Merocil

Indications

Meropenem is a strong, broad-spectrum antibiotic given by injection in hospital. It is used for serious bacterial infections, including:

• Severe pneumonia, including pneumonia caught in hospital.
• Complicated infections inside the abdomen and of the urinary tract.
• Bacterial meningitis (infection of the lining of the brain).
• Complicated skin and soft tissue infections.
• Blood infections (sepsis) and fever in patients with very low white blood cells.

It is usually kept for severe or resistant infections.

How It Works

Meropenem belongs to the carbapenem group of antibiotics. It stops bacteria from building their cell walls, so the bacteria burst and die. It works against many types of bacteria, including some that resist other antibiotics.

Dosage and Administration

• Given by a doctor or nurse into a vein, as an injection over a few minutes or as a drip.
• The dose and how often it is given (usually every 8 hours) are decided by the doctor based on the infection, body weight and kidney function.
• Children: as prescribed, by body weight.

The full course should be completed even if the patient feels better.

Interactions

• Valproic acid (Sodium Valproate): meropenem sharply lowers its blood level, which can lead to fits. They are usually not given together.
• Probenecid raises meropenem levels.
• Warfarin: its effect may change; blood tests should be checked.

Contraindications

• Allergy to meropenem or other carbapenems.
• Previous severe allergic reaction (such as anaphylaxis) to penicillins, cephalosporins or other beta-lactam antibiotics.

Side Effects

Common: diarrhoea, nausea, vomiting, headache, rash, itching, and pain or swelling at the injection site. Blood tests may show changes in liver tests or blood cells.

Get urgent medical help for signs of a serious allergy (swelling of the face or throat, trouble breathing, collapse), a severe skin reaction with blistering or peeling, fits, or severe or bloody diarrhoea, which can happen during or weeks after treatment. Tell the nurse or doctor at once about any of these.

Pregnancy and Lactation

Used in pregnancy and breastfeeding only if the doctor decides the benefit outweighs the risk. Small amounts pass into breast milk.

Precautions and Warnings

• Tell the doctor about any past allergy to antibiotics.
• Doses are lowered in kidney disease.
• Take care in people with epilepsy or other brain conditions, as fits can occur.
• Long courses can lead to infections with resistant germs or fungus (thrush).
• It should be used only when needed, to reduce antibiotic resistance.

Overdose

Overdose is unlikely as it is given in hospital, but too much may cause side effects such as fits, especially in kidney disease. It is treated in hospital, and dialysis can remove it.

Therapeutic Class

Carbapenem antibiotic (beta-lactam).

Storage

Store the powder vials below 30°C, away from light. Once mixed, it is used promptly as directed by the hospital pharmacy. Keep out of reach of children.