Meропенем Аптафарма (Meropenem Trihydrate)

Meropenem is a broad‑spectrum carbapenem used for serious bacterial infections affecting various organ systems.

• Complicated intra‑abdominal infections: provides bactericidal activity against mixed aerobic and anaerobic pathogens to achieve clinical cure.
• Complicated urinary tract infections: eradicates resistant Gram‑negative organisms to resolve infection.
• Hospital‑acquired pneumonia: targets multidrug‑resistant bacteria to improve respiratory outcomes.
• Ventilator‑associated pneumonia: offers coverage of likely pathogens in intubated patients.
• Severe sepsis and septic shock: delivers rapid bacterial killing to support hemodynamic stabilization.

• 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 lysis and bactericidal activity against a wide range of Gram‑positive and Gram‑negative organisms, including many resistant strains.

Adverse reactions may occur with meropenem therapy and are categorized by frequency.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: may be watery and self‑limiting.
• Headache: transient and often resolves without intervention.
• Rash: erythematous skin eruption.
• Elevated liver enzymes: transient increase in transaminases.
• Phlebitis at infusion site: local irritation.

Serious or Rare Side Effects

• Seizures: especially in patients with renal impairment or CNS disease.
• Clostridioides difficile infection: severe colitis risk.
• Anaphylaxis: acute hypersensitivity reaction.
• Severe neutropenia: marked reduction in white blood cells.
• Renal toxicity: acute kidney injury in susceptible individuals.
• Hypersensitivity reactions: including Stevens‑Johnson syndrome.

Meropenem requires careful clinical monitoring to minimize risks.

• Renal impairment: adjust dose based on creatinine clearance.
• Hypersensitivity: avoid in patients with known carbapenem allergy.
• Pregnancy: use only if benefit outweighs potential risk; data are limited.
• Seizure risk: monitor neurologic status, especially in CNS‑compromised patients.
• Superinfection: watch for overgrowth of non‑susceptible organisms.
• Store at ambient temperature: keep in original container, protect from light and moisture.

Meropenem may interact with other medicines, necessitating vigilance.

Major Interactions (Avoid)

• Valproic acid: carbapenems reduce serum valproate levels, risking seizure breakthrough.
• Concurrent carbapenems: additive nephrotoxicity.
• High‑dose aminoglycosides: increased risk of renal toxicity.
• Warfarin: may potentiate anticoagulant effect, requiring INR monitoring.
• Live vaccines: immunosuppression may diminish vaccine efficacy.

Moderate Interactions (Monitor Closely)

• Diuretics: may enhance electrolyte disturbances.
• NSAIDs: potential additive renal effects.
• Oral contraceptives: possible reduction in contraceptive efficacy.
• Phenytoin: may alter plasma concentrations.
• Other antibiotics: risk of antagonism or additive toxicity.