Meropenem Dosage
This dosage information may not include all the information needed to use Meropenem safely and effectively. See additional information for Meropenem.
The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.
Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Intraabdominal Infection
1 g IV every 8 hours for 7 to 14 days
Usual Adult Dose for Meningitis
1 to 2 g IV every 8 hours for 7 to 21 days
Usual Adult Dose for Nosocomial Pneumonia
1 g IV every 8 hours
Initial empiric treatment with broad-spectrum coverage according to the hospital's and/or ICU's antibiogram is recommended if multidrug-resistant organisms are suspected.
Duration: If the causative organism is not Pseudomonas aeruginosa, the duration of treatment should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.
Usual Adult Dose for Skin or Soft Tissue Infection
Complicated infection: 500 mg IV every 8 hours
Duration: Therapy should generally be continued for approximately 7 to 10 days, or for 3 days after the acute inflammation disappears, depending on the nature and severity of the infection. For more severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required.
Usual Pediatric Dose for Intraabdominal Infection
3 months or older: 20 mg/kg IV every 8 hours
Maximum dose: 3 g/day
Children 50 kg or more: 1 g IV every 8 hours
Usual Pediatric Dose for Meningitis
3 months or older: 40 mg/kg IV every 8 hours
Maximum dose: 6 g/day
Children 50 kg or more: 2 g IV every 8 hours
Usual Pediatric Dose for Skin and Structure Infection
Complicated: 3 months or older: 10 mg/kg IV every 8 hours
Maximum dose: 1.5 g/day
Children 50 kg or more: 500 mg IV every 8 hours
Renal Dose Adjustments
Adults:
CrCl 26 to 50 mL/min: Usual dose every 12 hours
CrCl 10 to 25 mL/min: One-half recommended dose every 12 hours
CrCl 9 mL/min or less: One-half recommended dose every 24 hours
Liver Dose Adjustments
No adjustment recommended
Precautions
Serious and occasionally fatal hypersensitivity reactions have been reported with antibiotics. The drug should be discontinued immediately at the first appearance of a skin rash or other signs of hypersensitivity. Severe, acute hypersensitivity reactions may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated.
Meropenem has been associated with seizures and other CNS side effects, most commonly in patients with CNS disorders such as brain lesions, history of seizures, bacterial meningitis, or concurrent medications with seizure potential. Recommended dosages should not be exceeded, especially in patients with risk factors. Neurologic evaluation, anticonvulsant therapy, and possible meropenem dosage adjustment or discontinuation are recommended for patients who experience tremors, myoclonus or seizures.
Clostridium difficile associated diarrhea (CDAD) has been reported with almost all antibiotics and may potentially be life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea following meropenem therapy. Mild cases generally improve with discontinuation of the drug, while severe cases may require supportive therapy and treatment with an antimicrobial agent effective against C difficile. Hypertoxin producing strains of C difficile cause increased morbidity and mortality; these infections can be resistant to antimicrobial treatment and may necessitate colectomy.
Dialysis
Adult:
Conventional hemodialysis: 500 mg IV every 24 hours; alternatively, a dose of 500 mg to 1 g may be given after each dialysis session
Both meropenem and its metabolite are eliminated appreciably during dialysis. The metabolite may, however, still accumulate and its effects at elevated concentrations are unknown. Meropenem should be used with caution, if at all, in patients receiving hemodialysis.
Continuous renal replacement therapy: Clearance may be significantly increased; therefore, dose adjustments may be necessary which should be individualized based on the estimated meropenem clearance. Alternatively, initial doses of 500 mg every 12 hours have been suggested for patients undergoing continuous venovenous hemofiltration, and 750 mg every 8 hours or 1500 mg every 12 hours for patients undergoing continuous venovenous hemodiafiltration.
Peritoneal dialysis: There is insufficient information in the medical literature to recommend a safe dosage.
Pediatric: There is insufficient information in the medical literature to recommend a safe dosage.
