Meropenem Kabi (Meropenem Trihydrate)

• Meropenem is a broad‑spectrum carbapenem antibiotic used to treat infections caused by susceptible Gram‑negative and Gram‑positive bacteria.
• Complicated intra‑abdominal infections: effective in treating severe intra‑abdominal infections caused by susceptible organisms.
• Complicated urinary tract infections: eradicates pathogens in complicated UTIs, including pyelonephritis.
• Hospital‑acquired pneumonia: clears bacterial pneumonia acquired during hospital stay.
• Ventilator‑associated pneumonia: resolves pneumonia in mechanically ventilated patients.
• Meningitis: penetrates the cerebrospinal fluid to treat bacterial meningitis.
• Severe sepsis and septic shock: provides rapid bacterial clearance in life‑threatening sepsis.

• Meropenem binds with high affinity 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. The molecule is resistant to most β‑lactamases, giving it activity against a wide range of Gram‑negative, Gram‑positive and anaerobic organisms.

Meropenem may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea or vomiting
• Diarrhoea, including mild C. difficile‑associated colitis
• Headache
• Rash or mild skin erythema
• Infusion‑site phlebitis or pain
• Transient elevation of liver enzymes

Serious or Rare Side Effects

• Seizures, especially in patients with renal impairment or CNS disease
• Severe C. difficile infection leading to colitis
• Anaphylactic or anaphylactoid reactions
• Neutropenia or agranulocytosis
• Renal toxicity or worsening renal function
• Severe hypersensitivity reactions such as Stevens‑Johnson syndrome

• When using Meropenem, clinicians should consider several safety precautions to minimise risk.
• Renal function: adjust dose in patients with impaired renal clearance.
• Hepatic impairment: monitor liver enzymes during prolonged therapy.
• Allergy history: avoid in patients with known hypersensitivity to carbapenems or other β‑lactams.
• Pregnancy and lactation: use only if potential benefit justifies potential risk.
• Concomitant valproic acid: monitor for reduced valproate levels and increased seizure risk.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Meropenem can interact with other medicines, affecting efficacy or safety.

Major Interactions (Avoid)

• Valproic acid: may lower serum valproate concentrations and precipitate seizures.
• Probenecid: can increase meropenem plasma levels, raising toxicity risk.
• Cytotoxic agents (e.g., cisplatin): additive nephrotoxicity.

Moderate Interactions (Monitor Closely)

• Loop diuretics: monitor renal function and electrolytes.
• Aminoglycosides: watch for combined nephrotoxic effects.
• NSAIDs: assess renal function during co‑administration.
• Warfarin: monitor INR for potential anticoagulant effect changes.