What is the antimicrobial coverage of Meropenem (generic name)?

From the Guidelines

Meropenem is a broad-spectrum carbapenem antibiotic that provides excellent coverage against many gram-positive, gram-negative, and anaerobic bacteria, and its use should be prioritized in serious infections where its coverage is necessary, such as complicated intra-abdominal infections, pneumonia, and sepsis, as recommended by the most recent guidelines 1.

Key Points

• Meropenem is effective against most Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter species, many streptococci, and anaerobes.
• It also covers many ESBL (extended-spectrum beta-lactamase) producing organisms.
• However, it has limited activity against methicillin-resistant Staphylococcus aureus (MRSA), Enterococcus faecium, and organisms that produce carbapenemases like KPC or NDM.
• The typical adult dosing is 1 gram IV every 8 hours, with dose adjustments needed for renal impairment.
• For central nervous system infections, doses may be increased to 2 grams every 8 hours due to its good penetration across the blood-brain barrier.

Coverage and Spectrum

• Meropenem has a broad spectrum of activity, making it suitable for use in a variety of infections, including complicated intra-abdominal infections, pneumonia, and sepsis.
• Its coverage includes many gram-positive, gram-negative, and anaerobic bacteria, as well as ESBL-producing organisms.

Use and Administration

• Meropenem should be used judiciously to prevent development of resistance, and therapy should be narrowed based on culture results whenever possible.
• It is generally reserved for serious infections where its broad-spectrum activity is necessary.
• The choice of meropenem should be based on the clinical condition of the patient, the individual risk for infection by resistant pathogens, and the local resistance epidemiology, as recommended by guidelines 1.

From the FDA Drug Label

Meropenem has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections [ see Indications and Usage (1)] Gram-positive bacteria Enterococcus faecalis(vancomycin-susceptible isolates only) Staphylococcus aureus(methicillin-susceptible isolates only) Streptococcus agalactiae Streptococcus pneumoniae(penicillin-susceptible isolates only) Streptococcus pyogenes Viridans group streptococci Gram-negative bacteria Escherichia coli Haemophilus influenzae Klebsiella pneumoniae Neisseria meningitidis Proteus mirabilis Pseudomonas aeruginosa Anaerobic bacteria Bacteroides fragilis Bacteroides thetaiotaomicron Peptostreptococcus species

Meropenem Coverage: Meropenem has broad-spectrum activity against various microorganisms, including:

• Gram-positive bacteria: such as Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pneumoniae (penicillin-susceptible isolates only), and Enterococcus faecalis (vancomycin-susceptible isolates only)
• Gram-negative bacteria: such as Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae
• Anaerobic bacteria: such as Bacteroides fragilis, Bacteroides thetaiotaomicron, and Peptostreptococcus species However, it is essential to note that meropenem does not have activity against methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE) 2

From the Research

Meropenem Coverage

• Meropenem is a broad-spectrum antibacterial agent of the carbapenem family, effective against a wide range of Gram-positive and Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae 3, 4, 5.
• It has been approved for use in various infections, including complicated intra-abdominal infection, complicated skin and skin structure infection, bacterial meningitis, nosocomial pneumonia, septicaemia, febrile neutropenia, and complicated urinary tract infection 3, 4, 6.
• Meropenem has shown similar efficacy to comparator antibacterial agents, such as imipenem/cilastatin, cefotaxime, and ceftazidime, in various infections 3, 4, 5, 7.
• The spectrum of activity of meropenem includes:
  • Gram-positive pathogens: effective against most species, but less active than imipenem against some strains 4, 7.
  • Gram-negative pathogens: effective against most species, including ESBL- and AmpC-producing Enterobacteriaceae, and Pseudomonas aeruginosa 3, 4, 5.
  • Anaerobic pathogens: effective against most species 4, 5.
• Meropenem is generally well-tolerated, with a low propensity for inducing seizures, making it suitable for treating bacterial meningitis 3, 5.