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| {{Ampicillin sulbactam}} | | | style="padding: 0 5px; font-size: 100%; background:#696969" align=center | <span style="color:WHITE;"> '''[[Meropenem|Meropenem]]'''</span> |
| {{CMG}}
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| | | ! style="padding: 0 5px; font-size: 85%; background:WHITE" align=left | FDA Package Insert (Merrem®) |
| ==Overview== | | |- |
| '''Meropenem''' is an ultra-broad spectrum injectable [[antibiotic]] used to treat a wide variety of infections, including [[meningitis]] and [[pneumonia]]. It is a [[beta-lactam]] and belongs to the subgroup of [[carbapenem]], similar to [[imipenem]] and [[ertapenem]]. Meropenem was originally developed by [[Sumitomo Pharmaceuticals]]. It is marketed outside Japan by [[AstraZeneca]] with the brand names '''Merrem®''' and '''Meronem®'''. Other brand names include '''Mepem®''' (Taiwan) and '''Meropen®''' (Japan, Korea). It gained [[FDA]] approval in July 1996. It penetrates well into many tissues and body fluids including the [[cerebrospinal fluid]], [[bile]], [[heart valve]]s, [[lung]], and [[peritoneal]] fluid.<ref name=AHFS>{{ cite book | title= AHFS DRUG INFORMATION® 2006 | publisher= American Society of Health-System Pharmacists | date= 2006 | edition= 2006 ed }} </ref> | | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem description|Description]] |
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| ==Category==
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem clinical pharmacology|Clinical Pharmacology]] |
| Carbapenem
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| | | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem microbiology|Microbiology]] |
| ==US Brand Names==
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| Meronem, Merrem<sup>®</sup>
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem indications and usage|Indications and Usage]] |
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| ==FDA Package Insert==
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem contraindications|Contraindications]] |
| '''[[Meropenem description|Description]]'''
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| '''| [[Meropenem clinical pharmacology|Clinical Pharmacology]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem warnings|Warnings]] |
| '''| [[Meropenem microbiology|Microbiology]]'''
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| '''| [[Meropenem indications and usage|Indications and Usage]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem precautions|Precautions]] |
| '''| [[Meropenem contraindications|Contraindications]]'''
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| '''| [[Meropenem warnings|Warnings]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem adverse reactions|Adverse Reactions]] |
| '''| [[Meropenem precautions|Precautions]]'''
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| '''| [[Meropenem adverse reactions|Adverse Reactions]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem overdosage|Overdosage]] |
| '''| [[Meropenem overdosage|Overdosage]]'''
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| '''| [[Meropenem clinical studies|Clinical Studies]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem clinical studies|Clinical Studies]] |
| '''| [[Meropenem dosage and administration|Dosage and Administration]]'''
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| '''| [[Meropenem compatibility reconstitution and stability|Compatibility, Reconstitution, and Stability]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem dosage and administration|Dosage and Administration]] |
| '''| [[Meropenem directions for use|Directions For Use]]'''
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| '''| [[Meropenem how supplied|How Supplied]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem compatibility reconstitution and stability|Compatibility, Reconstitution, and Stability]] |
| '''| [[Meropenem other size packages available|Other Size Packages Available]]'''
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| '''| [[Meropenem labels and packages|Labels and Packages]]'''
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem directions for use|Directions For Use]] |
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| ==Mechanisms of Action==
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem how supplied|How Supplied]] |
| Meropenem exerts its action by penetrating bacterial cells readily and interfering with the synthesis of
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| vital cell wall components, which leads to cell death.
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem other size packages available|Other Size Packages Available]] |
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| ===Mechanism of Effectiveness===
| | ! style="font-size: 80%; padding: 0 5px; background: #DCDCDC" align=left |[[Meropenem labels and packages|Labels and Packages]] |
| Meropenem is bactericidal except against [[Listeria monocytogenes]] where it is bacteriostatic. It inhibits bacterial wall synthesis like other [[beta-lactam]] antibiotics. In contrast to other beta-lactams, it is highly resistant to degradation by [[beta-lactamase]]s or [[cephalosporinase]]s. Resistance generally arises due to mutations in [[penicillin binding proteins]], production of metallo-beta-lactamases, or resistance to diffusion across the bacterial outer membrane.<ref name=Mosby> {{ cite book | title=Mosby's Drug Consult 2006 | publisher= Mosby, Inc. | date= 2006 | edition= 16 ed}} </ref> Unlike [[imipenem]], it is stable to [[dehydropeptidase-1]] and can therefore be given without [[cilastatin]].
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| ===Mechanism of Resistance===
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| There are several mechanisms of resistance to carbapenems: 1) decreased permeability of the
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| outer membrane of Gram-negative bacteria (due to diminished production of porins) causing
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| reduced bacterial uptake, 2) reduced affinity of the target penicillin binding proteins (PBP), 3)
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| increased expression of efflux pump components, and 4) production of antibiotic-destroying
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| enzymes (carbapenemases, metallo-β-lactamases).
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| ===Cross-Resistance===
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| Cross resistance is sometimes observed with isolates resistant to other carbapenems.
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| ==References==
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| {{Reflist|2}}
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| [[Category:Antibiotics]]
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| [[Category:Wikinfect]]
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