Meropenem Qilu (Meropenem)

Meropenem is a carbapenem antibiotic used to treat serious bacterial infections, particularly those involving the urinary tract when administered intravesically.

• Complicated urinary tract infection: eradicates susceptible Gram‑negative and Gram‑positive pathogens in the bladder.
• Catheter‑associated urinary infection: provides high local concentrations to treat biofilm‑related bacteria.
• Acute bacterial cystitis: reduces bacterial load and alleviates symptoms in resistant infections.

• 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 lysis. Its broad spectrum includes many Gram‑negative, Gram‑positive and anaerobic organisms, making it effective against multidrug‑resistant pathogens.

Common Side Effects

• Nausea: mild to moderate gastrointestinal discomfort.
• Diarrhea: may be watery and self‑limiting.
• Headache: transient and usually resolves without intervention.
• Injection site pain: local discomfort at the administration site.
• Elevated liver enzymes: transient increase in hepatic transaminases.
• Rash: mild skin erythema or pruritus.

Serious or Rare Side Effects

• Seizures: especially in patients with renal impairment or CNS disorders.
• Anaphylaxis: acute, potentially life‑threatening hypersensitivity reaction.
• Clostridioides difficile colitis: severe diarrhea due to bacterial overgrowth.
• Severe neutropenia: marked reduction in white blood cells.
• Renal impairment: acute kidney injury in susceptible individuals.
• Hypersensitivity reactions: including Stevens‑Johnson syndrome.

Meropenem should be used with caution in specific clinical situations.

• Renal function: adjust dose in patients with impaired renal clearance.
• Allergy: avoid in individuals with known hypersensitivity to carbapenems or other β‑lactam antibiotics.
• Seizure risk: monitor patients with a history of seizures or central nervous system disorders.
• Pregnancy: consider only if potential benefits outweigh potential risks.
• Antibiotic stewardship: limit use to infections confirmed or strongly suspected to be caused by susceptible organisms.
• Store at below 25°C: keep in the original container, protect from moisture and light.

Meropenem may interact with other medicines, requiring careful management.

Major Interactions (Avoid)

• Valproic acid: increased risk of seizures when combined.
• Probenecid: may reduce renal clearance of meropenem, raising plasma levels.
• Cytotoxic chemotherapy agents: potential for enhanced toxicity.

Moderate Interactions (Monitor Closely)

• Loop diuretics: may affect renal excretion and electrolyte balance.
• Aminoglycosides: additive nephrotoxic potential.
• Anticoagulants (e.g., warfarin): monitor INR as meropenem can alter anticoagulant effect.