Rx Update: May 1999
Mary Ross, R.Ph., M.B.A.
Peer Review Status: Internally Reviewed
Meropenem should be used with extreme caution in patients who have had a previous Type I hypersensitivity reaction with penicillins, cephalosporins, or other beta-lactam antibiotics. Administration of this drug with probenecid should be avoided as it has been found to inhibit the renal excretion of meropenem.
Various local injection site reactions were reported in approximately 6% of patients. Other adverse effects include: diarrhea (5%), nausea and vomiting (3.9%), headache (2.8%), rash (1.7%), pruritus (1.6%), apnea (1.2%), and constipation (1.2%). Seizures and other CNS adverse effects have also been reported with the use of meropenem; they occur more commonly in patients with pre-existing CNS disease (e.g., brain lesions or a history of seizure activity), and/or decreased renal function.
The recommended adult dose of meropenem is 500 mg to 1000 mg given IV every 8 hours. For children who weigh less than 50 kg, the recommended dosing range is from 20 mg/kg/dose to 40 mg/kg/dose (for meningitis; maximum dose of 2 grams) every 8 hours depending on the severity of the infection. Downward dosage adjustments are required in patients with renal impairment. Meropenem 500 mg and 1000 mg doses are administered in 50 ml and 100 ml of 0.9% NaCl, respectively. Doses are infused over 15 to 30 minutes.