The average breast milk concentration was 0.48 … 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. The protein binding of Meronem is low (approximately 2%) and, therefore, no interactions with other compounds based on displacement from plasma proteins would be expected. Rarely, pseudomembranous colitis has been reported on Meronem as with practically all antibiotics and may vary in severity from slight to life-threatening. similar to those in adults. VABP/VAP Ventilator Acquired (Bacterial) Pneumonia . In every case, it should be used under the direct supervision of the physician. – Meningitis – Pneumonias and Nosocomial Pneumonias 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. Meropenem is also used to treat bacterial meningitis (infection that causes inflammation of the tissue that covers the brain and spinal cord). For each gram of meropenem (anhydrous potency) the vial contains 90 mg (3.9 mmol) of sodium. of patients with bacterial meningitis, achieving concentrations in excess of those required to inhibit most bacteria. 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. In meningitis the recommended dosage is 2 g every 8 hours. Limited post-marketing experience indicates that adverse events following over dosage are consistent with the adverse event profile described in the undesirable effects Imipenem (imipenem with cilastatin) and meropenem are used for the treatment of severe hospital-acquired infections and polymicrobial infections caused by multiple-antibacterial resistant organisms (including septicaemia, hospital-acquired pneumonia, intra-abdominal infections, skin and soft-tissue infections, and complicated urinary-tract infections). With stratification by diagnosis and region, hospitalized patients with cUTI or AP received IV plazomicin (15 mg/kg q24h) or IV meropenem (1 g q8h) for 4–7 days, followed by optional oral therapy, for a total of 7–10 days of therapy. 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. Table 3 “In vitro” MIC-50 and MIC-90 for most relevant uropathogens. United Kingdom. Accidental overdosage could occur during therapy, particularly in patients with renal impairment. – Septicaemia 1 Jeff Loutit, MBChB, of The Medicines Company in San Diego, and … Torres A, Zhong N, Pachl J, et al. In animal studies meropenem has shown nephrotoxic effects, only at high dose levels (500 mg/kg). 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 Get the latest research from NIH: Please refer to the expiry date on the outer carton. UV Ultra Violet spectrometry . TGA Thermogravimetric Analysis . Susceptible                               >14                                  <4 In subjects with normal renal function, meropenem’s elimination half-life is approximately 1 hour. Jusprin to relieve mild to moderate pain such as headache toothache and muscle pain, إيفورتيل منشط قوى للدورة الدموية لعلاج هبوط وخفقان الدورة الدموية, بى بى سى مخدر موضعى ومسكن ومطهر لالتهابات الفم والحلق, أفالون كريم ازالة الام العضلات والتواء المفاصل وتليفها وحالات الروماتيزم, Megaprazole for infusion is indicated gastric antisecretory treatment and gastric antisecretory treatment, Meronem iv for urinary tract infections and intra abdominal and skin structure infections,, Megaprazole for infusion is indicated gastric…, Zurcal for Symptomatic gastro esophageal reflux…, Dimra to relieve pain in musculo skeletal conditions…. The elimination half-life for meropenem was approximately 1.5 to 2.3 hours in children under the age of 2 years and the pharmacokinetics are linear over the dose range of 10 to 40 mg/kg. E coli meningitis requires antibiotics, such as third-generation cephalosporins (eg, ceftriaxone). The concentration of meropenem in breast milk was evaluated in a study of a 41-year-old woman treated for a postpartum urinary tract infection caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli with meropenem 1 g IV q 8 h. Levels were taken from five samples, and ranged from 0.246 mcg/mL to 0.644 mcg/mL. The co-administration of Meronem with potentially nephrotoxic drugs should be considered with caution. Excipient: Anhydrous sodium carbonate 104mg      208 mg 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. Aztreonam (a monobactam) Ciprofloxacin (Resistance is increasing) & … For children over 3 months and up to 12 years of age the recommended dose is 10 – 20 mg/kg every 8 hours depending on type and severity of infection, susceptibility of the pathogen and the condition of the patient. Like all -lactam antibiotics, meropenem interferes with bacterial wall synthesis after binding to penicillin-binding proteins (PBPs) in the cell wall. As with other antibiotics, overgrowth of non-susceptible organisms may occur and, therefore, continuous monitoring of each patient is necessary. Minimum bactericidal concentrations (M BC) are commonly the same as the minimum inhibitory concentrations (MIC). 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. Wagenlehner FM, Sobel JD, Newell P, et al. 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. Meronem is compatible with the following infusion fluids: The clinical efficacy of the drug was stated in all the patients while the bacteriological efficacy amounted to 88.9 per cent. 5% or 10% Glucose solution 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. Effect of Meropenem-Vaborbactam vs Piperacillin-Tazobactam on Clinical Cure or Improvement and Microbial Eradication in Complicated Urinary Tract Infection: The TANGO I Randomized Clinical Trial. 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. In children over 50 kg weight, adult dosage 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. cadaveris, Clostridium sordellii, Clostridium butyricum, Clostridium clostridiiformis, Clostridium innocuum, Clostridium subterminale, Clostridium tertium, Eubacterium lentum, Eubacterium aerofaciens, Fusobacterium mortiferum, Fusobacterium necrophorum, 500 mg or 1 g . E coli pneumonia requires respiratory support, adequate oxygenation, and antibiotics, such as third-generation cephalosporins or fluoroquinolones. Antibiotic Spectrum Chart – Coverage for most antibiotics by class. Meronem IV to be used for bolus intravenous injection should be constituted with sterile Water for Injections (5 ml per 250 mg Meropenem). 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. Resistant                                  <11                                   > 16. Refer to” Posology and method of administration” above. post-antibiotic effect. The recommended daily dosage is as follows: Meropenem exerts its bactericidal action by interfering with vital bacterial cell wall synthesis. The ease with which it penetrates bacterial cell walls, its high level of stability to all serine Iactamases and its marked affinity for the Penicillin Binding Proteins (PBPs) explain the potent bactericidal action of meropenem against a broad spectrum of aerobic and anaerobic bacteria. No dosage adjustment is required for the elderly with normal renal function or eatinine clearance values above 50 ml/min. 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 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: – Empiric treatment, for presumed infections in adult patients with febrile neutropenia, used as monotherapy or in combination with anti-viral or anti-fungal agents. Iakovlev SV, Iakovlev VP, Derevianko II, Kira EF; Meropenem Study Group. Therefore, antibiotics should be prescribed with care for individuals with a history of gastr intestinal complaints, particularly colitis. Meronem should not be mixed with or added to other drugs. Meronem is generally well tolerated. 500 mg or 1 g . Method of Administration : Meropenem trihydrate                          570 mg         1140 mg E coli cholecystitis/cholangitis requires antibiotics such as third-generation cephalosporins that cover E coli and Klebsiella organisms. Mannitol 2.5% or 10% solution. After an IV dose of 500 mg, plasma levels of meropenem decline to values of 1 ~g/ml or less, 6 hours after administration. Meropenem and imipenem demonstrate good activity against Enterobacteriaceae, including strains producing ESBLs or AmpC (100% for E coli, 99% for other Enterobacteriaceae), meropenem usually being 2 to 4 fold more potent than imipenem [21–23]. For an IV dose the LDso in rodents is greater than 2000 mg/kg. 2018 Aug;37(8):1411-1419. doi: 10.1007/s10096-018-3260-4. 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. 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. Meropenem is an antibiotic that is used to treat severe infections of the skin or stomach. The sole metabolite of meropenem had a similar profile of toxicity in animal studies. These durations of infusion resulted in peak plasma levels of 110,91 and 94 mg/ml, respectively. The safety of Meronem in human pregnancy has not been evaluated. Urinary tract infection (UTI) is the most common bacterial infection. faecalis, Bordetella bronchiseptica, Brucella melitensis, Campylobacter coli, Campylobacter jejuni, Citrobacter freundii, Citrobacter divers us, Citrobacter koseri, Citrobacter amalonaticus, Stenotrophomonas maltophilia, Enterococcus faecium and methicillin-resistant staphylococci have been found to be resistant to meropenem. concentration of 50 mg/ml. Meronem is contraindicated in patients who have demonstrated hypersensitivity to this product. Meronem 500 mg   1000 mg Ceftazidime-avibactam versus meropenem in nosocomial pneumonia, including ventilator-associated … 10-25                             one-half unit dose               every 12 hours 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. Tallarigo C, Comunale L, Baldassarre R, Poletti G. Minerva Urol Nefrol. Trademark Please enable it to take advantage of the complete set of features! Meropenem was used in the monotherapy.