Recommended Adult Dosage of Meropenem for Various Infections
The standard adult dose of meropenem is 1 gram administered intravenously every 8 hours for most serious infections, with dosage adjustments required for renal impairment. 1
Standard Dosing by Infection Type
Intra-abdominal Infections
Skin and Skin Structure Infections
- 500 mg IV every 8 hours for uncomplicated infections 1
- 1 gram IV every 8 hours when treating infections caused by Pseudomonas aeruginosa 1
Complicated Skin and Soft Tissue Infections
Necrotizing Skin and Soft Tissue Infections
- 1 gram IV every 8 hours 2
Administration Methods
- Intravenous infusion over 15-30 minutes (preferred method) 1
- Intravenous bolus injection (5-20 mL) over 3-5 minutes for 1 gram doses 1
Dosage Adjustments for Renal Impairment
Meropenem is primarily excreted unchanged in the urine, making dose adjustments essential in patients with renal insufficiency 1:
| Creatinine Clearance (mL/min) | Dose | Dosing Interval |
|---|---|---|
| Greater than 50 | Recommended dose | Every 8 hours |
| 26 to 50 | Recommended dose | Every 12 hours |
| 10 to 25 | One-half recommended dose | Every 12 hours |
| Less than 10 | One-half recommended dose | Every 24 hours |
Special Considerations
Critically Ill Patients
For critically ill patients with severe infections, consider:
- Meropenem 1 gram IV every 8 hours 2
- Extended or continuous infusion may improve efficacy for serious infections, particularly with less susceptible pathogens 3
Patients with Healthcare-Associated Infections
- Meropenem 1 gram IV every 8 hours is recommended for healthcare-associated infections 2
Important Clinical Considerations
Pharmacokinetic/Pharmacodynamic Factors
- Efficacy of meropenem depends on time above MIC (T>MIC)
- Extended infusion (over 3 hours) may be beneficial for less susceptible organisms 3, 4
- Standard half-life is approximately 1 hour in patients with normal renal function 5
Safety Considerations
- Seizure risk increases with higher doses, particularly in patients with renal impairment or CNS disorders 6
- Monitor for hypersensitivity reactions, which can be serious or fatal 1
- Adjust dosing in patients on hemodialysis to avoid CNS toxicity 6
Monitoring
- Therapeutic drug monitoring may be beneficial in critically ill patients or those with impaired renal function 4
- For patients on continuous renal replacement therapy, residual diuresis should be considered when determining dosing regimens 7
Pitfalls to Avoid
- Failing to adjust dose based on renal function can lead to toxicity
- Inadequate dosing for Pseudomonas aeruginosa infections (should use 1 gram every 8 hours)
- Not considering extended infusion for less susceptible pathogens
- Overlooking drug interactions, particularly with valproic acid which can reduce seizure threshold
- Underestimating the importance of timing between doses to maintain adequate serum levels
Meropenem's broad-spectrum activity makes it an important antimicrobial for serious infections, but appropriate dosing based on infection site, pathogen, and patient factors is essential to optimize outcomes while minimizing adverse effects.