Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. commonly, these are "preferred" (on formulary) brand drugs. -Consult physician at once if watery and bloody stools (with or without stomach cramps and fever) develop. Methods and analysis The main objective of this project is to demonstrate the clinical non-inferiority of intravenous fosfomycin with regard to meropenem for treating bacteraemic urinary tract infections (UTI) caused by ESBL-EC. Diseases & Conditions, encoded search term (meropenem (Merrem IV)) and meropenem (Merrem IV), Opportunities to Improve Antibiotic Appropriateness in U.S. ICUs, FDA Panel Recommends Cefiderocol for Complicated UTI, Pleural Effusion as an Atypical Presentation of Kawasaki Disease, Rinse and Repeat? Indications of meropenem. Max: 1 gm/dose. Diseases & Conditions, 2010 Double the dose in meningitis and severe infection. Directions for administration For continuous intravenous infusion , manufacturer advises reconstitute each 1 g (as meropenem) vial to produce a 0.05 g (as meropenem)/mL solution with 20 … The FDA has approved a fixed-dose combination of meropenem, a carbapenem antibiotic, and vaborbactam, a new beta-lactamase inhibitor (Vabomere – Melinta), for IV treatment of adults with complicated urinary tract infections (UTIs) that are proven or strongly suspected to be caused by Escherichia coli, Klebsiella pneumoniae, or Enterobacter cloacae spp. Hemodialysis: Dose (adjusted for eGFR) should be administered after a hemodialysis session. Storage requirements: -The constituted solution must be diluted further (immediately) in a 0.9% Sodium Chloride Injection, USP infusion bag prior to IV infusion. -Powder (prior to constitution): Store vials at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Includes dosages for Skin and Structure Infection, Intraabdominal Infection, Nosocomial Pneumonia and more; plus renal, liver and dialysis adjustments. If 1g q12h is ordered for any other indication, dose will be interchanged to 1g q6h. Monitoring: The decision must take into consideration frequency and severity of UTI versus adverse effects, such as adverse drug reactions, C. difficile colitis, and antibiotic resistance. Administration advice: Data sources include IBM Watson Micromedex (updated 2 Nov 2020), Cerner Multum™ (updated 2 Nov 2020), ASHP (updated 23 Oct 2020) and others. Reference(s) National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. merrem-iv-meropenem-342565 -Do not operate machinery or motorized vehicles until it is reasonably well established that this drug is well tolerated. Indicated as a single agent therapy for the treatment of complicated skin and skin structure infections due to Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pyogenes, Streptococcus agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, and Peptostreptococcus species, 500 mg IV q8hr; not to exceed 2 g IV q8hr, Indicated as a single agent therapy for the treatment of complicated appendicitis and peritonitis caused by viridans group streptococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Bacteroides fragilis, B. thetaiotaomicron, and Peptostreptococcus species, 500 mg IV q8hr for ≤5 days in combination with fluoroquinolone, Indicated as a single agent therapy for the treatment of bacterial meningitis caused by Streptococcus pneumoniae (penicillin susceptible isolates), Haemophilus influenzae, and Neisseria meningitidis, ≥3 months: 40 mg/kg IV q8hr; not to exceed 2 g IV q8hr, ≥3 months: 20 mg/kg IV q8hr; not to exceed 1 g q8hr, ≥3 months: 10 mg/kg IV q8hr; not to exceed 500 mg IV q8hr, Rash (2-3%; includes diaper-area moniliasis in pediatric patients), Oral moniliasis (≤2% in pediatric patients), Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), erythema multiforme and acute generalized exanthematous pustulosis, Hypersensitivity to IV components, beta-lactams, or other drugs in this class, Hypersensitivity reactions have been reported, including fatalities; these reactions are more likely to occur in individuals with history of sensitivity to multiple allergens, Seizures have been reported, most commonly in patients with CNS disorders (eg, brain lesions, history of seizures) or with bacterial meningitis or compromised renal function, Seizures, headaches, or paresthesias may occur, potentially interfering with mental alertness or causing motor impairment, Clostridium difficile-associated diarrhea has been reported, To avoid development of drug resistance, drug should be used only in proven or strongly suspected bacterial infections or a prophylactic indication, Prolonged use may result in overgrowth of nonsusceptible organisms, Thrombocytopenia has been reported in patients with renal impairment, Co-administration of meropenem IV with valproic acid or divalproex sodium reduces serum concentrations of valproic acid potentially increasing risk of breakthrough seizures, Severe cutaneous adverse reactions (SCAR) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), erythema multiforme (EM) and acute generalized exanthematous pustulosis (AGEP) reported; if signs and symptoms suggestive of these reactions appear, therapy should be withdrawn immediately and an alternative treatment considered, There are insufficient human data to establish whether there is a drug-associated risk of major birth defects or miscarriages with meropenem in pregnant women, Drug has been reported to be excreted in human milk; no information is available on effects of drug on breast-fed child or on milk production; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breast-fed child from therapy or from the underlying maternal condition. According to Infectious Disease Physicians, 2010 In 8 patients the drug was administered intravenously in a dose of 1 g every 8 hours and in 4 patients with the creatinine clearance below 50 ml/min it was administered in a dose of 1 g every 12 hours (the treatment course of 7 to 10 days). -Constitute vial(s) with 0.9% Sodium Chloride Injection, USP; mix gently to dissolve. Skin and skin structure infections. Non species related breakpoints are based on the following dosages: EUCAST breakpoints apply to meropenem 1000 mg x 3 daily administered intravenously over 30 minutes as the lowest dose. Your list will be saved and can be edited at any time. Infants <32 weeks GA and PNA <2 weeks: 20 mg/kg IV q12hr, Infants <32 weeks GA and PNA ≥2 weeks: 20 mg/kg IV q8hr, Infants ≥32 weeks GA and PNA <2 weeks: 20 mg/kg IV q8hr, Infants ≥32 weeks GA and PNA ≥2 weeks: 30 mg/kg IV q8hr, No fetal toxicity or malformations were observed in pregnant rats and Cynomolgus monkeys administered intravenous meropenem during organogenesis at doses up to 2.4 and 2.3 times the maximum recommended human dose (MRHD) based on body surface area comparison, respectively; in rats administered intravenous meropenem in late pregnancy and during lactation period, there were no adverse effects on offspring at doses equivalent to approximately 3.2 times the MRHD based on body surface area comparison. We comply with the HONcode standard for trustworthy health information -, Drug class: carbapenems/beta-lactamase inhibitors. {{configCtrl2.info.metaDescription}} This site uses cookies. Pneumonias and nosocomial pneumonia. •2g q8h –Cefepime 2g q 8h allowed only in “neutropenic fever” -Serum creatinine levels and eGFR should be monitored at least daily in patients with changing renal function; the dose of this drug should be adjusted accordingly. provider for the most current information. Adult: In cases of severe pneumonia, complicated UTI, complicated intra-abdominal infections, complicated skin and skin structure infections, gynaecological infections: 0.5-1 g 8 hourly via infusion over approx 15-30 minutes or via bolus inj over approx 3-5 minutes. Burgos RM(1), Biagi MJ(1), Rodvold KA(1)(2), Danziger LH(1)(2). commonly, these are generic drugs. The dog is stable and ready to be discharged from the hospital. If you log out, you will be required to enter your username and password the next time you visit. Meropenem Dosing Substitution • For all adults and children > 50kg (normal renal function*): ... urinary tract infection. By clicking send, you acknowledge that you have permission to email the recipient with this information. Constitute the appropriate number of vials as needed for the dose. -Demonstrated anaphylactic reactions to beta-lactam antibacterial agents -Known hypersensitivity to either active component, any of the ingredients, or other drugs in the same class Four hundred forty-six patients (397 pediatric patients 3 months to less than 17 years of age) were enrolled in 4 separate clinical trials and randomized to treatment with meropenem (n=225) at a dose of 40 mg/kg every 8 hours or a comparator drug, i.e., cefotaxime (n=187) or ceftriaxone (n=34), at the approved dosing regimens. Empiric treatment for presumed infections in adult patients with febrile neutropenia. By continuing to browse this site you are agreeing to our use of cookies. The owner is comfortable giving SQ injections at home. Meningitis and life threatening infections: 40 mg/kg IV every 8 hours. Use: For the treatment of patients with complicated urinary tract infections (including pyelonephritis) due to susceptible Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex. A: Antibiotic prophylaxis may be considered in women with ≥ 2 urinary tract infections in 6 months or ≥ 3 urinary tract infections in 12 months. Use half normal dose every 24 hours if eGFR less than 10 mL/minute/1.73 m 2. This drug is available at a higher level co-pay. Cefiderocol was non-inferior to high-dose, extended infusion meropenem in patients with Gram-negative nosocomial pneumonia, according to a study published in The Lancet Infectious Diseases.. Applies to the following strengths: 1 g-1 g, 4 g IV every 8 hours This drug is available at a middle level co-pay. Meropenem is indicated for the treatment of the following infections in adults and children aged 3 months and older (see sections 4.4 and 5.1): • Severe pneumonia, including hospital and ventilator-associated pneumonia. Manufacturer advises reduce dose to 0.5 g every 12 hours if creatinine clearance less than 10 mL/minute. Should you take probiotics with antibiotics. Please confirm that you would like to log out of Medscape. General: Estimated glomerular filtration rate (GFR) at least 50 mL/min/1.73 m2: No adjustment recommended. We performed a prospective randomized open-label … -Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy. It can be used to treat severe infections of the lower respiratory tract, urinary tract, skin and skin structures, meningitis, septicaemia,febrile neutropenia, intra-abdominal and gynaecological infections. View the formulary and any restrictions for each plan. Urinary concentrations of meropenem in excess of 10 ~glml are maintained for up to 5 hours after the administration of a 500 mg dose. Meropenem is a safe and effective broad-spectrum antibiotic, commonly used in the intensive care unit, and it is a good therapeutic tool for management of severe urinary tract sepsis . Manage and view all your plans together – even plans in different states. Individual plans may vary Peritoneal dialysis: Data not available. Author information: (1)a College of Pharmacy , University of Illinois at Chicago , Chicago , IL , USA. -Avoid missing doses and complete the entire course of therapy. Restaurants May Be Key Component to COVID-19 Spread, 'Breakthrough Finding' Reveals Why Certain COVID Patients Die, Wear a Mask While Having Sex, Canada's Top Doctor Suggests. The easiest way to dilute meropenem is to do 2 vials at a time. Drugs, 2002 Inhibits cell-wall synthesis by binding to penicillin-binding proteins; resistant to most beta-lactamases, Penetrates well into most body fluids and tissues; CSF concentrations approximate those in plasma, Vd: Adults, 15-20 L; children, 0.3-0.4 L/kg, Metabolized in liver to open beta-lactam form (inactive), Half-life: Normal renal function, 1-1.5 hr; CrCl >30-80 mL/min, 1.9-3.3 hr; CrCl >2-30 mL/min, 3.82-5.7 hr, Excretion: Urine (~25% as inactive metabolites), Additive: Amphotericin B, metronidazole, multivitamins, Y-site: Amphotericin B, diazepam, metronidazole, Administer IV infusion over 15-30 minutes; administer IV bolus over 3-5 minutes, Store powder at controlled room temperature. 2 vials are used for 4 g (2 g meropenem and 2 g vaborbactam) dose. Comments: Other polymicrobial infections. 1 vial is used for 2 g (1 g meropenem and 1 g vaborbactam) or 1 g (0.5 g meropenem and 0.5 g vaborbactam) doses. Renal Dose Adjustments <10 one-half unit dose every 24 hours Meropenem is cleared by haemodialysis. The recipient will receive more details and instructions to access this offer. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 2 g x 3 daily was taken into consideration for severe infections and in setting the I/R breakpoint. and formulary information changes. Meropenem 1 g IV q8H should be used for all severe urinary infections if the organism is susceptible. Share cases and questions with Physicians on Medscape consult. Pharmacokinetic evaluation of meropenem and vaborbactam for the treatment of urinary tract infection. This drug is available at a higher level co-pay. 4 g meropenem-vaborbactam contains 2 g meropenem and 2 g vaborbactam This website also contains material copyrighted by 3rd parties. No fetal toxicity or malformations were observed in pregnant rats and Cynomolgus monkeys administered intravenous meropenem during organogenesis at doses up to 2.4 and 2.3 times the maximum recommended human dose (MRHD) based on body surface area comparison, respectively; in rats administered intravenous meropenem in late pregnancy and during lactation period, there were no … Gynecological infections such as endometritis. Detailed Meropenem dosage information for adults and children. Estimated GFR 30 to 49 mL/min/1.73 m2: 2 g IV every 8 hours Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Duration of therapy: Up to 14 days All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Access your plan list on any device – mobile or desktop. 237122-overview Pneumonia, peritonitis, neutropenia, septicemia: 20 mg/kg/dose every 8 hours. Available for Android and iOS devices. Meropenem 8.5 mg/kg SC/IV q 12 (SC) or 8 (IV)h Reserve for treatment of multidrug-resistant infections, particularly those caused by Enterobacteriaceae or Pseudomonas aeruginosa . This drug is available at the lowest co-pay. 966919-overview Appropriate antimicrobial dosing is challenging because of changes in pharmacokinetics (PK) parameters and an increase in multidrug-resistant (MDR) organisms in critically ill patients. Compare formulary status to other drugs in the same class. In this randomized, phase 3, non-inferiority trial, adults aged 18 years or older with hospital-acquired, ventilator- or, healthcare-associated Gram-negative pneumonia were enrolled. -Only compatible with 0.9% Sodium Chloride Injection, USP Measuring plasma drug concentrations may guide clinicians to adjust dosing and achieve therapeutics levels avoiding toxicity and resistance emergence [ 8 ]. Ertapenem 1 g IV q24H can be used for uncomplicated UTI. IV compatibility: Urinary tract infections. A: Generally acceptable. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvbWVycmVtLWl2LW1lcm9wZW5lbS0zNDI1NjU=, View explanations for tiers and Last updated on Nov 20, 2020. Approximately 70% of the administered dose is recovered as unchanged meropenem in the urine over 12 hours, after which little further urinary excretion is detectable. Mouthwash Might Mitigate COVID-19 Spread. 4 g IV every 8 hours Duration of therapy: Up to 14 days Use: For the treatment of patients with complicated urinary tract infections (including pyelonephritis) due to susceptible Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex. commonly, these are "non-preferred" brand drugs. These are the only indications for which this dose is appropriate. Meropenem (Merrem) is an injectable carbapenem and beta-lactam antibiotic that interferes with bacterial cell wall synthesis in sensitive organisms Has activity versus a wide array of organisms, including multi-drug resistant Acinetobacter baumannii, Pseudomonas aeruginosa and … What Is the Risk of Catching the Coronavirus on a Plane? Meropenem Updated September 2016 $48.50 for 500mg $63.50 for 1g Example A 30kg dog has a resistant urinary tract infection that is sensitive to meropenem. meropenem, or cefepime (unless the reaction was to ceftazidime). Use normal dose every 12 hours if eGFR 26–50 mL/minute/1.73 m 2. Drugs, 2002 Klebsiella pneumoniae has been frequently found to produce extended-spectrum β-lactamases (ESBLs).1 Infections caused by ESBL-producing pathogens are problematic because when co-resistance to other antimicrobial class is present, limited antibiotic options are available. CONTRAINDICATIONS: Medically reviewed by Drugs.com. Contact the applicable plan Following a single dose of VABOMERE, pharmacokinetic studies with meropenem and vaborbactam in subjects with renal impairment have shown that meropenem AUC 0-inf ratios to subjects with normal renal function are 1.28, 2.07, and 4.63 for subjects with mild (eGFR of 60 to 89 mL/min/1.73m 2), moderate (eGFR of 30 to 59 mL/min/1.73m 2), and severe (eGFR <30 mL/min/1.73m 2) renal … -Estimated GFR (eGFR) based on the Modification of Diet in Renal Disease equation. Most amoxicillin, doxycycline, ciprofloxacin, Macrobid, Augmentin, levofloxacin. -Renal: Renal function in elderly patients; serum creatinine levels and eGFR in patients with changing renal function (at least daily) For a history of other serious reactions (Type II, III, or IV e.g., hemolytic anemia, – thrombocytopenia, serum sickness, erythema multiforme, SJS/TEN, DRESS, etc), avoid the specifically implicated drug, … 1 g meropenem-vaborbactam contains 0.5 g meropenem and 0.5 g vaborbactam • Broncho-pulmonary infections in cystic fibrosis • Complicated urinary tract … Withdraw 20 mL of 0.9% Sodium Chloride Injection from an infusion bag and constitute each vial. Select one or more newsletters to continue. Ciprofloxacin or TMP/SMX can be used as alternatives to ertapenem for uncomplicated UTI if the organism is susceptible. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. -Administer all doses by IV infusion over 3 hours. informational and educational purposes only. Adding plans allows you to compare formulary status to other drugs in the same class. imipenem MIC of 4mg/L, the meropenem dose should be adjusted to 2 g q8hr. Safety and efficacy have not been established in patients younger than 18 years. 2 g meropenem-vaborbactam contains 1 g meropenem and 1 g vaborbactam The above information is provided for general prescription products. Controlled studies in pregnant women show no evidence of fetal risk. restrictions. Intra-abdominal infections. Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2. Antibiotics & Drinking Alcohol - Is it Safe? This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Meropenem/vaborbactam, sold under the trade name Vabomere among others, is a fixed dose combination drug for the treatment of complicated urinary tract infections.It contains the β-lactam antibiotic meropenem and the β-lactamase inhibitor vaborbactam.In August 2017, the U.S. Food and Drug Administration (FDA) approved it to treat complicated urinary tract infections and pyelonephritis. Max: 500 mg/dose. -Must complete IV infusion of the diluted solution within 4 hours if stored at room temperature or 22 hours if stored refrigerated. Meropenem Merrem ® - Renal dosing. Dose should be automatically adjusted by the pharmacist to 2g q8hr. Most -The manufacturer product information should be consulted. The clinical response rate in UTI at the end of therapy was 93-100% for meropenem 500 mg tds compared with 94-95% for ceftazidime 500 mg tds; for meropenem 500 mg bd it was 97%, significantly higher than that for imipenem/cilastatin 500 mg bd which was 90% (P = 0.03). Dosage and Administration Dosage for Patients with Hospital-acquired Bacterial Pneumonia and Ventilator-associated Bacterial Pneumonia (HABP/VABP) The recommended dose of ZERBAXA in adult patients with HABP/VABP and creatinine clearance (CrCl) greater than 50 mL/min is 3 grams (two 1.5 g vials) over 1-hour period every 8 hours for 8 to 14 days. Nitrofurantoin or fosfomycin may also be used for If continued treatment with MEROPENEM RANBAXY for Injection is necessary, the unit dose (based on the type and severity of infection) is recommended at the completion of the haemodialysis procedure to … This study aimed to evaluate the effects of an empirical therapy of high-dose versus standard-dose meropenem in sepsis and septic shock patients. vabomere-meropenem-vaborbactam-1000130 The clinical and bacteriological efficacies of meropenem in the treatment of 12 patients with urinary tract infection were studied. -Total duration of therapy is for up to 14 days. Examples: 1) Prescriber orders meropenem 1g q8hr in a patient with meningitis. -Compatibility with other drugs not established. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Consult WARNINGS section for dosing related precautions. Most Reconstitution/preparation techniques: Patient advice: -Diluted solution: May store at room temperature or refrigerated at 2C to 8C (36F to 46F); IV infusion must be completed within 4 or 22 hours, respectively. Estimated GFR less than 15 mL/min/1.73 m2: 1 g IV every 12 hours
2020 meropenem dose for uti