Meropenem

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Meropenem (Merrem) is a broad spectrum intravenous antibiotic and member of the carbapenem β-lactam drug class. These antibiotics are often reserved for multidrug resistant organisms (MDR) causing a wide variety of serious infections like hospital acquired pneumonia, intraabdominal infections, neutropenic fever, complicated soft tissue infections, and gram negative sepsis.

Like all carbapenems, meropenem has wonderful tissue penetration. It also covers Pseudomonas (unlike ertapenem) and is less likely to lower the seizure threshold compared to imipenem. Because of meropenem’s incredibly broad coverage, I try to remember what bugs it does NOT cover: methicillin resistant Staphylococcus aureus (MRSA), atypicals, and Stenotrophomonas (in fact, carbapenem use is a risk factor for Steno infections). To address the lack of MRSA coverage, I often write for meropenem with vancomycin when clinically indicated in the ICU.

Most recently, a novel antibiotic called Vabomere (combination of VABOrbactam and MERopenem) was FDA approved to treat complicated pyelonephritis and urinary tract infections. It’s scary to think that bacteria are developing resistance to even our most powerful antibiotics (ie, carbapenem-resistant Enterobacteriaceae, or CRE). We ALL need to continue being stewards of appropriate antibiotic practice… and thank your friends in infectious disease!

Drop me a comment below with comments and questions! 🙂

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