Carbapenem類 Treatment of intra-abdominal infections (complicated appendicitis and peritonitis); treatment of bacterial meningitis in pediatric patients ≧3 months of age caused by S. pneumoniae, H. influenzae, and N. meningitidis; treatment of complicated skin and skin structure infections caused by susceptible organisms

Meropem is a broad- spectrum carbapenem antibiotic. It is active against Gram(+) and Gram(-) bacteria. Meropem exerts its action by penetrating bacterial cells readily and interfering with the synthesis of vital cell wall components, which leads to cell death. In vitro, meropenem is more active than imipenem against many Gram (-) pathogens; it has shown activity against strains of Enterobacteriaceae and Pseudomonas aeruginosa resistant to imipenem, aminoglycosides, quinolones, and third-generation cephalosporins.

Distribution: penetrates well into most body fluids and tissues; CSF concentrations approximate those of the plasma; Excretion: Urine (~70% as unchanged drug); Elimination half-life: Normal renal function: 1-1.5 hours, ClCr 30-80 mL/min: 1.9-3.3 hours, ClCr 2-30 mL/min: 3.82-5.7 hours

Hypersensitivity to meropenem; any component, other carbapenems, or in patients who have experienced anaphylactic reactions to beta-lactams.

B

Excretion in breast milk unknown/use caution

Headache, nausea, diarrhea, oral moniliasis (up to 2% in pediatric patients), rash; inflammation at the injection site, anemia, may be less likely than imipenem to induce seizure.

Adults:ClCr≧ 51 mL/min:0.5-1 g IV Q8H; ClCr: 26-50 mL/min: 1 g IV Q12H; ClCr: 10-25 mL/min: 0.25 g-0.5 g IV Q12H; ClCr＜10 mL/min: 0.25 g- 0.5 g IV Q24H.

Children with healthy renal function: complicated skin and skin structure infections: 10 mg/kg IV Q8H; intra-abdominal infections: 20 mg/kg IV Q8H; meningitis: 40 mg/kg IV Q8H; infusion 15-30 minutes

If reconstituted with normal saline, meropenem is stable for up to 2 hours at 15–25°C or for up to 18 hours at 4℃; If reconstituted with D5W, stable for up to 1 hour at 15–25°C or for up to 8 hours at 4℃