What is the recommended dosage of Meropenem (Meropenem) for patients?

From the Guidelines

Meropenem is recommended to be dosed at 1 gram intravenously every 8 hours for most serious infections in adults with normal renal function. This dosage is based on the most recent and highest quality study available, which provides recommendations for the treatment of infections due to multidrug-resistant organisms 1. For patients with renal impairment, dosage adjustments are necessary, with a creatinine clearance of 26-50 mL/min requiring 1 gram every 12 hours, 10-25 mL/min requiring 500 mg every 12 hours, and <10 mL/min requiring 500 mg every 24 hours.

Key Considerations

• For children, the standard dose is 20-40 mg/kg every 8 hours, with a maximum of 2 grams per dose.
• Meropenem should be infused over 15-30 minutes for standard administration, though extended infusions of 3 hours may be beneficial for certain resistant infections, as suggested by the study 1.
• The typical treatment duration ranges from 7-14 days depending on the infection site and severity.
• Meropenem is a 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 Details

• Common side effects include headache, diarrhea, nausea, and injection site reactions.
• The study 1 provides recommendations for the treatment of various infections, including bloodstream infections, complicated urinary tract infections, and complicated intra-abdominal infections.
• The choice of combination antimicrobial therapy should be based on susceptibility tests, and extended-infusion of meropenem for 3 hours is suggested if the meropenem MIC is ≥ 8 mg/L.
• Combinations of tigecycline with polymyxin or meropenem are suggested in clinically unstable patients.

Dosage Summary

• Adult dosage: 1 gram intravenously every 8 hours
• Pediatric dosage: 20-40 mg/kg every 8 hours, with a maximum of 2 grams per dose
• Dosage adjustment for renal impairment: required for patients with creatinine clearance < 50 mL/min.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION 500 mg every 8 hours by intravenous infusion over 15 to 30 minutes for complicated skin and skin structure infections (cSSSI) for adult patients. When treating infections caused by Pseudomonas aeruginosa, a dose of 1 gram every 8 hours is recommended. (2. 1) 1 gram every 8 hours by intravenous infusion over 15 minutes to 30 minutes for intra-abdominal infections for adult patients. (2.1) Recommended meropenem for injection Dosage Schedule for Adult Patients with Renal Impairment Creatinine Clearance (mL/min) Dose (2) (dependent on type of infection) (2) Dosing Interval Greater than 50Recommended dose (500 mg cSSSI and 1 gram Intra-abdominal)Every 8 hours 26 to 50Recommended doseEvery 12 hours 10 to 25One-half recommended doseEvery 12 hours Less than 10One-half recommended doseEvery 24 hours Recommended meropenem for injection Dosage Schedule for Pediatric Patients3 Months of Age and Older with Normal Renal Function(2. 3) Type of InfectionDose (mg/kg)Up to a Maximum DoseDosing Interval Complicated skin and skin structure*10500 mgEvery 8 hours Intra-abdominal201 gramEvery 8 hours Meningitis402 gramsEvery 8 hours

The recommended dosage of Meropenem for patients is as follows:

• Adult patients:
  • 500 mg every 8 hours for complicated skin and skin structure infections (cSSSI)
  • 1 gram every 8 hours for intra-abdominal infections and when treating infections caused by Pseudomonas aeruginosa
• Pediatric patients 3 months of age and older:
  • 10 mg/kg (up to 500 mg) every 8 hours for complicated skin and skin structure infections
  • 20 mg/kg (up to 1 gram) every 8 hours for intra-abdominal infections
  • 40 mg/kg (up to 2 grams) every 8 hours for meningitis
• Dosage adjustment for renal impairment:
  • Creatinine clearance greater than 50 mL/min: recommended dose every 8 hours
  • Creatinine clearance 26-50 mL/min: recommended dose every 12 hours
  • Creatinine clearance 10-25 mL/min: one-half recommended dose every 12 hours
  • Creatinine clearance less than 10 mL/min: one-half recommended dose every 24 hours 2

From the Research

Recommended Dosage of Meropenem

The recommended dosage of Meropenem varies depending on the patient's renal function and the severity of the infection.

• For patients with normal renal function, the daily dosage may range from 0.5 to 1 g every 6 to 8 hours 3.
• The daily dose of meropenem can be safely increased to 6 g in patients with normal renal function 3.
• For patients with renal impairment, dosage adjustments are necessary, and the dosage may need to be reduced 4.
• For patients undergoing continuous renal replacement therapy (CRRT), the dosage of meropenem may need to be adjusted based on the type of membrane and treatment modality used 4, 5.
• For critically ill patients, including those with sepsis, the recommended dosing regimen may include continuous infusion of meropenem to achieve adequate efficacy indexes 5, 6.
• The dosage of meropenem should be based on renal function rather than age, and extended infusion may be required to achieve therapeutic target attainment for patients with normal renal function 7.

Factors Affecting Dosage

Several factors can affect the dosage of meropenem, including:

• Renal function: Creatinine clearance has a significant impact on the clearance of meropenem, and dosage adjustments are necessary for patients with renal impairment 4, 5, 6, 7.
• Body size: Body size can affect the volume of distribution of meropenem, and dosage adjustments may be necessary for patients with extreme body sizes 7.
• Age: Age does not have a significant impact on the pharmacokinetics of meropenem, and dosage should be based on renal function rather than age 7.
• Type of infection: The severity and type of infection can affect the recommended dosage of meropenem, and higher doses may be necessary for more severe infections 3, 5, 6.