Estimated GFR 15 to 29 mL/min/1.73 m2: 2 g IV every 12 hours Medically reviewed by Drugs.com. and formulary information changes. Ciprofloxacin or TMP/SMX can be used as alternatives to ertapenem for uncomplicated UTI if the organism is susceptible. These are the only indications for which this dose is appropriate. Compare formulary status to other drugs in the same class. Consult WARNINGS section for dosing related precautions. Manufacturer advises reduce dose to 0.5 g every 12 hours if creatinine clearance less than 10 mL/minute. Meropenem is indicated for the treatment of the following infections in adults and children aged 3 months and older (see sections 4.4 and 5.1): • Severe pneumonia, including hospital and ventilator-associated pneumonia. 1 vial is used for 2 g (1 g meropenem and 1 g vaborbactam) or 1 g (0.5 g meropenem and 0.5 g vaborbactam) doses. Max: 500 mg/dose. merrem-iv-meropenem-342565 2 g meropenem-vaborbactam contains 1 g meropenem and 1 g vaborbactam For pediatric patients from 3 months of age and older, the MERREM I.V. Detailed Meropenem dosage information for adults and children. In 8 patients the drug was administered intravenously in a dose of 1 g every 8 hours and in 4 patients with the creatinine clearance below 50 ml/min it was administered in a dose of 1 g every 12 hours (the treatment course of 7 to 10 days). Peritoneal dialysis: Data not available. 2 g x 3 daily was taken into consideration for severe infections and in setting the I/R breakpoint. Skin and skin structure infections. -Powder (prior to constitution): Store vials at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Nitrofurantoin or fosfomycin may also be used for Please confirm that you would like to log out of Medscape. Approximately 70% of the administered dose is recovered as unchanged meropenem in the urine over 12 hours, after which little further urinary excretion is detectable. -Do not operate machinery or motorized vehicles until it is reasonably well established that this drug is well tolerated. This drug is available at a higher level co-pay. Four hundred forty-six patients (397 pediatric patients 3 months to less than 17 years of age) were enrolled in 4 separate clinical trials and randomized to treatment with meropenem (n=225) at a dose of 40 mg/kg every 8 hours or a comparator drug, i.e., cefotaxime (n=187) or ceftriaxone (n=34), at the approved dosing regimens. If 1g q12h is ordered for any other indication, dose will be interchanged to 1g q6h. Intra-abdominal infections. Meropenem (Merrem) is an injectable carbapenem and beta-lactam antibiotic that interferes with bacterial cell wall synthesis in sensitive organisms Has activity versus a wide array of organisms, including multi-drug resistant Acinetobacter baumannii, Pseudomonas aeruginosa and … Infants <32 weeks GA and PNA <2 weeks: 20 mg/kg IV q12hr, Infants <32 weeks GA and PNA ≥2 weeks: 20 mg/kg IV q8hr, Infants ≥32 weeks GA and PNA <2 weeks: 20 mg/kg IV q8hr, Infants ≥32 weeks GA and PNA ≥2 weeks: 30 mg/kg IV q8hr, No fetal toxicity or malformations were observed in pregnant rats and Cynomolgus monkeys administered intravenous meropenem during organogenesis at doses up to 2.4 and 2.3 times the maximum recommended human dose (MRHD) based on body surface area comparison, respectively; in rats administered intravenous meropenem in late pregnancy and during lactation period, there were no adverse effects on offspring at doses equivalent to approximately 3.2 times the MRHD based on body surface area comparison. Data sources include IBM Watson Micromedex (updated 2 Nov 2020), Cerner Multum™ (updated 2 Nov 2020), ASHP (updated 23 Oct 2020) and others. Most Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2. Burgos RM(1), Biagi MJ(1), Rodvold KA(1)(2), Danziger LH(1)(2). Inhibits cell-wall synthesis by binding to penicillin-binding proteins; resistant to most beta-lactamases, Penetrates well into most body fluids and tissues; CSF concentrations approximate those in plasma, Vd: Adults, 15-20 L; children, 0.3-0.4 L/kg, Metabolized in liver to open beta-lactam form (inactive), Half-life: Normal renal function, 1-1.5 hr; CrCl >30-80 mL/min, 1.9-3.3 hr; CrCl >2-30 mL/min, 3.82-5.7 hr, Excretion: Urine (~25% as inactive metabolites), Additive: Amphotericin B, metronidazole, multivitamins, Y-site: Amphotericin B, diazepam, metronidazole, Administer IV infusion over 15-30 minutes; administer IV bolus over 3-5 minutes, Store powder at controlled room temperature. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Other polymicrobial infections. Duration of therapy: Up to 14 days No fetal toxicity or malformations were observed in pregnant rats and Cynomolgus monkeys administered intravenous meropenem during organogenesis at doses up to 2.4 and 2.3 times the maximum recommended human dose (MRHD) based on body surface area comparison, respectively; in rats administered intravenous meropenem in late pregnancy and during lactation period, there were no … Should you take probiotics with antibiotics. commonly, these are "non-preferred" brand drugs or specialty By continuing to browse this site you are agreeing to our use of cookies. We performed a prospective randomized open-label … Includes dosages for Skin and Structure Infection, Intraabdominal Infection, Nosocomial Pneumonia and more; plus renal, liver and dialysis adjustments. commonly, these are "non-preferred" brand drugs. • Broncho-pulmonary infections in cystic fibrosis • Complicated urinary tract … Reference(s) National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. The easiest way to dilute meropenem is to do 2 vials at a time. The recipient will receive more details and instructions to access this offer. Meropenem Updated September 2016 $48.50 for 500mg $63.50 for 1g Example A 30kg dog has a resistant urinary tract infection that is sensitive to meropenem. Mouthwash Might Mitigate COVID-19 Spread. Estimated GFR less than 15 mL/min/1.73 m2: 1 g IV every 12 hours Currently, imipenem or meropenem is regarded as the drug of choice for infections caused by ESBL-producing pathogens.1,2 However, the selective pressure from increasing use of carbapenems will lead to development of carbapenem-resista… Meropenem is a safe and effective broad-spectrum antibiotic, commonly used in the intensive care unit, and it is a good therapeutic tool for management of severe urinary tract sepsis . Manage and view all your plans together – even plans in different states. <10 one-half unit dose every 24 hours Meropenem is cleared by haemodialysis. imipenem MIC of 4mg/L, the meropenem dose should be adjusted to 2 g q8hr. Most provider for the most current information. Indicated 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, Streptococcus agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, and Peptostreptococcus species, 500 mg IV q8hr; not to exceed 2 g IV q8hr, Indicated as a single agent therapy for the treatment of complicated appendicitis and peritonitis caused by viridans group streptococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Bacteroides fragilis, B. thetaiotaomicron, and Peptostreptococcus species, 500 mg IV q8hr for ≤5 days in combination with fluoroquinolone, Indicated as a single agent therapy for the treatment of bacterial meningitis caused by Streptococcus pneumoniae (penicillin susceptible isolates), Haemophilus influenzae, and Neisseria meningitidis, ≥3 months: 40 mg/kg IV q8hr; not to exceed 2 g IV q8hr, ≥3 months: 20 mg/kg IV q8hr; not to exceed 1 g q8hr, ≥3 months: 10 mg/kg IV q8hr; not to exceed 500 mg IV q8hr, Rash (2-3%; includes diaper-area moniliasis in pediatric patients), Oral moniliasis (≤2% in pediatric patients), Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), erythema multiforme and acute generalized exanthematous pustulosis, Hypersensitivity to IV components, beta-lactams, or other drugs in this class, Hypersensitivity reactions have been reported, including fatalities; these reactions are more likely to occur in individuals with history of sensitivity to multiple allergens, Seizures have been reported, most commonly in patients with CNS disorders (eg, brain lesions, history of seizures) or with bacterial meningitis or compromised renal function, Seizures, headaches, or paresthesias may occur, potentially interfering with mental alertness or causing motor impairment, Clostridium difficile-associated diarrhea has been reported, To avoid development of drug resistance, drug should be used only in proven or strongly suspected bacterial infections or a prophylactic indication, Prolonged use may result in overgrowth of nonsusceptible organisms, Thrombocytopenia has been reported in patients with renal impairment, Co-administration of meropenem IV with valproic acid or divalproex sodium reduces serum concentrations of valproic acid potentially increasing risk of breakthrough seizures, Severe cutaneous adverse reactions (SCAR) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), erythema multiforme (EM) and acute generalized exanthematous pustulosis (AGEP) reported; if signs and symptoms suggestive of these reactions appear, therapy should be withdrawn immediately and an alternative treatment considered, There are insufficient human data to establish whether there is a drug-associated risk of major birth defects or miscarriages with meropenem in pregnant women, Drug has been reported to be excreted in human milk; no information is available on effects of drug on breast-fed child or on milk production; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breast-fed child from therapy or from the underlying maternal condition.
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