MERREM® I. V. (meropenem for injection) is a sterile, pyrogen-free, synthetic, broad-spectrum, carbapenem antibiotic for intravenous administration. It is (4R,5S,6S)-3-[[(3S,5S)-5-(Dimethylcarbamoyl)-3-pyrrolidinyl]thio]-6-[(1R)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2. 0]hept-2-ene-2-carboxylic acid trihydrate.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of MERREM I.V. and other antibacterial drugs, MERREM I.V. should only be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
MERREM I.V. is indicated as single agent therapy for the treatment of the following infections when caused by susceptible isolates of the designated microorganisms:
Skin and Skin Structure Infections
Complicated skin and skin structure infections due to Staphylococcus aureus (β-lactamase and non-β-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.
Bacterial Meningitis (Pediatric patients > 3 months only)
Bacterial meningitis caused by Streptococcus pneumoniae ‡, Haemophilus influenzae (β-lactamase and non-β-lactamase-producing isolates), and Neisseria meningitidis.
‡ The efficacy of meropenem as monotherapy in the treatment of meningitis caused by penicillin nonsusceptible isolates of Streptococcus pneumoniae has not been established.
MERREM I.V. has been found to be effective in eliminating concurrent bacteremia in association with bacterial meningitis.
For information regarding use in pediatric patients (3 months of age and older) see PRECAUTIONS - Pediatrics ADVERSE REACTIONS, and DOSAGE AND ADMINISTRATION sections.
Appropriate cultures should usually be performed before initiating antimicrobial treatment in order to isolate and identify the organisms causing infection and determine their susceptibility to MERREM I.V.
MERREM I.V. is useful as presumptive therapy in the indicated condition (i.e., intra-abdominal infections) prior to the identification of the causative organisms because of its broad spectrum of bactericidal activity.
Antimicrobial therapy should be adjusted, if appropriate, once the results of culture(s) and antimicrobial susceptibility testing are known.
Published Studies Related to Merrem (Meropenem)
Evaluation of the efficacy and safety of intravenous ciprofloxacin versus meropenem in the treatment of postoperative infection. [2011.10.19]
Therapeutic options for postoperative infection in gastrointestinal surgery are limited. To identify new treatment alternatives, the Japan Society for Surgical Infection conducted a multicenter prospective, randomized, controlled clinical trial comparing the efficacy of intravenous ciprofloxacin (CIP IV) and intravenous meropenem (MEM IV).
Comparison of 30-min and 3-h infusion regimens for imipenem/cilastatin and for meropenem evaluated by Monte Carlo simulation. [2010.11]
Imipenem/cilastatin and meropenem are carbapenem antibiotics that are infused intravenously (IV) over 30 to 45 min...
Efficacy of ceftriaxone or meropenem as initial therapies in Whipple's disease. [2010.02]
BACKGROUND & AIMS: Whipple's disease is a chronic infection caused by the actinomycete Tropheryma whipplei. We conducted a randomized controlled trial of the efficacy of antimicrobials that are able to cross the blood-brain barrier and to which T whipplei is susceptible... CONCLUSIONS: This was a randomized controlled trial to show that treatment with ceftriaxone or meropenem, followed by trimethoprim-sulfamethoxazole, cures patients with Whipple's disease. One asymptomatic individual with infection of the cerebrospinal fluid required additional therapy.
Microbiological equivalence of serum bacteriostatic and bactericidal activities of the sera from healthy volunteers receiving original meropenem (Meronem) and generic meropenem (Mero). [2010.01]
CONCLUSION: The sera from healthy volunteers receiving Meronem and Mero had microbiological equivalence in terms of serum bacteriostatic and bactericidal activities.
Meropenem dosing in critically ill patients with sepsis and without renal dysfunction: intermittent bolus versus continuous administration? Monte Carlo dosing simulations and subcutaneous tissue distribution. [2009.07]
OBJECTIVES: To compare the plasma and subcutaneous tissue concentration-time profiles of meropenem administered by intermittent bolus dosing or continuous infusion to critically ill patients with sepsis and without renal dysfunction, and to use population pharmacokinetic modelling and Monte Carlo simulations to assess the cumulative fraction of response (CFR) against Gram-negative pathogens likely to be encountered in critical care units... CONCLUSIONS: This is the first study to compare the relative concentration-time data of bolus and continuous administration of meropenem at the subcutaneous tissue and plasma levels. We found that the administration of meropenem by continuous infusion maintains higher concentrations in subcutaneous tissue and plasma than by intermittent bolus dosing. Administration by extended or continuous infusion will achieve superior CFR against less-susceptible organisms in patients without renal dysfunction.
Clinical Trials Related to Merrem (Meropenem)
Pharmacokinetic Study of Extended Infusion Meropenem in Adult Cystic Fibrosis Patients [Recruiting]
Meropenem is an intravenous antibiotic commonly used to treat acute exacerbation of
respiratory infections in cystic fibrosis. The research study aims to determine if a
different method of infusing the drug over 3 hours or longer, instead of the traditional
half-hour will improve target attainment of drug concentrations and bactericidal activity. A
secondary aim is to assess if the pharmacokinetics of meropenem is different during active
infection compared to non-infective stage. Twelve patients admitted with acute respiratory
infection and who requires meropenem will be enrolled into the study. Meropenem blood
concentrations collected over 8 hours will be measured after half-hour and 3-hour infusions
on different days. A pharmacokinetic modelling and Monte Carlo simulation program will use
the data to assess and predict the optimal method of dosing. When patients return for a
follow-up clinic visit, a single dose of meropenem will be administered and blood
concentrations will be measured to determine the pharmacokinetics during non-infective
A Safety and Tolerability Study of Doripenem Compared With Meropenem in Children Hospitalized With Complicated Intra-abdominal Infections [Recruiting]
The purpose of the study is to evaluate the safety and tolerability of doripenem compared
with meropenem in children hospitalized with complicated intra abdominal infections.
Population Pharmacokinetics of Prolonged Infusion Meropenem in Cystic Fibrosis (CF) Children [Recruiting]
This study will determine the concentrations of the antibiotic meropenem when administered
as a 3 hour prolonged infusion in children with cystic fibrosis who are hospitalized with an
acute pulmonary exacerbation. Safety and practicality of administering meropenem as a 3
hour infusion will be measured.
A Study of Meropenem Standard 30 Minute Infusion Versus Prolonged 3 Hour Infusion in Intensive Care Unit (ICU) Patients [Recruiting]
Meropenem is a powerful antibiotic used in intensive care for people who have very serious
infections. Meropenem is rapidly removed from the blood by the kidneys and it is very
expensive. In very ill patients in intensive care, it is uncertain how best to give this
antibiotic. Studies have suggested that a smaller dose given over a longer period of time,
results in blood levels of meropenem that are just as good as when a higher dose is given
over a shorter period of time. This direct comparison has not been tested in intensive care
patients. It is important to know this because if giving a lesser amount more slowly is
just as good, then doctors will choose to give meropenem this way. To establish whether
this is the case, the investigators plan to conduct an initial (pilot) study in ten
intensive care patients at Austin hospital.
Adult (age 18 years or older) patients in intensive care who have a serious infection being
treated with the antibiotic, meropenem for three days or more will be able to participate in
this study. The decision to start meropenem will be made by the intensive care doctors and
they will give it in the usual way for 24 hours.
The investigators will then in a random way (like tossing of a coin), give the participant
meropenem either in the usual way (1 gram infused over 30 minutes) or give them a smaller
amount, but over a longer period of time (500 milligrams infused over 3 hours). This will
be done for 24 hours. They will then receive meropenem in the alternative way for another
24 hours. After this time the intensive care doctors will decide how meropenem will
continue to be given.
Blood levels of meropenem will be measured to see if they are the same when meropenem is
given in each of the two different ways. During each different way of giving meropenem, 7
blood samples will need to be taken. Ten mls (or one spoonful) of blood will be required
for each measurement. Blood levels will be taken through monitoring lines, which will be
Other information will also be collected about the participant during this study. This will
include their age, gender, height, weight, information about what other medical conditions
they have and measurements of how well their kidneys are functioning.
Pharmacokinetics and Safety of Meropenem in Infants Below 90 Days of Age With Probable and Confirmed Meningitis [Not yet recruiting]
This phase I-II multicenter international trial is designed to study the pharmacokinetics of
meropenem and to characterize the safety profile of meropenem in the treatment of infants ≤
90 days of postnatal age with probable or confirmed bacterial meningitis.
Reports of Suspected Merrem (Meropenem) Side Effects
Drug Interaction (6),
Anticonvulsant Drug Level Decreased (5),
Rash Maculo-Papular (5),
Renal Failure Acute (4),
Drug Level Increased (3),
Laryngeal Oedema (2),
Dyspnoea (2), more >>
Page last updated: 2011-12-09