Carbapenem·Infectious Diseases - Other Antibiotics

Meropenem

ESBL-producing intra-abdominal/urinary sepsis, severe hospital-acquired pneumonia, bacterial meningitis

CARBAPENEMMerrem500 mgS4TGA

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

6 g/day

Half-life

1 h

High risk: Valproate

CRITICAL

Caution: Seizure

RISK

Cautions

Avoid / Cautions

Anaphylaxis to carbapenems. Pregnancy Category B2.

Where it stands

Rapid Summary

Overview

Ultra-broad-spectrum carbapenem antibiotic. Resistant to almost all beta-lactamases including ESBLs. Highly restricted reserve agent.

Clinical Focus

Destroys Sodium Valproate blood levels. Co-administration guarantees breakthrough seizures in epileptic patients.

Bottom Line

Meropenem is the broadest-spectrum carbapenem reserved for multi-resistant and life-threatening infections, but must be used as last resort to prevent carbapenem resistance and lowers the seizure threshold.

Formulation & Access

Brand Names

Merrem

Parenteral

Ampoules (500 mg, 1 g) for IV injection/infusion.

Prescribing & PBS

Hospital supply. Strictly governed by Antimicrobial Stewardship.

Indications & Use

Primary

TGA

ESBL-producing intra-abdominal/urinary sepsis, severe hospital-acquired pneumonia, bacterial meningitis.

Clinical Place

Last line of defense against highly resistant Gram-negative organisms. Do not use for simple CAP or cellulitis.

Quick reference

Class & Role

Carbapenem — Ultra-broad-spectrum carbapenem antibiotic.

Route / Formulation

Ampoules (500 mg, 1 g) for IV injection/infusion. (Merrem)

Usual Dose & Max

IV 1 g q8h. Max 6 g/day (For severe meningitis).

Key Indication Doses

Severe Sepsis / ESBL: IV 1 g q8h. Bacterial Meningitis: IV 2 g q8h (To ensure adequate BBB penetration). Renal Impairment: If eGFR 10-25, give 1g q12h. If eGFR < 10, give 500mg q24h.

Best Uses

Key Risks

Neurological: Can lower seizure threshold (though significantly safer than Imipenem). Gastrointestinal: C. difficile infection, nausea, diarrhea. Immunological: Cross-reactivity with true IgE penicillin allergy is very low (~1%), but caution is required.

Key Interactions

Sodium Valproate (Epilim). Meropenem rapidly accelerates the hepatic breakdown of Valproate. Blood levels drop to zero within 24 hours. The interaction cannot be overcome by increasing Valproate dose. Use alternative antibiotic or antiepileptic.

Monitoring

Monitor U&E and eGFR to guide dose reduction. Monitor LFTs. Monitor for neurological signs/seizures in patients with severe renal failure (accumulation risk).

Clinical Pearl

Like Piperacillin/Tazobactam, running Meropenem over 3-4 hours instead of a 30-minute bolus massively increases the 'Time above MIC', providing significantly better clinical cure rates in critical ICU patients.

Access

Merrem

Brand: Merrem

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Carbapenem·Infectious Diseases - Other Antibiotics

Meropenem

ESBL-producing intra-abdominal/urinary sepsis, severe hospital-acquired pneumonia, bacterial meningitis

CARBAPENEMMerrem500 mgS4TGA

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

6 g/day

Half-life

1 h

High risk: Valproate

CRITICAL

Caution: Seizure

RISK

Cautions

Avoid / Cautions

Anaphylaxis to carbapenems. Pregnancy Category B2.

Where it stands

Rapid Summary

Overview

Ultra-broad-spectrum carbapenem antibiotic. Resistant to almost all beta-lactamases including ESBLs. Highly restricted reserve agent.

Clinical Focus

Destroys Sodium Valproate blood levels. Co-administration guarantees breakthrough seizures in epileptic patients.

Bottom Line

Formulation & Access

Brand Names

Merrem

Parenteral

Ampoules (500 mg, 1 g) for IV injection/infusion.

Prescribing & PBS

Hospital supply. Strictly governed by Antimicrobial Stewardship.

Indications & Use

Primary

TGA

ESBL-producing intra-abdominal/urinary sepsis, severe hospital-acquired pneumonia, bacterial meningitis.

Clinical Place

Last line of defense against highly resistant Gram-negative organisms. Do not use for simple CAP or cellulitis.

Quick reference

Class & Role

Carbapenem — Ultra-broad-spectrum carbapenem antibiotic.

Route / Formulation

Ampoules (500 mg, 1 g) for IV injection/infusion. (Merrem)

Usual Dose & Max

IV 1 g q8h. Max 6 g/day (For severe meningitis).

Key Indication Doses

Severe Sepsis / ESBL: IV 1 g q8h. Bacterial Meningitis: IV 2 g q8h (To ensure adequate BBB penetration). Renal Impairment: If eGFR 10-25, give 1g q12h. If eGFR < 10, give 500mg q24h.

Best Uses

Key Risks

Key Interactions

Monitoring

Monitor U&E and eGFR to guide dose reduction. Monitor LFTs. Monitor for neurological signs/seizures in patients with severe renal failure (accumulation risk).

Clinical Pearl

Access

Merrem

Brand: Merrem

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.