From the Research
For ESBL urinary tract infections, the recommended dose of Merrem (meropenem) is typically 1 gram administered intravenously every 8 hours for uncomplicated cases, or 2 grams every 8 hours for more severe infections, as supported by the most recent study 1.
Key Considerations
- Treatment duration generally ranges from 7 to 14 days, depending on infection severity and clinical response.
- Dose adjustments are necessary for patients with renal impairment:
- For creatinine clearance 26-50 mL/min, give 1 gram every 12 hours.
- For 10-25 mL/min, give 500 mg every 12 hours.
- For <10 mL/min, give 500 mg every 24 hours.
- Meropenem is effective against ESBL-producing organisms because it's a carbapenem antibiotic that remains stable against these beta-lactamase enzymes.
- The drug works by binding to penicillin-binding proteins to inhibit bacterial cell wall synthesis.
Monitoring and Side Effects
- Monitor renal function during treatment.
- Watch for seizures (especially in patients with CNS disorders or renal impairment).
- Be alert for potential side effects including headache, nausea, diarrhea, and injection site reactions.
Evidence Support
The recommendation is based on the most recent and highest quality study available, which compared the efficacy of meropenem with other treatments for UTIs, including those caused by ESBL-producing organisms 1. While other studies provide additional context and support for the use of meropenem in various infections 2, 3, 4, 5, the study from 2024 offers the most current and relevant guidance for treating ESBL UTIs.