There are no established dose recommendations for patients receiving peritoneal dialysis. -Complicated infections due to Pseudomonas aeruginosa: 1 g IV every 8 hours 72 × serum creatinine (mg/dL). We comply with the HONcode standard for trustworthy health information -. Consider IVIg. IDSA recommendations: Once-daily administration of gentamicin is safe and effective for most patients. British National Formulary - BNF (Add filter) 15 October 2020 Indications, dose, contra-indications, side-effects, interactions, cautions, warnings and other safety information for MEROPENEM WITH VABORBACTAM. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Maximum dose: 1 g/dose CrCl 10 to 25 mL/min: One-half recommended dose every 12 hours IV compatibility: -Renal: Renal organ system functions (periodically during prolonged therapy); renal function in elderly patients bolus, add 10 ml of sterile water for injection to 500 mg/20 ml vial size or 20 ml to 1 g/30 ml vial size to provide 50 mg/ml. Meropenem exhibits dose-proportional linear PK properties with dosages of meropenem from 10 to 40 mg/kg. -Do not use flexible container in series connections. -Do not operate machinery or motorized vehicles until it is reasonable well established that this drug is well tolerated. Authoritative and practical information on the selection and clinical use of medicines. Page 1 of 3 King Edward Memorial Hospital & Perth Children’s Hospital Neonatology Meropenem - Neonatal NEONATAL MEROPENEM This document should be read in conjunction with this DISCLAIMER Restricted: Requires Microbiologist review within 24 hours of initiation Presentation Vial: 500mg Classification Bactericidal carbapenem antibiotic. Patient advice: -Compatible for IV infusion: Sodium Chloride Injection 0.9%, Dextrose Injection 5% Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, K pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species, 3 months or older: 40 mg/kg IV every 8 hours NOTE: space oral dose two hours before or six hours after calcium, magnesium and iron. -Concentration of solution for IV infusion: Ranges from 1 to 20 mg/mL The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Solutions of intravenous MERREM IV should not be frozen. resistant to other antibiotics. Shake to dissolve and let stand until clear. HML restricted (accepted in SSH and CHCH and shared care centres on National Febrile Neutropenia protocol). Typhoid Fever (Off-label) 15-20 mg/kg/day PO divided q12hr for 7-14 days. There is no experience in pediatric patients with renal impairment. -Hepatic: Hepatic organ system functions (periodically during prolonged therapy) Urinary . • For I.V. Higher doses (40 mg/kg/dose IV every 8 hours) have been used in patients with severe infections. every 8 h) with other antimicrobial agents … Dosage should be reduced in patients with creatinine clearance of 50 mL/min or less. Pediatric patients: Data not available. Applying Pharmacokinetic and Pharmacodynamic Principles to Meropenem . Available for Android and iOS devices. -Pediatric patients 3 months or older: Administer as IV infusion over about 15 to 30 minutes or as an IV bolus injection over about 3 to 5 minutes; limited safety data available to support use of a 40 mg/kg (maximum of 2 g) bolus dose. -Infants 32 weeks or older GA and PNA 2 weeks or older: 30 mg/kg IV every 8 hours Injection vials (500 mg and 1 gram) may be directly re-constituted with a compatible infusion fluid. Plasma concentrations of meropenem for neonates, infants and children after a single dose of 20 or 40 mg/kg (Ped Infec Dis J 1997; 16:263-8) CSF concentrations are approximately 15% of the simultaneous serum concentrations during the first 1 to 4 h after IV infusion during the first 24 to 48 h of therapy in children with meningitis CrCl greater than 25 to 50 mL/min: Recommended dose every 12 hours -Infants less than 32 weeks gestational age (GA) and postnatal age (PNA) less than 2 weeks: 20 mg/kg IV every 12 hours General: Meropenem Merrem ® - Renal dosing. The recommended dose of MERREM IV is 500 mg given every 8 hours for skin and skin structure infections and 1 gram given every 8 hours for intra-abdominal infections. Meropenem, sold under the brandname Merrem among others, is a broad-spectrum antibiotic used to treat a variety of bacterial infections. Source: Kuti JL, et al. Approximately 70% (50% to 75%) of a meropenem dose administered intravenously is recovered unchanged in the urine over 12 hours 1. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Solutions prepared for infusion (MERREM IV concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Dextrose Injection 5% should be used immediately. -Adults: Administer by IV infusion over about 15 to 30 minutes; alternatively, doses of 1 g may be administered as an IV bolus injection over about 3 to 5 minutes. Hemodialysis, peritoneal dialysis: Data not available. A 20 mg/kg dose of meropenem results in peak serum concentrations of about 50 μg/mL. The required dose should be administered after completion of the haemodialysis cycle. Manufacturer advises reduce dose to 0.5 g every 12 hours if creatinine clearance less than 10 mL/minute. Use normal dose every 12 hours if eGFR 26–50 mL/minute/1.73 m 2. Administer MERREM IV as an intravenous infusion over approximately 15 minutes to 30 minutes or as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes. Greater than 50 mL/min: Recommended dose every 8 hours Doses of 1 gram may also be administered as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes. Do not use flexible container in series connections. -Recommended as an alternative therapy. Data sources include IBM Watson Micromedex (updated 2 Nov 2020), Cerner Multum™ (updated 2 Nov 2020), ASHP (updated 23 Oct 2020) and others. For pediatric patients (with normal renal function) less than 3 months of age, with complicated intra-abdominal infections, the MERREM IV dose is based on gestational age (GA) and postnatal age (PNA). -Recommended as empiric therapy of hospital-acquired pneumonia (including ventilator-associated pneumonia) and healthcare-associated pneumonia Maximum dose: 2 g/dose Economic benefit of a meropenem dosage strategy based on pharmacodynamic concepts. There is limited safety data available to support the administration of a 40 mg/kg (up to a maximum of 2 grams) bolus dose. American Thoracic Society, IDSA recommendations: 1 g IV every 8 hours There is inadequate information regarding the use of MERREM IV in patients on hemodialysis or peritoneal dialysis. Use normal dose every 12 hours if estimated glomerular filtration rate 26–50 mL/minute/1.73 m 2.. Use half normal dose every 12 hours if estimated glomerular filtration rate 10–25 mL/minute/1.73 m 2.. Use half normal dose every 24 hours if estimated glomerular filtration rate less than 10 mL/minute/1.73 m 2. -Efficacy as monotherapy in the treatment of meningitis due to penicillin nonsusceptible isolates of S pneumoniae has not been established. Reference(s) National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Freshly prepared solutions of MERREM IV should be used. 3 months or older: 10 mg/kg IV every 8 hours Select one or more newsletters to continue. • For I.V. Hepatic impairment. -Avoid missing doses and complete the entire course of therapy. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Compatibility of MERREM IV with other drugs has not been established. Meropenem clearance increases with gestational age and chronologic age as the kidneys mature. Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2. 8 hours (maximum dose is 2 grams every 8 hours), depending on the type of infection (cSSSI, cIAI, intra-abdominal infection or meningitis). Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. 400 mg/day PO in single daily dose or divided q12hr. TDM-monograph Meropenem October 2015, CONCEPT version Page 4 of 5 meropenem 500 mg every 8 hours, or 1 gram every 6 hours in patients with normal renal function. Directions for administration For continuous intravenous infusion , manufacturer advises reconstitute each 1 g (as meropenem) vial to produce a 0.05 g (as meropenem)/mL solution with 20 mL Sodium Chloride 0.9%. Maximum dose: 1 g/dose -For IV bolus: Constitute injection vials with sterile Water for Injection; shake to dissolve then let stand until clear. -Solution for IV infusion when constituted with Sodium Chloride Injection 0.9%: If unable to use freshly prepared solution immediately, may store for 1 hour at up to 25C (77F) or 15 hours at up to 5C (41F) • For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. -Pediatric patients younger than 3 months: Administer as IV infusion over 30 minutes. If continued treatment with MEROPENEM RANBAXY for Injection is necessary, the unit dose (based on the type and severity of infection) is recommended at the completion of the haemodialysis … Medically reviewed by Drugs.com. <10 one-half unit dose every 24 hours Meropenem is cleared by haemodialysis. -Constituted solution for IV bolus: If unable to use freshly prepared solution immediately, may store up to 3 hours at up to 25C (77F) or for 13 hours at up to 5C (41F) Hepatic impairment. -For IV infusion: May constitute infusion vials directly with compatible infusion fluid; alternatively, may constitute an injection vial, add the resulting solution to an IV container, then further dilute with an appropriate infusion fluid Meropenem is cleared by haemodialysis and haemofiltration. The required dose should be administered after completion of the haemodialysis cycle. -Dry powder: Store at controlled room temperature 20C to 25C (68F to 77F) Uses: As a single agent therapy for the treatment of complicated skin and skin structure infections due to Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pyogenes, S agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), P aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, Peptostreptococcus species, 1 g IV every 8 hours -Compatible for IV bolus: Sterile Water for Injection He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University.. For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. Some of these include meningitis, intra-abdominal infection, pneumonia, sepsis, and anthrax. See. Comments: Four hundred forty-six patients (397 pediatric patients 3 months to less than 17 years of age) were enrolled in 4 separate clinical trials and randomized to treatment with meropenem (n=225) at a dose of 40 mg/kg every 8 hours or a comparator drug, i.e., cefotaxime (n=187) or ceftriaxone (n=34), at the approved dosing regimens. See dosing table 3 below. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. -Effective in eliminating concurrent bacteremia associated with bacterial meningitis. Alternatively, an injection vial may be re-constituted, then the resulting solution added to an intravenous container and further diluted with an appropriate infusion fluid. Publishers of the British National Formulary. -Solution for IV infusion when constituted with Dextrose Injection 5%: Freshly prepared solution should be used immediately. Acts by interfering with bacterial cell wall … Infants and children: 40 mg/kg IV every 8 hours (See dosing table below.). The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Approximately 70% (50% to 75%) of a meropenem dose administered intravenously is recovered unchanged in the urine over 12 hours 1. Table 1: Recommended MERREM IV Dosage Schedule for Adult Patients with Renal Impairment, Table 2: Recommended MERREM IV Dosage Schedule for Pediatric Patients 3 Months of Age and Older with Normal Renal Function, Table 3: Recommended MERREM IV Dosage Schedule for Pediatric Patients Less than 3 Months of Age with Complicated Intra-abdominal Infections and Normal Renal Function, Table 4: Volume of Sterile Water for Injection for Reconstitution of Injection Vials, We comply with the HONcode standard for trustworthy health information -, Recommended dose (500 mg cSSSI and 1 gram Intra-abdominal).
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