From the Guidelines
For severe infections, meropenem is typically dosed at 1 gram intravenously every 8 hours for adults with normal renal function. This recommendation is based on the most recent and highest quality study available, which is the 2022 European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant gram-negative bacilli 1.
Key Considerations
- The dosage may need to be adjusted based on renal function, with reduced doses for patients with creatinine clearance less than 50 mL/min.
- In critically ill patients or for particularly resistant organisms, the dose may be increased to 2 grams every 8 hours.
- Meropenem is a broad-spectrum carbapenem antibiotic that works by inhibiting bacterial cell wall synthesis and is effective against many gram-positive, gram-negative, and anaerobic bacteria, including many multidrug-resistant organisms.
Important Side Effects and Interactions
- Monitor for seizures, especially in patients with CNS disorders or renal impairment.
- Be aware of potential cross-reactivity in patients with penicillin allergies.
Additional Guidance
- The 2010 guidelines by the Surgical Infection Society and the Infectious Diseases Society of America also recommend meropenem as a treatment option for complicated intra-abdominal infections, with a dosage of 1 gram every 8 hours 1.
- However, the 2022 ESCMID guidelines provide more up-to-date and specific recommendations for the treatment of severe infections caused by multidrug-resistant gram-negative bacilli.
From the FDA Drug Label
- 1 Adult Patients The recommended dose of meropenem for injection is 500 mg given every 8 hours for skin and skin structure infections and 1 gram given every 8 hours for intra-abdominal infections. When treating complicated skin and skin structure infections caused by P. aeruginosa, a dose of 1 gram every 8 hours is recommended
- 3 Use in Pediatric Patients Pediatric Patients 3 Months of Age and Older For pediatric patients 3 months of age and older, the meropenem for injection dose is 10 mg/kg, 20 mg/kg or 40 mg/kg every 8 hours (maximum dose is 2 grams every 8 hours), depending on the type of infection (cSSSI, cIAI, intra-abdominal infection or meningitis).
The dose of Merrem (Meropenem) for severe infection is:
- For adult patients:
- 1 gram every 8 hours for intra-abdominal infections
- 1 gram every 8 hours for complicated skin and skin structure infections caused by P. aeruginosa
- For pediatric patients 3 months of age and older:
- 20 mg/kg every 8 hours (up to a maximum of 1 gram) for complicated intra-abdominal infections
- 40 mg/kg every 8 hours (up to a maximum of 2 grams) for meningitis
- 20 mg/kg every 8 hours (or 1 gram for pediatric patients weighing over 50 kg) for complicated skin and skin structure infections caused by P. aeruginosa 2
From the Research
Merrem (Meropenem) Dose for Severe Infection
- The dose of Merrem (Meropenem) for severe infection can vary depending on the specific condition being treated and the patient's renal function 3, 4, 5, 6, 7.
- For adults with severe infections, a dose of 1g every 8 hours is commonly used 4.
- However, some studies suggest that a dose of 500mg every 6 hours may be equally effective and could be considered a therapeutic option 4.
- For critically ill patients with severe infections, a continuous infusion of meropenem may be more effective than intermittent bolus administration 5.
- A study found that a loading dose of 2g of meropenem followed by a continuous infusion of 4g over 24 hours was effective in treating severe infections in critically ill patients 5.
- The dose of meropenem may need to be adjusted in patients with renal insufficiency or those undergoing renal replacement therapy 3, 7.
- Meropenem is approved for use in a variety of serious infections, including complicated intra-abdominal infection, complicated skin and skin structure infection, and bacterial meningitis 6.
- The pharmacokinetics of meropenem can vary in critically ill patients, and standard dosing regimens may not always produce adequate plasma concentrations 7.