Thus, meropenem was the dominant strategy as it was both less expensive and more effective. Meropenem should not be used in breast-feeding women unless the potential benefit for the mother justifies the potential risk to the baby. Introduction. Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter spp. As with all beta-lactam antibiotics, serious and occasionally fatal hypersensitivity reactions have been reported (see sections 4.3 and 4.8). A study of 12 patients administered meropenem 1000 mg 8 hourly post-surgically for intra-abdominal infections showed a comparable Cmax and half-life to normal subjects but a greater volume of distribution 27 l. Meropenem is cleared by haemodialysis with clearance during haemodialysis being approximately 4 times higher than in anuric patients. The concomitant use of meropenem and valproic acid/sodium valproate/valpromide is not recommended (see section 4.5). Continue typing to refine. Each 500 mg vial contains 104 mg sodium carbonate which equates to approximately 2 mEq of sodium (approximately 45 mg). There are no established dose recommendations for patients receiving peritoneal dialysis. For storage conditions after reconstitution of the medicinal product, see section 6.3. Treatment of patients with bacteraemia that occurs in association with, or is suspected to be associated with, any of the infections listed above. Bloodstream Infections. A positive direct or indirect Coombs test may develop during treatment with meropenem. Further, prolonged storage of reconstituted meropenem in elastomeric infusion devices may be required in rural or remote administration sites where several days’ supply may be needed. When suggestions are available use up and down arrows to review and ENTER to select. meropenem: [ mer″o-pen´em ] a broad-spectrum β-lactam antibiotic effective against a wide variety of gram-positive and gram-negative organisms; used in treatment of … Due to the rapid onset and the extent of the decrease, co-administration of valproic acid/sodium valproate/valpromide with carbapenem agents is not considered to be manageable and therefore should be avoided (see section 4.4). Consideration should be given to official guidance on the appropriate use of antibacterial agents. Therefore, this study aimed to … Hypersensitivity to any other carbapenem antibacterial agent. Alternatively, doses up to 1 g can be given as an intravenous bolus injection over approximately 5 minutes. Standard aseptic techniques should be used for solution preparation and administration. VABOMERE ® (meropenem and vaborbactam) is indicated for the treatment of patients 18 years of age and older with complicated urinary tract infections (cUTI) including pyelonephritis caused by the following susceptible microorganisms: Escherichia coli, Klebsiella pneumoniae, and … Seizures have infrequently been reported during treatment with carbapenems, including meropenem (see section 4.8). The identification and antimicrobial susceptibility tests on any such isolate must be repeated and if the result is confirmed the isolate sent to a reference laboratory. Medicinal products that inhibit peristalsis should not be given. Patients who have a history of hypersensitivity to carbapenems, penicillins or other beta-lactam antibiotics may also be hypersensitive to meropenem. This site uses cookies. Use in patients with liver disease: patients with pre-existing liver disorders should have liver function monitored during treatment with meropenem. Find its price or cost, dose, when to use, how to use, side effects, adverse effects, substitutes. IMPACT - SPECULATIVE . When multiple doses are administered 8-hourly to subjects with normal renal function, accumulation of meropenem does not occur. Description: Meropenem (SM 7338) is an ultra-broad spectrum injectable antibiotic. Glanders and melioidosis: Use of meropenem in humans is based on in vitro B.mallei and B. pseudomallei susceptibility data and on limited human data. Background: The rising incidence of resistance to currently available antibiotics among pathogens, particularly Gram-negative pathogens, in complicated intra-abdominal infections (cIAIs) has become a challenge for clinicians. Pooled analysis from the TANGO 1 and TANGO 2 trials were released by The Medicines Company. Treatment with meropenem had an expected cost of £19,026 and QALYs were 4.768. Pooled analysis from the two phase III TANGO 1 and TANGO 2 trials for meropenem/vaborbactam showed that mortality at 28 days was 25% in treatment-arm vs. 44% for best available therapy (43.7% reduction). The tables below provide general recommendations for dosing. 1. There is no evidence of an increased risk of any adverse drug reaction in children based on the limited available data. A 2015 meta analysis concluded that the anti-pseudomonal penicillin-beta lactamase inhibitor combination piperacillin-tazobactam gives results equivalent to treatment with a carbapenem in patients with sepsis. Tuesday, November 19th 2019, London 07:30. Direct antiglobulin test (Coombs test) seroconversion. meropenem/vaborbactam would lead to an overall cost of [commercial in confidence figure removed] in Year 1, increasing to [commercial in confidence figure removed] in Year 5. There was no evidence of increased sensitivity to meropenem in juveniles compared to adult animals. Diagn Microbiol Infect Dis. Species for which acquired resistance may be a problem, $ Species that show natural intermediate susceptibility, £ 3. In vitro: Meropenem has an antibacterial spectrum which is broadly similar to that of imipenem but, whilst slightly less active against staphylococci and enterococci, it is more active against Pseudomonas aeruginosa, all Enterobacteriaceae and Haemophilus influenzae. Do not freeze the reconstituted solution. All methicillin-resistant staphylococci are resistant to meropenem. They are for use only for organisms that do not have specific breakpoints. Alternatively, meropenem doses of up to 20 mg/kg may be given as an intravenous bolus over approximately 5 minutes. anaphylactic reaction, severe skin reaction) to any other type of beta-lactam antibacterial agent (e.g. Find its price or cost, dose, when to use, how to use, side effects, adverse effects, substitutes. By Imraan Joosub, Andy Gray, Analyn Crisostomo and Abdul Salam. 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. Meropenem was provided by Molekula (Gillingham, Dorset, UK), whereas amoxicillin and clavulanate were bought from Sigma-Aldrich (Poole, Dorset, UK). As necessary, expert advice should be sought when the local prevalence of resistance is such that the utility of the agent in at least some types of infections is questionable. Meropenem is a broad-spectrum carbapenem antibiotic with clinical utility in a wide range of multidrug-resistant Gram-negative infections.1 Outpatient parenteral antimicrobial therapy (OPAT) is becoming an increasingly important model for managing infections both in the UK and worldwide. Concomitant use with valproic acid/sodium valproate/valpromide. The use of OPAT to deliver meropenem as a continuous infusion in the “hospital in the home” setting has many advantages. Chemical and physical in-use stability for a prepared solution for infusion using 0.9% sodium chloride solution has been demonstrated for 3 hours at up to 25°C or 24 hours under refrigerated conditions (2-8°C). Animal studies indicate that meropenem is well tolerated by the kidney. Interaction studies have only been performed in adults. Before initiating therapy with meropenem, careful inquiry should be made concerning previous hypersensitivity reactions to beta-lactam antibiotics. The dose of meropenem administered and the duration of treatment should take into account the type of infection to be treated, including its severity, and the clinical response. penicillins or cephalosporins). As with other antibacterial drugs, prolonged use of VABOMERE may result in overgrowth of nonsusceptible organisms. The rising incidence of resistance to currently available antibiotics among pathogens, particularly Gram-negative pathogens, in complicated intra-abdominal infections (cIAIs) has become a challenge for clinicians. There are limited safety data available to support the administration of a 2 g dose in adults as an intravenous bolus injection. Date of first authorisation/renewal of the authorisation. By continuing to browse the site you are agreeing to our policy on the use of cookies. Therefore, it is important to consider this diagnosis in patients who present with diarrhoea during or subsequent to the administration of meropenem (see section 4.8). Meropenem is already marketed in the UK; a 10 vial pack of 500mg powder for solution for injection costs £77. In individuals with normal renal function, rapid renal elimination will occur. The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. 2004;49(1):41-46. From a microbiological point of view, unless the method of opening/reconstitution/dilution precludes the risk of microbiological contamination, the product should be used immediately. Use normal dose every 12 hours if eGFR 26–50 mL/minute/1.73 m 2.. Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2.. Use half normal dose every 24 hours if eGFR less than 10 mL/minute/1.73 m 2. 4.7 Effects on ability to drive and use machines No studies on the effect on the ability to drive and use machines have been performed. Prices are for cash paying customers only and are not valid with insurance plans. EUCAST clinical MIC breakpoints for meropenem (2013-02-11, v 3.1), Haemophilus influenzae1, 2 and Moraxella catarrhalis2, Gram-positive anaerobes except Clostridium difficile. Meropenem was FDA-approved in the United States in July of 1996 and is used today for a variety of infections including pneumonia, bacteremia, osteomyelitis, urinary tract infection, and meningitis. Some of these include meningitis, intra-abdominal infection, pneumonia, sepsis, and anthrax. Currently, there is a lack of stability data on meropenem at various concentrations in elastomeric infusion devices for use in outpatient parenteral antimicrobial therapy (OPAT). Each vial contains meropenem trihydrate equivalent to 500 mg anhydrous meropenem. Haemodialysis will remove meropenem and its metabolite. As a precautionary measure, it is preferable to avoid the use of meropenem during pregnancy. † Alternatively, meropenem doses of up to 20 mg/kg may be given as an intravenous bolus over approximately 5 minutes. The base case also predicts NHS resource savings valued at £6,091 in Year 1, increasing to £15,228 in Year 5. Cost-minimization analysis of imipenem/cilastatin versus meropenem in moderate to severe infections at a tertiary care hospital in Saudi Arabia . The acquisition cost of meropenem alone is £17.78 (excluding VAT) for 1 vial containing 1 g of powder for solution for injection (Drug Tariff, October 2019). Meropenem is usually given by intravenous infusion over approximately 15 to 30 minutes (see sections 6.2, 6.3, and 6.6).
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