Brands, Medical Use, Clinical Data
- Antibacterials for Systemic Use
- Powder for solution (for injection)
Brands / Synonyms
Antibiotic SM 7338; Meropenem anhydrous; Meropenem, anhydrous; Meropenemum [INN-Latin]; Merrem; Merrem I.V.; Merrem I.V.
For use as single agent therapy for the treatment of the following infections when caused by susceptible isolates of the designated microorganisms: complicated skin and skin structure infections due to Staphylococcus aureus (b-lactamase and non-b-lactamase producing, methicillin-susceptible isolates only), Streptococcus pyogenes, Streptococcus agalactiae, viridans group streptococci, Enterococcus faecalis (excluding vancomycin-resistant isolates), Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis and Peptostreptococcus species; complicated appendicitis and peritonitis caused by viridans group streptococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Bacteroides fragilis, B. thetaiotaomicron, and Peptostreptococcus species. Also for use in the treatment of bacterial meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (b-lactamase and non-b-lactamase-producing isolates), and Neisseria meningitidis.
Meropenem is a broad-spectrum carbapenem antibiotic. It is active against Gram-positive and Gram-negative bacteria. Meropenem exerts its action by penetrating bacterial cells readily and interfering with the synthesis of vital cell wall components, which leads to cell death.
Mechanism of Action
The bactericidal activity of meropenem results from the inhibition of cell wall synthesis. Meropenem readily penetrates the cell wall of most Gram-positive and Gram-negative bacteria to reach penicillin-binding- protein (PBP) targets. Its strongest affinities are toward PBPs 2, 3 and 4 of Escherichia coli and Pseudomonas aeruginosa; and PBPs 1, 2 and 4 of Staphylococcus aureus.
In mice and rats, large intravenous doses of meropenem (2200-4000 mg/kg) have been associated with ataxia, dyspnea, convulsions, and mortalities.
Biotrnasformation / Drug Metabolism
Primarily excreted unchanged. There is one metabolite which is microbiologically inactive.
MERREM I.V. is contraindicated in patients with known hypersensitivity to any component of this product or to
other drugs in the same class or in patients who have demonstrated anaphylactic reactions to b-lactams.
Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal excretion of
meropenem. This led to statistically significant increases in the elimination half-life (38%) and in the extent of
systemic exposure (56%). Therefore, the coadministration of probenecid with meropenem is not recommended.
There is evidence that meropenem may reduce serum levels of valproic acid to subtherapeutic levels (therapeutic
range considered to be 50 to 100 µg/mL total valproate).