Storage requirements: Drugs, 2002 View the formulary and any restrictions for each plan. Most Other polymicrobial infections. restrictions. commonly, these are generic drugs. What Is the Risk of Catching the Coronavirus on a Plane? If you log out, you will be required to enter your username and password the next time you visit. In this randomized, phase 3, non-inferiority trial, adults aged 18 years or older with hospital-acquired, ventilator- or, healthcare-associated Gram-negative pneumonia were enrolled. commonly, these are "non-preferred" brand drugs. Should you take probiotics with antibiotics. Nitrofurantoin or fosfomycin may also be used for Administration advice:, View explanations for tiers and Access your plan list on any device – mobile or desktop. Max: 1 gm/dose. Restaurants May Be Key Component to COVID-19 Spread, 'Breakthrough Finding' Reveals Why Certain COVID Patients Die, Wear a Mask While Having Sex, Canada's Top Doctor Suggests. Contact the applicable plan The recipient will receive more details and instructions to access this offer. prescription products. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. These are the only indications for which this dose is appropriate. -Constitute vial(s) with 0.9% Sodium Chloride Injection, USP; mix gently to dissolve. amoxicillin, doxycycline, ciprofloxacin, Macrobid, Augmentin, levofloxacin. Examples: 1) Prescriber orders meropenem 1g q8hr in a patient with meningitis. Cefiderocol was non-inferior to high-dose, extended infusion meropenem in patients with Gram-negative nosocomial pneumonia, according to a study published in The Lancet Infectious Diseases.. Use: For the treatment of patients with complicated urinary tract infections (including pyelonephritis) due to susceptible Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex. Estimated glomerular filtration rate (GFR) at least 50 mL/min/1.73 m2: No adjustment recommended. Withdraw 20 mL of 0.9% Sodium Chloride Injection from an infusion bag and constitute each vial. -Must complete IV infusion of the diluted solution within 4 hours if stored at room temperature or 22 hours if stored refrigerated. Select one or more newsletters to continue. 1 g meropenem-vaborbactam contains 0.5 g meropenem and 0.5 g vaborbactam Gynecological infections such as endometritis. -Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy. Ciprofloxacin or TMP/SMX can be used as alternatives to ertapenem for uncomplicated UTI if the organism is susceptible. • Broncho-pulmonary infections in cystic fibrosis • Complicated urinary tract … Ertapenem 1 g IV q24H can be used for uncomplicated UTI. Estimated GFR less than 15 mL/min/1.73 m2: 1 g IV every 12 hours Compare formulary status to other drugs in the same class. 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. Non species related breakpoints are based on the following dosages: EUCAST breakpoints apply to meropenem 1000 mg x 3 daily administered intravenously over 30 minutes as the lowest dose. Meropenem/vaborbactam, sold under the trade name Vabomere among others, is a fixed dose combination drug for the treatment of complicated urinary tract infections.It contains the β-lactam antibiotic meropenem and the β-lactamase inhibitor vaborbactam.In August 2017, the U.S. Food and Drug Administration (FDA) approved it to treat complicated urinary tract infections and pyelonephritis. Urinary concentrations of meropenem in excess of 10 ~glml are maintained for up to 5 hours after the administration of a 500 mg dose. The easiest way to dilute meropenem is to do 2 vials at a time. Indications of meropenem. 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 . Subscribe to newsletters for the latest medication news, new drug approvals, alerts and updates. 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). Last updated on Nov 20, 2020. If continued treatment with MEROPENEM RANBAXY for Injection is necessary, the unit dose (based on the type and severity of infection) is recommended at the completion of the haemodialysis procedure to … We performed a prospective randomized open-label … Hemodialysis: Dose (adjusted for eGFR) should be administered after a hemodialysis session. Mouthwash Might Mitigate COVID-19 Spread. Most and formulary information changes. It can be used to treat severe infections of the lower respiratory tract, urinary tract, skin and skin structures, meningitis, septicaemia,febrile neutropenia, intra-abdominal and gynaecological infections. 237122-overview For a history of other serious reactions (Type II, III, or IV e.g., hemolytic anemia, – thrombocytopenia, serum sickness, erythema multiforme, SJS/TEN, DRESS, etc), avoid the specifically implicated drug, … Safety and efficacy have not been established in patients younger than 18 years. 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. dose is 10, 20 or 40 mg/kg every 8 hours (maximum dose is 2 g every 8 hours), depending on the type of infection (complicated skin and skin structure, intra-abdominal or meningitis). Meropenem Dosing Substitution • For all adults and children > 50kg (normal renal function*): ... urinary tract infection. -Known hypersensitivity to either active component, any of the ingredients, or other drugs in the same class CONTRAINDICATIONS: The decision must take into consideration frequency and severity of UTI versus adverse effects, such as adverse drug reactions, C. difficile colitis, and antibiotic resistance. Share cases and questions with Physicians on Medscape consult. 4 g IV every 8 hours Duration of therapy: Up to 14 days Use: For the treatment of patients with complicated urinary tract infections (including pyelonephritis) due to susceptible Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex. This drug is available at a higher level co-pay. provider for the most current information. We comply with the HONcode standard for trustworthy health information -, Drug class: carbapenems/beta-lactamase inhibitors. Max: 500 mg/dose. Duration of therapy: Up to 14 days Reconstitution/preparation techniques: 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. Applies to the following strengths: 1 g-1 g, 4 g IV every 8 hours This drug is available at a higher level co-pay. Burgos RM(1), Biagi MJ(1), Rodvold KA(1)(2), Danziger LH(1)(2). Manufacturer advises reduce dose to 0.5 g every 12 hours if creatinine clearance less than 10 mL/minute. Meropenem 1 g IV q8H should be used for all severe urinary infections if the organism is susceptible. Children: Urinary tract Infection, soft tissue infection and skin infections: 10 mg/kg/dose IV every 8 hours. commonly, these are "preferred" (on formulary) brand drugs. The FDA has approved a fixed-dose combination of meropenem, a carbapenem antibiotic, and vaborbactam, a new beta-lactamase inhibitor (Vabomere – Melinta), for IV treatment of adults with complicated urinary tract infections (UTIs) that are proven or strongly suspected to be caused by Escherichia coli, Klebsiella pneumoniae, or Enterobacter cloacae spp. If 1g q12h is ordered for any other indication, dose will be interchanged to 1g q6h. Please confirm that you would like to log out of Medscape. -Demonstrated anaphylactic reactions to beta-lactam antibacterial agents Comments: 2 g x 3 daily was taken into consideration for severe infections and in setting the I/R breakpoint. To view formulary information first create a list of plans. Renal Dose Adjustments Individual plans may vary General: By clicking send, you acknowledge that you have permission to email the recipient with this information. 4 g meropenem-vaborbactam contains 2 g meropenem and 2 g vaborbactam A: Generally acceptable. Estimated GFR 30 to 49 mL/min/1.73 m2: 2 g IV every 8 hours -Only compatible with 0.9% Sodium Chloride Injection, USP All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. -Serum creatinine levels and eGFR should be monitored at least daily in patients with changing renal function; the dose of this drug should be adjusted accordingly. -Powder (prior to constitution): Store vials at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). For pediatric patients from 3 months of age and older, the MERREM I.V. Manage and view all your plans together – even plans in different states. Consult WARNINGS section for dosing related precautions. This website also contains material copyrighted by 3rd parties. 2 g meropenem-vaborbactam contains 1 g meropenem and 1 g vaborbactam Available for Android and iOS devices. The clinical and bacteriological efficacies of meropenem in the treatment of 12 patients with urinary tract infection were studied. A: Antibiotic prophylaxis may be considered in women with ≥ 2 urinary tract infections in 6 months or ≥ 3 urinary tract infections in 12 months. Klebsiella pneumoniae has been frequently found to produce extended-spectrum β-lactamases (ESBLs).1 Infections caused by ESBL-producing pathogens are problematic because when co-resistance to other antimicrobial class is present, limited antibiotic options are available. Meropenem Merrem ® - Renal dosing. 966919-overview Skin and skin structure infections. -Renal: Renal function in elderly patients; serum creatinine levels and eGFR in patients with changing renal function (at least daily) -Compatibility with other drugs not established. 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. This drug is available at the lowest co-pay. Antibiotics & Drinking Alcohol - Is it Safe? The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. complex. The owner is comfortable giving SQ injections at home. Dose should be automatically adjusted by the pharmacist to 2g q8hr. -The constituted solution must be diluted further (immediately) in a 0.9% Sodium Chloride Injection, USP infusion bag prior to IV infusion. Drugs, 2002 -The manufacturer product information should be consulted. Methods and analysis The main objective of this project is to demonstrate the clinical non-inferiority of intravenous fosfomycin with regard to meropenem for treating bacteraemic urinary tract infections (UTI) caused by ESBL-EC. The dog is stable and ready to be discharged from the hospital. This drug is available at a middle level co-pay. Pneumonias and nosocomial pneumonia. Most merrem-iv-meropenem-342565 provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2. -Avoid missing doses and complete the entire course of therapy. •2g q8h –Cefepime 2g q 8h allowed only in “neutropenic fever” Adult: In cases of severe pneumonia, complicated UTI, complicated intra-abdominal infections, complicated skin and skin structure infections, gynaecological infections: 0.5-1 g 8 hourly via infusion over approx 15-30 minutes or via bolus inj over approx 3-5 minutes. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Most Adding plans allows you to compare formulary status to other drugs in the same class. Double the dose in meningitis and severe infection. meropenem, or cefepime (unless the reaction was to ceftazidime). 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 … 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. Use half normal dose every 24 hours if eGFR less than 10 mL/minute/1.73 m 2. 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… 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 clinical response rate in UTI at the end of therapy was 93-100% for meropenem 500 mg tds compared with 94-95% for ceftazidime 500 mg tds; for meropenem 500 mg bd it was 97%, significantly higher than that for imipenem/cilastatin 500 mg bd which was 90% (P = 0.03).