Meropenem

General Information

Documented infections due to organisms producing inducible β-lactamases or Extended-Spectrum β-lactamases (ESBL) resistant to alternate agents.

Empiric Treatment of life-threatening infections where multi-drug resistant organisms suspected (i.e. severe sepsis, neutropenic patient with absolute neutrophil count < 0.5)

Therapy of P. aeruginosa infections where other agents cannot be used due to allergy or toxicity

Unacceptable Uses

Therapy of documented or suspected infections due to MRSA, Enterococcus spp., Stenotrophomonas maltophilia, Chlamydia spp. and Mycoplasma spp.

Treatment of infections due to organisms susceptible to less costly and/or narrower-spectrum agents

Common Usage

Therapy of serious, often nosocomial infections involving resistant gram negative organisms

Adverse Effects

Immediate and delayed-type allergy
GI disturbance
Cytopenias, positive Coombs
Liver enzyme abnormalities

Major Interactions

Carbapenems may cause rapid and profound decrease in valproic acid levels.
Increasing valproic acid dosage is often NOT sufficient to overcome this interaction.
Avoid this combination if at all possible.