Professional Documents
Culture Documents
Meropenem
Meropenem
Meropenem
Trade Names:
Text
• Pharmacologic Category
Cell Wall synthesis inhibitors antibacterial,
is a member of the Carbapenem group.
• Mechanism Of Action
Inhibits bacterial cell wall synthesis by
binding to several of the penicillin-
binding-proteins, which in turn inhibit the
final transpeptidations tep of
peptidoglycan synthesis in bacterial cell
wall, thus inhibiting cell wall biosynthesis;
bacteria eventually lyse due to ongoing
activity of cell wall autolytic enzymes
(autolysins and murein hydrolases) while
cell wall assembly is arrested.
• Antibacterial spectrum
is highly resistant to β-lactamase.
is one of the antibiotics of last resort for
many bacterial infections.
it has a broad-spectrum of antimicrobial
activity against most aerobic and
anaerobic bacteria (Gram-positive and
gram-negative) with the exception of
occasional Pseudomonas strains.
Its strongest affinity is toward PBPs of
Escherichia coli and Pseudomonas
aeruginosa, and PBPs of Staphylococcus
aureus.
Bactericidal concentrations are typically 1
to 2 times the bacteriostatic
concentrations.
• indications
_ Bacterial meningitis
_ complicated skin infections and
subcutaneous tissue infections
_ intra-abdominal infections (complicated
appendicitis and peritonitis )
_ Bacteremia associated with
intravascular line
_ Cystic fibrosis
_ Febrile neutropenia
_ Hospital acquired pneumonia
_ Necrotizing fasciitis
_ Nocardiosis, Solid Organ Transplant
Recipients
_ Osteomyelitis, Native vertebral.
• Pharmacokinetics
A) Absorption:
Tmax, IV: approximately 1 hour after the
start of the infusion.
Meropenem is known to reach
therapeutic levels in bacterial meningitis
even without inflammation.
B) Distribution:
Vd, adults: 12 to 20 L
Vd, obese adults (mean BMI 65.5
kg/m(2)): 25.1 L
Vd, continuous renal replacement: 28.8 L
Vd, preterm neonates (27 to 32 weeks
gestational age, 21 days mean postnatal
age): 0.74 L/kg
Vd, neurocritical care (adult): 7.11 L
Protein binding: approximately 2%.
C) Metabolism:
Meropenem does not undergo
metabolism by renal dihydropeptidase
enzyme.
Extrarenal: 20% to 25% up to 50% if CrCl
less than 20 mL/min.
D) Excretion:
Renal excretion: 70% unchanged
Fecal excretion: Approximately 2%
Renal clearance: 140 to 230 mL/min
Dialyzable: (hemodialysis) 79 mL/min
Hemofiltration: 47%
Total body clearance: 188 to 300 mL/min
Total body clearance, obese adults (mean
BMI 65.5 kg/m(2)): 8.1 L/hr
Total body clearance, continuous renal
replacement: 3.03 L/hr
Total body clearance, adults patients in
neurocritical care: 14.87 L/hr.
E) Elimination Half Life:
Adults and children 2 years or older: 1
hour
Adults, obese (mean BMI 65.5 kg/m[2]):
2.8 hours
Pediatric patients 3 months to 2 years: 1.5
hours
Preterm neonates (27 to 32 weeks
gestational age, 21 days mean postnatal
age): 3.4 hours
Impaired renal function: 3.4 to 20 hours
or longer.
• Contraindications
Text
Text
Text.
• Precautions
Text
Text
Text.
• Pregnancy:
Text.
• Breast Feeding:
Text.
• Adverse Effects
Text
Text
Text.
• Interactions
Text
Text
Text.