Meropenem Inresa (Meropenem Trihydrate)

Meropenem is a broad‑spectrum carbapenem used for serious bacterial infections in the hospital setting.

• Complicated intra‑abdominal infections: provides bacterial eradication in severe abdominal sepsis.
• Complicated urinary tract infections: eliminates resistant uropathogens causing kidney and bladder infections.
• Nosocomial pneumonia: treats hospital‑acquired lung infections resistant to other antibiotics.
• Septicemia: rapidly clears bloodstream infections caused by Gram‑negative and Gram‑positive bacteria.
• Meningitis: penetrates the cerebrospinal fluid to treat bacterial meningitis.

• Meropenem binds to penicillin‑binding proteins (PBPs) on bacterial cell walls, inhibiting the final transpeptidation step of peptidoglycan synthesis. This disruption weakens the cell wall, leading to osmotic instability and bacterial cell death. Its high affinity for a broad range of PBPs gives it activity against many Gram‑negative, Gram‑positive and anaerobic organisms, including those resistant to other beta‑lactams.

Adverse reactions may occur with meropenem therapy.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhea: may be watery and self‑limiting.
• Rash: skin redness or itching.
• Headache: transient headache during treatment.
• Elevated liver enzymes: mild, reversible increase in transaminases.
• Injection site pain: discomfort at the IV site.

Serious or Rare Side Effects

• Seizures: especially in patients with renal impairment or CNS disorders.
• Clostridioides difficile‑associated diarrhea: severe colitis requiring medical attention.
• Anaphylaxis: acute allergic reaction with respiratory and circulatory compromise.
• Stevens‑Johnson syndrome/toxic epidermal necrolysis: severe skin reactions.
• Neutropenia: marked reduction in white blood cells.
• Acute renal failure: worsening kidney function in susceptible individuals.

Use meropenem with careful clinical monitoring and consider patient‑specific factors.

• Renal function: adjust dose in patients with impaired renal clearance.
• Allergy: avoid in individuals with known hypersensitivity to carbapenems or other beta‑lactams.
• Pregnancy: prescribe only if the potential benefit justifies the potential risk to the fetus.
• Valproic acid co‑administration: monitor for reduced valproate levels and possible seizure breakthrough.
• Seizure risk: observe patients with a history of CNS disorders for neurologic signs.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Meropenem may interact with other medicines; some require avoidance while others need monitoring.

Major Interactions (Avoid)

• Valproic acid: meropenem reduces plasma valproate concentrations, increasing seizure risk.
• Probenecid: may decrease renal clearance of meropenem, leading to higher systemic exposure.

Moderate Interactions (Monitor Closely)

• Loop diuretics: combined use may heighten nephrotoxicity.
• Aminoglycosides: additive risk of kidney injury when given together.
• Warfarin: monitor INR as meropenem can alter anticoagulant effect.
• CNS stimulants (e.g., caffeine, theophylline): may lower seizure threshold.