Is meropenem administered intravenously (IV) or orally (PO)?

From the Guidelines

Meropenem should be administered intravenously (IV) at a dose of 1 g every 8 hours, as it is not available in an oral (PO) formulation and requires direct delivery into the bloodstream to maintain its stability and effectiveness. According to the guidelines for the diagnosis and management of skin and soft tissue infections, meropenem is recommended as a first-line antimicrobial agent for mixed infections, with a specified adult dosage of 1 g every 8 hours IV 1. The drug's stability and effectiveness are compromised if it were to be given orally, as it would be degraded by stomach acid. For patients with renal impairment, dosage adjustments are necessary to prevent accumulation of the drug. The administration of meropenem IV should be infused over 15-30 minutes for standard doses. Key points to consider when administering meropenem include:

• Dosage: 1 g every 8 hours IV for adults
• Administration: Infuse over 15-30 minutes for standard doses
• Renal impairment: Dosage adjustments are necessary to prevent accumulation of the drug
• Availability: Meropenem is only available in an intravenous formulation, and no oral formulation is available 1.

From the FDA Drug Label

Meropenem for injection should be administered by intravenous infusion over approximately 15 minutes to 30 minutes. Doses of 1 gram may also be administered as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes.

Meropenem is administered intravenously (IV), there is no mention of oral (PO) administration in the provided drug labels 2, 2, or 2.

From the Research

Administration of Meropenem

• Meropenem can be administered intravenously (IV) or intramuscularly (IM) 3
• The usual dosages are 500 mg or 1 g 8 hourly in adults and 10 or 20 mg/kg 8 hourly in children 3
• In bacterial meningitis, the meropenem dosage in adults is 2 g 8 hourly and 40 mg/kg 8 hourly in children 3
• Meropenem can be given by 15-30 min IV infusion or by bolus injection over approximately 5 min 3

Pharmacokinetics of Meropenem

• Meropenem is predominately excreted unchanged in the urine 4
• The half-life of meropenem is approximately 1 hour in healthy volunteers, but can be prolonged up to 13.7 hours in anuric patients with end-stage renal disease 4
• Plasma meropenem concentrations reach a peak of between 53 and 62 mg/L after the administration of meropenem 1g intravenously to healthy volunteers 4

Therapeutic Drug Monitoring

• Therapeutic drug monitoring (TDM) of meropenem is recommended, especially in critically ill patients and those with impaired renal function 5
• TDM data can help to maximize the clinical outcomes of the treatment with meropenem by guiding the most appropriate dose regimens 5
• The daily dose of meropenem commonly ranges from 3 to 6 g/day 5

Clinical Use of Meropenem

• Meropenem is indicated for the treatment of serious bacterial infections, including complicated intra-abdominal infection, complicated skin and skin structure infection, and bacterial meningitis 6
• Meropenem has a broad spectrum of in vitro activity against Gram-positive and Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae 6