Meropenem

A to Z Drug Facts

Meropenem

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(mare-oh-PEN-em)

Merrem

Class: Anti-infective/carbapenem

Action Inhibits cell wall synthesis.

Indications Treatment of intra-abdominal infections in adults and children ³ mo and meningitis in children ³ 3 mo when caused by susceptible microorganisms.

Contraindications Hypersensitivity to any component of this product or to other drugs in the same class or in patients who have demonstrated anaphylactic reactions to B-lactarus.

Route/Dosage

Intra-abdominal infections

ADULTS: IV 1 g IV q 8 hr. CHILDREN ³ 3 MO: IV 20 mg/kg q 8 hr. Maximum dose: 2 g every 8 hr.

Meningitis

CHILDREN ³ 3 MO: IV 40 mg/kg q 8 hr. Maximum dose: 2 g every 8 hr.

Interactions

Probenecid: Inhibits renal excretion of meropenem. Coadministration is not recommended. INCOMPATIBILITIES: Do not physically mix with solutions containing other drugs.

Lab Test Interferences None well documented.

Adverse Reactions

RESP: Apnea. CNS: Headache. DERM: Rash; pruritis. EENT: Stomatitis. GI: Diarrhea; nausea; vomiting; constipation. GU: Vaginitis. OTHER: Injection site reactions (pain, edema, inflammation).

Precautions

Pregnancy: Category B. Lactation: Undetermined. Children: Safety and efficacy in children < 3 months not established. CNS: Seizures and other CNS adverse events have occurred. Use with caution in patients with CNS disorders, meningitis or renal dysfunction. Renal function impairment: Reduced clearance may occur. Adjust dose downward accordingly in patients with creatinine clearance < 50 ml/min. Refer to manufacturer's package insert for dose calculations. Thrombocytopenia, without bleeding, has been observed. Hypersensitivity: Administer drug with caution to penicillin-sensitive patients due to possible cross-reactivity. Pseudomembranous colitis: Consider possibility in patients with diarrhea. Superinfection: May result in bacterial or fungal overgrowth of non-susceptible organisms.

PATIENT CARE CONSIDERATIONS

Administration/Storage

For IV administration only. Do not use solution if discolored or if particulate matter is seen.
For IV bolus administration, reconstitute with sterile water for injection. Shake to dissolve and let stand until clear. May administer over 3–5 min.
For IV infusion, reconstitute infusion vial with compatible infusion fluid or use ADD-Vantage flexible diluent container for ADD-Vantage vial following instructions. Can administer over 15–30 min.
Store dry powder for reconstitution at controlled room temperature.
Stability of reconstituted meropenem is dependent on diluent and container (eg, syringe, infusion vial, minibag, ADD-Vantage diluent bag). Refer to manufacturer's package insert for guidelines.

Assessment/Interventions

Obtain complete patient history, including drug history and any known allergies, especially to penicillin and B-lactam antibiotics.
Notify physician if signs of superinfection (eg, vaginitis, stomatitis) or pseudomembranous colitis (eg, diarrhea with blood or pus) occurs.
Assess for signs and symptoms of anaphylaxis (shortness of breath, wheezing, laryngeal edema). Have resuscitation equipment available.
If seizures occur, withhold drug, institute safety measures and notify physician.
If culture and sensitivity is ordered, obtain specimen(s) rior to first dose.
Withhold drug and notify physician if any of the following occur: fever, rash, hives.
Monitor vital signs, sputum, urine, stool and WBC at beginning of and throughout therapy.

OVERDOSAGE: SIGNS & SYMPTOMS
	Seizures

Patient/Family Education

Instruct patient to report to physician or nurse itching, rash, hives, difficulty breathing, diarrhea, black “furry” tongue, loose, foul-smelling stool or vaginal itching or discharge.