Meropenem Dosing for a 30 kg Male with Sepsis
For a 30 kg male patient with sepsis, the recommended meropenem dose is 20 mg/kg every 8 hours, which equals 600 mg IV every 8 hours. 1
Dosing Rationale
- The FDA-approved dosing for pediatric patients (which applies to patients weighing under 50 kg) recommends 20 mg/kg every 8 hours for complicated intra-abdominal infections, which is an appropriate regimen for sepsis 1
- For a 30 kg patient, this calculates to 600 mg per dose (30 kg × 20 mg/kg = 600 mg) 1
- Meropenem should be administered intravenously over approximately 15-30 minutes 1
- The maximum dose for this weight would be 1 gram every 8 hours (based on adult dosing for severe infections) 1, 2
Administration Considerations
- Meropenem can be administered as an intravenous infusion over 15-30 minutes 1
- Alternatively, doses can be administered as an intravenous bolus injection over approximately 3-5 minutes 1
- Extended infusion over 3 hours may be considered if treating resistant organisms with MIC ≥ 8 mg/L 2, 3
- For sepsis, maintaining adequate plasma concentrations is critical; continuous infusion has shown tendency for superior bacteriological efficacy compared to intermittent administration 3
Duration of Therapy
- Treatment duration should be 5-7 days for most infections, guided by clinical response 2
- For patients with no identified pathogen who have recovered by day 10, treatment can be discontinued 4
- For specific pathogens like Enterobacteriaceae, treatment should continue for 21 days 4
Special Considerations
- If there is suspicion of extended-spectrum beta-lactamase (ESBL) producing organisms, meropenem remains an appropriate choice 4
- For patients with renal impairment, dosage adjustment is necessary when creatinine clearance is 50 mL/min or less 1
- For sepsis with high minimum inhibitory concentrations (MICs), extended or continuous infusion may improve pharmacodynamic target attainment 5, 3
- Monitor clinical response within 48-72 hours of initiating therapy to assess effectiveness 2
Monitoring
- Assess clinical response within 48-72 hours of initiating therapy 2
- Monitor renal function throughout treatment, as meropenem is primarily eliminated by the kidneys 1
- For patients with changing renal function, dose adjustments may be necessary 1
This dosing recommendation balances the need for adequate antimicrobial coverage in sepsis while considering the patient's weight and the pharmacokinetic properties of meropenem.