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Lanmer®

Category
Antibiotics

Meropenem is a carbapenem antibiotic for parenteral use, that is relatively stable to human dehydropeptidase-1 (DHP-1) and therefore, does not require the addition of an inhibitor of DHP-1.

Meropenem exerts its bactericidal action by interfering with vital bacterial cell wall synthesis. The ease with which it penetrates bacterial cell walls, its high level of  stability to all serine β-lactamases and its marked affinity for the Penicilline Binding Proteins (PBTs) explain the potent bactericidal action of meropenem against a broad spectrum of aerobic and anaerobic bacteria. Minimum bactericidal concentrations (MBC) are commonly the same as the minimum inhibitory concentrations (MIC). For 76 % of the bacteria tested, the MBC : MIC ratios were 2 or less.

Meropenem is stable in susceptibility tests and these tests can be performed using normal routine methods. In vitro tests show that meropenem acts synergistically with various antibiotics. It has been demonstrated both in vitro and in vivo that meropenem has a post antibiotic effect.

A single set of meropenem susceptibility criteria are recommended based on pharmacokinetics and correlation of clinical and microbiological outcomes with zone diameter and minimum inhibitory concentrations (MIC) of the infecting organisms.  

 

COMPOSITION

Each vial of 1.28 g dry powder contains 1.28 g Meropenem sodium carbon equivalent to 1 g Meropenem.

 

INDICATIONS

Meropenem i.v. is indicated for treatment, in adult and children, of the following infections caused by single or multiple bacteria sensitive to meropenem :

·         Pneumonias and Nosocomial Pneumonias

·         Urinary tract infections

·         Intra-abdominal infections

·         Gynaecological infections, such as endometritis

·         Skin and Skin Structure infections

·         Meningitis

·         Septicaemia

Empiric treatment, for presumed infections in adult patients with febrile neutropenia, used as monotherapy or in combination with anti-viral or anti-fungal agents.

Meropenem has proved efficacious alone or in combination with other antimicrobial agents in the treatment of polymicrobial infections. There is no experience in paediatric patients with neutropenia or primary or secondary immunodeficiency.

 

CONTRAINDICATIONS

Meropenem is contraindicated in patients who have demonstrated hypersensitivity to this product.

 

PRECAUTIONS AND WARNINGS

There is some clinical and laboratory evidence of partial cross-allergenicity between other carbapenems and beta-lactam antibiotics, penicillines and cephalosphorines. Severe reactions (including anaphylaxis) have been reported with most beta-lactam antibiotics. Before initiating therapy with meropenem, careful enquiry should be made concerning previous hypersensitivity reactions to beta-lactam antibiotics. Meropenem should be used with caution in patients with such a history. If an allergic reaction to meropenem occurs, the drug should be discontinued and appropriate measures taken.

Use of meropenem in patients with hepatic disease should be made with careful monitoring of transaminase and bilirubin levels.

As with other antibiotics, overgrowth of non-susceptible organisms may occur and, therefore, continuous monitoring of each patient is necessary.

Use in infections caused by methicillin resistant staphylococcus is not recommended. Rarely, pseudomembranous colitis has been reported on Meropenem as with practically all antibiotics and may vary in severity from slight to life-threatening. Therefore, antibiotics should be prescribed with care for individuals with a history of gastrointestinal complaints, particularly colitis. It is important to consinder the diagnosis of pseudomembranous colitis in the case of patients who develop diarrhoea in association with the use of meropenem. Although studies indicate that a toxin produced by Clostridium difficile is one of the main causes antibiotic-associated colitis, other causes should be considere. The co-administration of meropenem with potentially nephrotoxic drugs should be considered with caution. (For dosage see “Dosage and Administration”).

Paediatric Use

Efficacy and tolerability in infants under 3 months old have not been established; therefore, Meropenem is not recommended for use below this age. There is no experience in children with altered hepatic or renal function.

Keep all medicines away from children.

 

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