enteral feeds one hour before and after dose (do not use oral suspension in feeding tubes due to clogging) 70% Clindamycin 600 mg IV q8h Clindamycin 450 mg PO TID 90% Fluconazole IV once daily (daily dose same for both IV and PO administration) Select one or more newsletters to continue. Meropenem Merrem ® - Renal dosing. -Recommended as empiric therapy of hospital-acquired pneumonia (including ventilator-associated pneumonia) and healthcare-associated pneumonia Authoritative and practical information on the selection and clinical use of medicines. See dosing table 2 below. Data sources include IBM Watson Micromedex (updated 2 Nov 2020), Cerner Multum™ (updated 2 Nov 2020), ASHP (updated 23 Oct 2020) and others. There is no experience in pediatric patients with renal impairment. Comments: The required dose should be administered after completion of the haemodialysis cycle. Active ingredients Size Unit NHS indicative price Drug tariff Drug tariff price; Meropenem (as Meropenem trihydrate) 500 mg; 10: vial (POM) £103.14 (Hospital only) Part VIIIA Category C 400 mg/day PO in single daily dose or divided q12hr. Manufacturer advises reduce dose to 0.5 g every 12 hours if creatinine clearance less than 10 mL/minute. Synopsis: Comparison of 2 meropenem dosing regimens, 500 mg q 6 h and 1000 mg q 8h, found that the resultant pharmacokinetics and pharmacodynamics were equivalent. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Uses: As a single agent therapy for the treatment of complicated skin and skin structure infections due to S aureus (methicillin-susceptible isolates only), S pyogenes, S agalactiae, viridans group streptococci, E faecalis (vancomycin-susceptible isolates only), P aeruginosa, E coli, P mirabilis, B fragilis, Peptostreptococcus species, Less than 3 months: For pediatric patients (with normal renal function) less than 3 months of age, with complicated intra-abdominal infections, the MERREM IV dose is based on gestational age (GA) and postnatal age (PNA). Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. CrCl 10 to 25 mL/min: One-half recommended dose every 12 hours Faropenem is an orally active beta-lactam antibiotic belonging to the penem group. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. Duration of therapy: As short as 7 days recommended (reducing from traditional 14 to 21 days) if causative organism is not P aeruginosa and patient has good clinical response Select one or more newsletters to continue. Consult WARNINGS section for dosing related precautions. All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. -Adults: Administer by IV infusion over about 15 to 30 minutes; alternatively, doses of 1 g may be administered as an IV bolus injection over about 3 to 5 minutes. IV compatibility: -Pediatric patients 3 months or older: Administer as IV infusion over about 15 to 30 minutes or as an IV bolus injection over about 3 to 5 minutes; limited safety data available to support use of a 40 mg/kg (maximum of 2 g) bolus dose. Shake to dissolve and let stand until clear. Dental abscess : ... Gentamicin once-daily dosing. Page 1 of 3 King Edward Memorial Hospital & Perth Children’s Hospital Neonatology Meropenem - Neonatal NEONATAL MEROPENEM This document should be read in conjunction with this DISCLAIMER Restricted: Requires Microbiologist review within 24 hours of initiation Presentation Vial: 500mg Classification Bactericidal carbapenem antibiotic. • For I.V. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 3 months or older: 10 mg/kg IV every 8 hours Compatibility of MERREM IV with other drugs has not been established. Maximum dose: 1 g/dose Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Greater than 50 mL/min: Recommended dose every 8 hours Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, K pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species, 3 months or older: 40 mg/kg IV every 8 hours -Do not use flexible container in series connections. -Infants less than 32 weeks gestational age (GA) and postnatal age (PNA) less than 2 weeks: 20 mg/kg IV every 12 hours Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2. Maximum dose: 2 g/dose -For IV infusion: May constitute infusion vials directly with compatible infusion fluid; alternatively, may constitute an injection vial, add the resulting solution to an IV container, then further dilute with an appropriate infusion fluid Date last published: ... under 50kg; 40mg/kg q8h (max dose 2g/dose q8h) over 50kg; dose as for child 12 - 18 years : Child 12 years - 18 years ... .

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