Meropenem: Difference between revisions

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{{drugbox
__NOTOC__
| IUPAC_name = 3-[5-(dimethylcarbamoyl) pyrrolidin-2-yl] sulfanyl-6- (1-hydroxyethyl)-4-methyl-7-oxo- 1-azabicyclo[3.2.0] hept-2-ene-2-carboxylic acid
{{Meropenem}}
| image = Meropenem.svg
{{CMG}}
| CAS_number = 119478-56-7
| ATC_prefix = J01
| ATC_suffix = DH02
| ATC_supplemental =
| PubChem = 64778
| DrugBank = APRD01097
| C = 17 | H = 25 | N = 3 | O = 5 | S = 1
| molecular_weight = 383.464 g/mol
| bioavailability = 100%
| protein_bound = Approximately 2%.
| metabolism =
| elimination_half-life = 1 hour
| excretion = [[Kidney|Renal]]
| pregnancy_category = B
| legal_status = ℞-only <small>(U.S.)</small>
| routes_of_administration = IV
}}
{{SI}}


==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&reg;''' and '''Meronem&reg;'''. Other brand names include '''Mepem&reg;''' (Taiwan) and'''Meropen&reg;''' (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>


'''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&reg;''' and '''Meronem&reg;'''. Other brand names include '''Mepem&reg;''' (Taiwan) and '''Meropen&reg;''' (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>
==Category==
'''Carbapenems
'''
==US Brand Names==
Merrem


== Mechanism of action ==  
==FDA Package Insert==
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]].
'''[[Meropenem description|Description]]'''
'''| [[Meropenem clinical pharmacology|Clinical Pharmacology]]'''
== Indications ==
'''| [[Meropenem microbiology|Microbiology]]'''
The spectrum of action includes many [[gram-positive]] and [[gram-negative]] bacteria and even some [[anaerobic]] bacteria. The overall spectrum is similar to [[imipenem]] although meropenem is more active against [[Enterobacteriaceae]] and less active against gram-positive bacteria. It is also very resistant to extended-spectrum [[beta lactamase]]s but may be more susceptible to metallo-beta-lactamases.<ref name=AHFS/> However, meropenem should <b>not</b> be used to treat [[MRSA]] infections.
'''| [[Meropenem indications and usage|Indications and Usage]]'''
'''| [[Meropenem contraindications|Contraindications]]'''
'''| [[Meropenem warnings|Warnings]]'''
'''| [[Meropenem precautions|Precautions]]'''
'''| [[Meropenem adverse reactions|Adverse Reactions]]'''
'''| [[Meropenem overdosage|Overdosage]]'''
'''| [[Meropenem clinical studies|Clinical Studies]]'''
'''| [[Meropenem dosage and administration|Dosage and Administration]]'''
'''| [[Meropenem compatibility reconstitution and stability|Compatibility, Reconstitution, and Stability]]'''
'''| [[Meropenem directions for use|Directions For Use]]'''
'''| [[Meropenem how supplied|How Supplied]]'''
'''| [[Meropenem other size packages available|Other Size Packages Available]]'''
'''| [[Meropenem labels and packages|Labels and Packages]]'''


== Administration ==
== Mechanism of action ==
Meropenem must be administered [[intravenous]]ly. It is supplied as a white crystalline powder to be dissolved in 5% monobasic potassium phosphate solution.  
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]].


== Common adverse effects ==  
==References==
The most common adverse effects are [[diarrhea]] (4.8%), [[nausea]] and [[vomiting]] (3.6%), injection-site inflammation (2.4%), [[headache]] (2.3%), [[rash]] (1.9%), and [[thrombophlebitis]] (0.9%).<ref name=Mosby/> Many of these adverse effects were observed in the setting of severely ill individuals who were already taking many medications. Meropenem also has a reduced potential for causing seizures in comparison with [[imipenem]].
{{Reflist|2}}


== References ==
[[Category:Antibiotics]]
<div class="references-small" ><references/></div>
[[Category:Wikinfect]]
<br style="clear: both;" />
 
{{CephalosporinAntiBiotics}}
[[Category:Carbapenem antibiotics]]
 
[[zh:美羅培南]]
{{WH}}
{{WikiDoc Sources}}

Revision as of 20:26, 20 December 2013

Meropenem
MERREM® FDA Package Insert
Description
Clinical Pharmacology
Microbiology
Indications and Usage
Contraindications
Warnings
Precautions
Adverse Reactions
Overdosage
Clinical Studies
Dosage and Administration
Compatibility, Reconstitution, and Stability
How Supplied
Labels and Packages

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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) andMeropen® (Japan, Korea). It gained FDA approval in July 1996. It penetrates well into many tissues and body fluids including the cerebrospinal fluid,bile, heart valves, lung, and peritoneal fluid.[1]

Category

Carbapenems

US Brand Names

Merrem

FDA Package Insert

Description | Clinical Pharmacology | Microbiology | Indications and Usage | Contraindications | Warnings | Precautions | Adverse Reactions | Overdosage | Clinical Studies | Dosage and Administration | Compatibility, Reconstitution, and Stability | Directions For Use | How Supplied | Other Size Packages Available | Labels and Packages

Mechanism of action

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-lactamases or cephalosporinases. Resistance generally arises due to mutations inpenicillin binding proteins, production of metallo-beta-lactamases, or resistance to diffusion across the bacterial outer membrane.[2] Unlike imipenem, it is stable to dehydropeptidase-1 and can therefore be given without cilastatin.

References

  1. AHFS DRUG INFORMATION® 2006 (2006 ed ed.). American Society of Health-System Pharmacists. 2006.
  2. Mosby's Drug Consult 2006 (16 ed ed.). Mosby, Inc. 2006.