Meropenem
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-MEROPENEM |
|---|---|
| Type | Drug |
| Aliases | MeronemMerremМеропенем |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 SRC-NCCN-MM-2025 |
Drug Facts
| Class | Carbapenem β-lactam antibiotic (broad-spectrum, MDR coverage) |
|---|---|
| Mechanism | Broad-spectrum carbapenem β-lactam that binds multiple penicillin- binding proteins (PBP-2 primarily, also PBP-3 and -1) with rapid bactericidal activity against most Gram-negative bacilli (including ESBL-producing Enterobacterales, AmpC overproducers, and many Pseudomonas), Gram-positive cocci (except MRSA, ampicillin-resistant enterococci), and most anaerobes including Bacteroides fragilis. Extremely stable against most β-lactamases including ESBLs and AmpC, but hydrolyzed by carbapenemases (KPC, NDM, OXA-48, VIM, IMP). Lower seizure-risk than imipenem (no DHP-1 inhibitor needed; reduced PBP-2 affinity in CNS). FDA-approved 1996. Reserved for documented or strongly suspected MDR Gram-negative infections, severe sepsis with broad-spectrum coverage need, and FN failing initial empirical therapy at 72-96 hours. |
| Typical dosing | Febrile neutropenia / severe sepsis (adult): 1 g IV every 8 hours via 30-min infusion OR 2 g IV q8h via 3-hour prolonged infusion for severe Pseudomonas or MDR coverage. Bacterial meningitis: 2 g IV q8h. Pediatric (≥3 months): 20-40 mg/kg IV q8h (60 mg/kg q8h for meningitis), max 2 g per dose. Renal adjustment required: CrCl 26-50 → 1 g q12h; CrCl 10-25 → 0.5 g q12h; CrCl <10 → 0.5 g q24h; hemodialysis → 0.5 g q24h with dose after dialysis; CRRT → 1 g q12h (or 1 g q8h for high-flow). Hepatic: no adjustment. Duration in FN: until ANC recovery and afebrile ≥48 h, typically 7-14 days; in MDR documented infections, 10-14 days. Prolonged infusion (3 h) preferred for critically ill patients to op... |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Notes
Reserve antibiotic — escalation choice in febrile neutropenia after 72-96 hours of empirical pip-tazo or cefepime without clinical improvement, and first-line for documented or strongly suspected MDR Gram-negative infection (ESBL Enterobacterales, AmpC overproducers, Pseudomonas with broad resistance). Antimicrobial stewardship critical: prolonged carbapenem use selects for carbapenem-resistant organisms (KPC, NDM, OXA-48). CRITICAL interaction: meropenem dramatically reduces valproate levels (60-100% drop within hours) — patients on valproate for seizures or mood stabilization need a switch to levetiracetam BEFORE meropenem start, with overlap of 2-3 days. Lower seizure risk than imipenem, but still elevated with renal dysfunction and CNS pathology — meticulous renal dosing required. Avoid in uncomplicated indications where pip-tazo or cefepime suffices. Ukraine: widely available, NSZU-covered for critical infections.
Used By
No reverse references found in the YAML corpus.