PROTOCOL FOR MEROPENEM DESENSITIZATION Name: DOB: MR #: Date of Procedure: *** Consent for desensitization must be obtained prior

to initiation of procedure. 1. Patient must be monitored in medical ward with hourly pulse rate, temperature and respiratory rate and hourly blood pressure determinations during desensitization. Examine patient for pruritic marks, hives or erythroderma. (If patient is pregnant, monitor fetal heart rate q 1-2 hourly.) 2. No premedication is needed. 3. Keep epinephrine 1:1000 aqueous solution as a STAND BY in a syringe. A crash cart must be available for expected problems. An IV access must be available at all times during desensitization. 4. Mix 500 mg of Meropenem IV in 1000 cc of diluent, then infuse as follows: 10cc/ hour IV over 1st hour, if no reaction, 20 cc/hour IV over the 2nd hour, if no reaction, 40 cc/hour IV over the 3rd hour, if no reaction, 80 cc/hour IV over next hours until solution is consumed. If no reaction occurred, may give the appropriate dose as per ID recommendation. If patient develops a reaction during desensitization, drop the schedule to 2 doses less than the last dose that caused the signs and symptoms and then continue desensitization after premedicating with Benadryl 25 mg IM stat and every 8 hours for 24 hours. Patient/legal guardian has been made aware of procedure. If any questions please page the Fellow at beeper # 917-760-1078. Thank you for the consult. _________________________ Signature of Fellow/Attending __________________________________ Name of Allergy Fellow/Attending (Date)