From the Research
Meropenem is not typically available in oral form; it is administered intravenously or intramuscularly due to poor oral bioavailability. Common side effects of meropenem include diarrhea, nausea, vomiting, headache, rash, and injection site reactions. More serious side effects may include seizures (especially in patients with CNS disorders or renal impairment), Clostridium difficile-associated diarrhea, and allergic reactions including anaphylaxis. Meropenem is contraindicated in patients with known hypersensitivity to carbapenems or with a history of severe immediate hypersensitivity reactions to beta-lactam antibiotics. Caution should be exercised in patients with renal impairment, as dose adjustments are necessary based on creatinine clearance. Patients with a history of seizures or CNS disorders should be monitored closely. Meropenem may interact with valproic acid, reducing its serum levels and potentially decreasing seizure control. The drug crosses the placental barrier and should be used during pregnancy only if clearly needed. Since meropenem is only available in parenteral forms, patients requiring this antibiotic typically need to be in a healthcare setting for administration by qualified personnel.
Key Points to Consider
- The most recent and highest quality study on meropenem use and therapeutic drug monitoring in clinical practice was published in 2021 1.
- Meropenem has a broad spectrum of in vitro activity against Gram-positive and Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae 2.
- The daily dose of meropenem commonly ranged from 3 to 6 g/day, and therapeutic drug monitoring (TDM) is recommended to guide therapy, especially in critically ill patients and those with impaired renal function 1.
- Meropenem is well tolerated and has a favorable safety profile, with common adverse events including diarrhea, rash, and nausea/vomiting 3, 4.
- The drug is contraindicated in patients with known hypersensitivity to carbapenems or with a history of severe immediate hypersensitivity reactions to beta-lactam antibiotics.
Administration and Monitoring
- Meropenem should be administered intravenously or intramuscularly, and patients requiring this antibiotic typically need to be in a healthcare setting for administration by qualified personnel.
- Patients with renal impairment should be monitored closely, and dose adjustments should be made based on creatinine clearance.
- Patients with a history of seizures or CNS disorders should be monitored closely, and meropenem may interact with valproic acid, reducing its serum levels and potentially decreasing seizure control.