Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
Meropenem
Indication
- Carbapenem antibiotic used to treat sepsis and meningitis caused by multidrug-resistant gram-negative and gram-positive aerobic and anaerobic bacteria including E. coli, Serratia and Pseudomonas aeruginosa
- The Paediatric Infectious Disease Service is automatically notified when a patient is prescribed meropenem
Dosage Guidelines
- Meningitis:
- 40 mg/kg/dose IV q8h
- Sepsis:
- 0 to 7 days: 20 mg/kg/dose IV q12h
- Greater than 7 days: 20 mg/kg/dose IV q8h
Administration
- IV intermittent slow infusion over 30 minutes (20 mg/mL concentration)
- To make 20 mL of a 20 mg/mL solution:
- Reconstitution: add 10 mL sterile water for injection to 500 mg vial (concentration = 50 mg/mL) Solution is stable for 3 hours at room temperature.
- Draw up 8 mL of 50 mg/mL reconstituted solution and add to 12 mL of normal saline to make a total volume of 20 mL (final concentration = 20 mg/mL)
- IV direct over 3-5 minutes (50 mg/mL concentration)
Adverse Effects
- Thrombophelbitis, diarrhea, rash, anemia, leukopenia, neutropenia, hypoglycemia
- May cause elevations in AST, ALT, ALP, bilirubin, urea and serum creatinine
Comments
- Consult pharmacist for dosing in renal impairment
Supplied As
- 500 mg vial (powder)
- 20 mg/mL patient specific syringe, prepared by Pharmacy