You are here: Urology Textbook > Drugs in Urology > Meropenem
Meropenem: Mechanism of Action, Side Effects and Dosage
Meropenem is a broad-spectrum beta-lactam antibiotic from the carbapenem group and is effective against a broad spectrum of both gram-positive and gram-negative bacteria.
Mechanism of Action:
Meropenem inhibits the peptidoglycan synthesis of the bacterial wall: it binds to so-called penicillin-binding proteins (peptidoglycan synthetases) and inhibits the polymerization of the peptidoglycan and covalent cross-linking of the bacterial wall. Meropenem is very stable against beta-lactamases, including ESBL.
Antibiotic Spectrum of Meropenem:
A broad spectrum of activity against both gram-positive and gram-negative bacteria, including Pseudomonas, enterococci, and anaerobes. Compared to imipenem, it has a broader antibiotic spectrumin against gram-negative bacteria, but is somewhat weaker in against gram-positive bacteria (such as enterococci).
Urological Indications for Meropenem:
Reserve antibiotic for severe complicated urinary tract infections (pyelonephritis, catheter-associated infections, prostatitis, epididymitis) and urosepsis, after the failure of other broad-spectrum antibiotics or for treatment of multi-resistant bacteria.
Pharmacokinetics of Meropenem:
- Only intravenous administration is possible.
- Half-life 1 hour, minimal hepatic metabolism, unchanged renal excretion in 70%.
Side Effects of Meropenem
Meropenem is better tolerated than imipenem.
- Frequent diarrhea, vomiting, and nausea. Rare pseudomembranous colitis.
- Allergic reactions occur in 1–3%, with a low risk of cross-allergy to penicillin or cephalosporins.
- CNS: Tremor, myoclonus, epilepsy, confusion, dizziness. Meronem causes fewer neurotoxic side effects than imipenem.
- Positive direct Coombs test, very rare hemolytic anemia or leukopenia.
- Drop in blood pressure with rapid intravenous administration.
- Hepatotoxicity is possible.
Drug Interactions:
Meropenem lowers the valproic acid level. An increase in INR is possible when given together with warfarin.
Contraindications:
Allergy to carbapenems, history of seizures, or CNS disorders. Use with caution in cases of allergy to penicillin or cephalosporins or during pregnancy.
Dosage of Meropenem
- 500–1000 mg meronem 1-1-1 (every 8 hours) for adults, depending on the severity of the infection.
- Children receive 10–20 mg/kg body weight every 8 hours.
- A dose reduction is necessary in cases of renal insufficiency: the maximum dose of meronem is 1000 mg every 12 hours for a GFR of 50–25 ml/min, 500 mg every 12 hours for a GFR of 25–10 ml/min, and 500 mg every 24 hours for a GFR below 10 ml/min.
Imipenem | Index | Gentamicin |
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
References
Simon und Stille 1997 SIMON, C. ; STILLE, W.:
Antibiotika-Therapie in Klinik und Praxis.
9. Auflage.
Stuttgart New York : Schattauer, 1997
Deutsche Version: Pharmakologie und Nebenwirkungen von Meropenem
Urology-Textbook.com – Choose the Ad-Free, Professional Resource
This website is designed for physicians and medical professionals. It presents diseases of the genital organs through detailed text and images. Some content may not be suitable for children or sensitive readers. Many illustrations are available exclusively to Steady members. Are you a physician and interested in supporting this project? Join Steady to unlock full access to all images and enjoy an ad-free experience. Try it free for 7 days—no obligation.