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Meropenem Dosage

Medically reviewed on November 2, 2017.

Applies to the following strengths: 500 mg/ 50 mL-NaCl 0.9%; 1000 mg/ 50 mL-NaCl 0.9%; 1000 mg; 500 mg

Usual Adult Dose for Skin and Structure Infection

500 mg IV every 8 hours
-Complicated infections due to Pseudomonas aeruginosa: 1 g IV every 8 hours

Uses: As a single agent therapy for the treatment of complicated skin and skin structure infections due to Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pyogenes, S agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), P aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, Peptostreptococcus species

Usual Adult Dose for Intraabdominal Infection

1 g IV every 8 hours

Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, Klebsiella pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species

Usual Adult Dose for Meningitis

Infectious Diseases Society of America (IDSA) recommendations: 2 g IV every 8 hours for 7 to 21 days

Comments:
-Recommended as an alternative therapy

Usual Adult Dose for Nosocomial Pneumonia

American Thoracic Society, IDSA recommendations: 1 g IV every 8 hours
Duration of therapy: As short as 7 days recommended (reducing from traditional 14 to 21 days) if causative organism is not P aeruginosa and patient has good clinical response

Comments:
-Recommended as empiric therapy of hospital-acquired pneumonia (including ventilator-associated pneumonia) and healthcare-associated pneumonia
-If multidrug-resistant organisms suspected, initial empiric treatment with broad-spectrum coverage (according to the hospital's and/or ICU's antibiogram) is recommended.
-Shortening the duration of therapy may reduce the risk of superinfections with resistant organisms.

Usual Pediatric Dose for Skin and Structure Infection

3 months or older: 10 mg/kg IV every 8 hours
Maximum dose: 500 mg/dose

-Complicated infections due to P aeruginosa: 20 mg/kg IV every 8 hours
Maximum dose: 1 g/dose

Uses: As a single agent therapy for the treatment of complicated skin and skin structure infections due to S aureus (methicillin-susceptible isolates only), S pyogenes, S agalactiae, viridans group streptococci, E faecalis (vancomycin-susceptible isolates only), P aeruginosa, E coli, P mirabilis, B fragilis, Peptostreptococcus species

Usual Pediatric Dose for Intraabdominal Infection

Less than 3 months:
-Infants less than 32 weeks gestational age (GA) and postnatal age (PNA) less than 2 weeks: 20 mg/kg IV every 12 hours
-Infants less than 32 weeks GA and PNA 2 weeks or older: 20 mg/kg IV every 8 hours
-Infants 32 weeks or older GA and PNA less than 2 weeks: 20 mg/kg IV every 8 hours
-Infants 32 weeks or older GA and PNA 2 weeks or older: 30 mg/kg IV every 8 hours

3 months or older: 20 mg/kg IV every 8 hours
Maximum dose: 1 g/dose

Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, K pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species

Usual Pediatric Dose for Meningitis

3 months or older: 40 mg/kg IV every 8 hours
Maximum dose: 2 g/dose

Comments:
-Effective in eliminating concurrent bacteremia associated with bacterial meningitis.
-Efficacy as monotherapy in the treatment of meningitis due to penicillin nonsusceptible isolates of S pneumoniae has not been established.

Uses: As a single agent therapy for the treatment of bacterial meningitis due to S pneumoniae, Haemophilus influenzae, Neisseria meningitidis

IDSA recommendations:
Infants and children: 40 mg/kg IV every 8 hours
Maximum dose: 2 g/dose

Comments:
-Recommended as an alternative therapy

Renal Dose Adjustments

Adults:
Greater than 50 mL/min: Recommended dose every 8 hours
CrCl greater than 25 to 50 mL/min: Recommended dose every 12 hours
CrCl 10 to 25 mL/min: One-half recommended dose every 12 hours
CrCl less than 10 mL/min: One-half recommended dose every 24 hours

Pediatric patients: Data not available

Liver Dose Adjustments

No adjustment recommended.

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Hemodialysis, peritoneal dialysis: Data not available

Other Comments

Administration advice:
-Adults: Administer by IV infusion over about 15 to 30 minutes; alternatively, doses of 1 g may be administered as an IV bolus injection over about 3 to 5 minutes.
-Pediatric patients 3 months or older: Administer as IV infusion over about 15 to 30 minutes or as an IV bolus injection over about 3 to 5 minutes; limited safety data available to support use of a 40 mg/kg (maximum of 2 g) bolus dose.
-Pediatric patients younger than 3 months: Administer as IV infusion over 30 minutes.
-Do not use flexible container in series connections.

Storage requirements:
-Dry powder: Store at controlled room temperature 20C to 25C (68F to 77F)
-Constituted solution for IV bolus: If unable to use freshly prepared solution immediately, may store up to 3 hours at up to 25C (77F) or for 13 hours at up to 5C (41F)
-Solution for IV infusion when constituted with Sodium Chloride Injection 0.9%: If unable to use freshly prepared solution immediately, may store for 1 hour at up to 25C (77F) or 15 hours at up to 5C (41F)
-Solution for IV infusion when constituted with Dextrose Injection 5%: Freshly prepared solution should be used immediately.
-Do not freeze IV solutions.

Reconstitution/preparation techniques:
-For IV bolus: Constitute injection vials with sterile Water for Injection; shake to dissolve then let stand until clear.
-For IV infusion: May constitute infusion vials directly with compatible infusion fluid; alternatively, may constitute an injection vial, add the resulting solution to an IV container, then further dilute with an appropriate infusion fluid

IV compatibility:
-Compatible for IV bolus: Sterile Water for Injection
-Compatible for IV infusion: Sodium Chloride Injection 0.9%, Dextrose Injection 5%
-Compatibility with other drugs not established; this drug should not be mixed with or physically added to solutions containing other drugs.

General:
-Culture and susceptibility information should be considered when selecting treatment or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.
-This drug is useful as presumptive therapy in the indicated condition before causative organism is identified due to broad spectrum of bactericidal activity.
-Concentration of solution for IV bolus: Up to 50 mg/mL
-Concentration of solution for IV infusion: Ranges from 1 to 20 mg/mL

Monitoring:
-General: Organ system functions (periodically during prolonged therapy)
-Hematologic: Hematopoietic organ system functions (periodically during prolonged therapy)
-Hepatic: Hepatic organ system functions (periodically during prolonged therapy)
-Renal: Renal organ system functions (periodically during prolonged therapy); renal function in elderly patients

Patient advice:
-Avoid missing doses and complete the entire course of therapy.
-Do not operate machinery or motorized vehicles until it is reasonable well established that this drug is well tolerated.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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