Meropenem Trihydrate

Meropenem trihydrate is an antibiotic of the carbapenem class that is used to treat a wide range of bacterial infections. It is effective against Gram-negative and Gram-positive bacteria as well as some anaerobes. It is a broad-spectrum antibiotic used to treat serious infections caused by multidrug-resistant microorganisms. It is a sterile, white to off-white, odorless or nearly odorless, crystalline powder.

Uses For

Meropenem trihydrate is used to treat severe, complicated, or life-threatening bacterial infections of the lungs, urinary tract, skin, soft tissue, and gynecologic infections, septicemia, and meningitis in adults and children.

Mechanism of action

Meropenem trihydrate works by inhibiting the synthesis of the bacterial cell wall, which ultimately leads to cell death. It binds to several penicillin-binding proteins and acts as a competitive inhibitor, limiting the actions of enzymes necessary for the formation of the bacterial cell wall.

How long does it take to work?

The therapeutic effects of meropenem trihydrate can be seen within 1-2 days of starting the antibiotic. However, it can take up to 7-10 days to achieve a full cure.

Absorption

Meropenem trihydrate is rapidly and completely absorbed, reaching peak concentrations in the blood within 1 to 2 hours.

Route of elimination

Meropenem trihydrate is primarily eliminated through the kidneys via glomerular filtration and tubular secretion. Approximately 50-70% of the drug is eliminated unchanged in the urine.

Dosage

The dosage and duration of therapy shall be established depending on type, severity of infection and the condition of the patient. The recommended daily dosage is as follows-

Adults:

The usual dose is 500 mg to 1 gm by intravenous administration every 8 hours.
Pneumonia, urinary tract infections, gynaecological infections such as endometritis, pelvic inflammatory disease, skin and skin structure infections: 500 mg IV every 8 hours.
Nosocomial pneumonias, peritonitis, presumed infections in neutropenic patients and septicaemia: 1 g IV every 8 hours.
Intra-abdominal infections: 500 mg to 1 gm every 8 hours.
Cystic fibrosis: Upto 2 gm every 8 hours.
Meningitis: 2 gm IV every 8 hours.

Children:

3 months to 12 years: 10 to 40 mg/kg intravenously every 8 hours depending on type and severity of infection, susceptibility of the pathogens and the condition of the patient.
Intra-abdominal infections: 20 mg/kg every 8 hours.
Cystic fibrosis (4-18 years): 25-40 mg/kg every 8 hours.
Meningitis: 40 mg/kg IV every 8 hours.
Febrile neutropenia: 20 mg/kg every 8 hours.
Children over 50 kg weight: use adult dosage.
There is no experience in children with hepatic or renal impairment.

The recommended dose of meropenem trihydrate for adults and children is 500-1000 mg intravenously administered every 8 hours. Dosages should be adjusted for patients with kidney or liver impairment.

Administration

Meropenem trihydrate is usually given intravenously every 8 hours over 30 minutes to 60 minutes. For mild or moderate bacterial infections, a single oral dose may be administered.

Side Effect

Common side effects of meropenem trihydrate include headache, diarrhea, nausea, vomiting, abdominal pain, rash, dizziness and convulsions. Rare side effects include kidney damage, anaphylactic shock, and liver damage.

Toxicity

The LD50 of meropenem trihydrate is not known. Overdose of meropenem trihydrate may cause serious side effects including severe allergic reactions, kidney damage, anaphylactic shock, and liver damage.

Precaution

Meropenem trihydrate should not be used in patients with a history of anaphylactic shock or hypersensitivity to meropenem or any other drug within the carbapenem class. Meropenem trihydrate can also interact with other medications, so patients should inform their doctor of all medications they are taking before using this medication.

Interactions

Meropenem trihydrate may interact with other medications, including antibiotics, cephalosporins, diuretics, and probenecid. It also may interact with vitamins, herbal supplements, and over-the-counter medications.

Disease Interaction

Meropenem trihydrate may interact with certain diseases or medical conditions, such as kidney or liver impairment, drug allergies, sickle cell anemia. Patients with such conditions should inform their doctor before using this medication.

Drug Interaction

Drug interactions with meropenem trihydrate may occur when taken with other medications, such as antibiotics, cephalosporins, diuretics, and probenecid. Patients should inform their doctor of any other medications they are taking before starting treatment with this medication.

Food Interactions

No food interactions with meropenem trihydrate have been reported. Patients should discuss with their doctor any dietary changes or restrictions before starting treatment.

Pregnancy Use

Safety and efficacy of meropenem trihydrate in pregnant women have not been established. Women who are pregnant or planning to become pregnant should consult with their healthcare provider before taking this medication.

Lactation Use

It is not known whether meropenem trihydrate is excreted in breast milk. Women who are breastfeeding should consult with their doctor or healthcare provider before taking this medication.

Acute Overdose

Symptoms of an overdose include anaphylaxis, convulsions, and nephrotoxicity. Treatment involves supportive care and drug treatment as appropriate. Dialysis may be necessary in severe cases.

Contraindication

Meropenem trihydrate is contraindicated in patients with a history of anaphylactic shock or hypersensitivity to meropenem or any other drug within the carbapenem class. It should also not be used in pregnant or breastfeeding women or patients with kidney or liver problems.

Use Direction

Meropenem trihydrate should be taken exactly as prescribed by your doctor. Do not take more or less than prescribed or for longer or shorter than prescribed. The medication should be taken at evenly spaced intervals. Make sure to drink ample amounts of fluids during treatment.

Storage Condition

Meropenem trihydrate should be stored at room temperature between 15-30℃ in a tightly sealed container, away from light and moisture. Keep out of reach of children.

Volume of Distribution

The volume of distribution of meropenem trihydrate is 0.4 to 0.9 L/kg, which indicates that the drug is widely distributed in the body.

Half Life

The elimination half-life (t½) of meropenem trihydrate is approximately 1.5-2 hours, which is relatively short compared to other antibiotics.

Clearance

The average systemic clearance of meropenem trihydrate is 0.25 to 0.5 L/kg/hour. The clearance is higher in patients with normal renal function than those with impaired renal function.

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