Meropenem

Meropenem is a carbapenem antibiotic for parenteral use which is relatively stable to human dehydropeptidase-1 (DHP-1) and therefore, does not require the addition of an inhibitor of DHP-1. Meropenem exerts its bactericidal action by interfering with vital bacterial cell wall synthesis. In vitro Antibacterial spectrum of meropenem includes the majority of clinically significant gram positive and gram negative, aerobic and anaerobic strains of bacteria.

Meropemem has been studied in many types of infections studied are intra abdominal infections, hospital acguired pneumonia, septicaemia and bacterial meningitis in immonocompetent patients and fever in neutropenic patients, Meropenem has been as effective as more effective than imipenem/cilastation, ceftazidime or ceftriaxone or cefotaxime in meningitis.

Indication:

Meropenem indicated for treatment caused by single or multiple bacteria such as ; Pneunomia including nosocomial pnemonia, urinary tract infections, intra abdominal infections, gynaecological infections. Empiric treatment, for presumed infections in adults patients with febrile neutropenia, used as monotherapy or in combination with antiviral of antifugal agents. Paediactric Use : Efficacy and tolerability in infants under 3 months old have not been established; therefore, Meropenem is not recommended for use below this age. There is no experience in children with altered hepatic or renal function.

here is some clinical and laboratory evidence of partial cross-allergenicity between other carbapenems and beta-lactam antibiotics, penicillines and cephalosphorines. Severe reactions (including anaphylaxis) have been reported with most beta-lactam antibiotics. Before initiating therapy with meropenem, careful enquiry should be made concerning previous hypersensitivity reactions to beta-lactam antibiotics. Meropenem should be used with caution in patients with such a history. If an allergic reaction to meropenem occurs, the drug should be discontinued and appropriate measures taken.

Use of meropenem in patients with hepatic disease should be made with careful monitoring of transaminase and bilirubin levels. As with other antibiotics, overgrowth of non-susceptible organisms may occur and, therefore, continuous monitoring of each patient is necessary.

Use in infections caused by methicillin resistant staphylococcus is not recommended. Rarely, pseudomembranous colitis has been reported on Meropenem as with practically all antibiotics and may vary in severity from slight to life-threatening. Therefore, antibiotics should be prescribed with care for individuals with a history of gastrointestinal complaints, particularly colitis. It is important to consinder the diagnosis of pseudomembranous colitis in the case of patients who develop diarrhoea in association with the use of meropenem. Although studies indicate that a toxin produced by Clostridium difficile is one of the main causes antibiotic-associated colitis, other causes should be considere. The co-administration of meropenem with potentially nephrotoxic drugs should be considered with caution.