From the Guidelines
Meropenem is typically dosed at 1 gram intravenously every 8 hours for severe infections in adults with normal renal function, as recommended by the most recent guidelines 1. The dosage of Meropenem may vary depending on the severity of the infection and the patient's renal function.
- For life-threatening infections, including severe sepsis or infections caused by less susceptible organisms, the dose may be increased to 2 grams every 8 hours.
- For patients with renal impairment, dose adjustment is necessary based on creatinine clearance:
- for clearance 26-50 mL/min, give 1 gram every 12 hours;
- for clearance 10-25 mL/min, give 500 mg every 12 hours;
- and for clearance less than 10 mL/min, give 500 mg every 24 hours. The duration of therapy typically ranges from 7-14 days depending on the infection site and severity, but may be longer for certain infections like osteomyelitis. 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, as supported by the guidelines from the European Society of Clinical Microbiology and Infectious Diseases 1. It penetrates well into most body tissues and fluids, making it suitable for treating various severe infections including intra-abdominal infections, pneumonia, sepsis, and meningitis. According to the guidelines, for patients with severe infections due to third-generation cephalosporin-resistant Enterobacterales, a carbapenem (imipenem or meropenem) is recommended as targeted therapy 1. Additionally, the initial intravenous adult dosages of antibiotics for empiric treatment of complicated intra-abdominal infection, including Meropenem, are outlined in the guidelines by the Surgical Infection Society and the Infectious Diseases Society of America 1.
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.
- Alternatively, a dose of 500mg every 6 hours has been shown to be effective and may be considered a therapeutic option 4.
- For critically ill patients with severe infections, a continuous infusion of meropenem may be used, with a loading dose of 2g followed by a continuous infusion of 4g over 24 hours 5.
- The dose of meropenem may need to be adjusted in patients with renal insufficiency or those undergoing renal replacement therapy 3, 7.
- Studies have shown that standard dosing regimens may not always produce adequate plasma concentrations in critically ill patients, and monitoring of meropenem concentrations may be necessary to ensure effective treatment 7.
Specific Dosing Regimens
- For complicated intra-abdominal infection, complicated skin and skin structure infection, and bacterial meningitis, meropenem is approved for use at a dose of 1g every 8 hours 6.
- For nosocomial pneumonia, septicaemia, febrile neutropenia, and complicated urinary tract infection, meropenem may be used at a dose of 1g every 8 hours 6.
- For severe community-acquired pneumonia, meropenem may be used at a dose of 1g every 8 hours 6.
Considerations for Dosing
- The pharmacokinetics of meropenem may differ in critically ill patients compared to healthy or less ill subjects, and dosing regimens may need to be adjusted accordingly 7.
- Meropenem concentrations should be maintained above the minimum inhibitory concentrations for the majority of the dosing interval to ensure effective treatment 7.
- Monitoring of meropenem concentrations may be necessary to ensure adequate plasma concentrations and to adjust dosing regimens as needed 7.