Meropenem – kdc

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

500 mg – 1 g every 8 hoursHigher doses used in cystic fibrosis and meningitis (up to 2 g every 8 hours)

PHARMACOKINETICS

Molecular weight :437.5

%Protein binding :2

%Excreted unchanged in urine : 70

Volume of distribution (L/kg) :0.351

half-life – normal/ESRD (hrs) :1/6–13.72

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : 500 mg – 2 g every 12 hours

10 to 20 : 500 mg – 1 g every 12 hours or 500 mg every 8 hours

<10 : 500 mg – 1 g every 24 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Dialysed. Dose as in GFR

<10 : mL/min

HD :Dialysed. Dose as in GFR

<10 : mL/min or 1–2 g post dialysis2

HDF/high flux :Dialysed. Dose as in GFR

<10 : mL/min

CAV/VVHD :Dialysed. 0.5–1 g every 8 hours2,3 or 1 g every 12 hours1 CVVhdF1 g every 12 hours3

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsProbenecid: avoid concomitant use

ADMINISTRATION

Reconstition

Add 5 mL water for injection to each 250 mg of meropenem

Route

Rate of Administration

Bolus: 5 minutes IV Infusion: 15–30 minutes

Comments

Further dilute in 50–200 mL sodium chloride 0.9%, glucose 5% or glucose 10% if for infusionStable for 24 hours once reconstituted Minimum volume 1 g in 10 mL. (UK Critical Care Group, Minimum Infusion Volumes for fluid restricted critically ill patients, 3 rd Edition, 2006)

OTHER INFORMATION

Metabolite is inactive and renally excreted Each 1 g vial contains 3.9 mmol of sodium Has less potential to induce seizures than imipenemHas been used intraperitoneally for peritoneal dialysis Pseudomonas peritonitis at concentration of 100 mg/L50% is removed by CVVHF, 13–53% by CVVHDF, 50% by intermittent

HD :.2Differences in renal replacement doses are due to the different flow rates used in the studies

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