Meropenem Injection Dosing by Weight
For injection administration of meropenem, the standard pediatric dose is 20 mg/kg every 8 hours for complicated intra-abdominal infections, with a maximum dose of 1 gram per dose. 1
Adult Dosing
- Standard adult dose: 1 gram every 8 hours for intra-abdominal infections 1
- For skin and soft tissue infections: 500 mg every 8 hours 1
- For P. aeruginosa infections: 1 gram every 8 hours 1
- Maximum daily dose: 6 grams
Pediatric Dosing
Children 3 Months and Older:
- Complicated intra-abdominal infections: 20 mg/kg every 8 hours (maximum: 1 gram per dose) 2, 1
- Complicated skin/soft tissue infections: 10 mg/kg every 8 hours (maximum: 500 mg per dose) 1
- Bacterial meningitis: 40 mg/kg every 8 hours (maximum: 2 grams per dose) 1
- For children weighing >50 kg: Use adult dosing 1
Infants Less Than 3 Months:
Based on gestational age (GA) and postnatal age (PNA) for intra-abdominal infections 1:
- Infants <32 weeks GA and PNA <2 weeks: 20 mg/kg every 12 hours
- Infants <32 weeks GA and PNA ≥2 weeks: 20 mg/kg every 8 hours
- Infants ≥32 weeks GA and PNA <2 weeks: 20 mg/kg every 8 hours
- Infants ≥32 weeks GA and PNA ≥2 weeks: 30 mg/kg every 8 hours
Renal Adjustment
Adults:
- CrCl >50 mL/min: No adjustment needed
- CrCl 26-50 mL/min: Standard dose every 12 hours
- CrCl 10-25 mL/min: Half standard dose every 12 hours
- CrCl <10 mL/min: Half standard dose every 24 hours 1
Pediatrics:
Limited data available for pediatric renal adjustment. Consider nephrology consultation for children with severe renal impairment.
Administration Methods
- Intravenous infusion: Administer over 15-30 minutes 1
- Intravenous bolus: Can be given over 3-5 minutes (5-20 mL) 1
- For infants <3 months: Administer as intravenous infusion over 30 minutes 1
Clinical Considerations
- Pharmacokinetic studies show that 20 mg/kg every 8 hours maintains plasma concentrations above MIC90 for most susceptible pathogens 3
- Extended infusion (3-hour) may improve target attainment for less susceptible organisms with MICs of 4-8 mg/L 4
- For critically ill children on continuous renal replacement therapy, dosing should be adjusted based on effluent flow rate 5
Important Precautions
- Inspect solution for particulate matter before administration 1
- Do not mix with other medications in the same infusion 1
- Freshly prepared solutions should be used when possible 1
By following these weight-based dosing guidelines, optimal meropenem concentrations can be achieved to effectively treat serious infections while minimizing the risk of adverse effects.