Neonatal Drug Therapy Manual

Meropenem

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated January 26, 2022 - 6:00pm

Alternate Name(s): 
Merrem
Classification: 
Antibiotic, Carbapenem
Original Date: 
August 2003
Revised Date: 
July 2017
Indications: 
  • Infections due to multiresistant Gram (-) and Gram (+) bacteria
Administration: 
  • IV intermittent infusion: over 15 - 30 minutes
Dosage: 
  • < 2 kg:
    • 0 - 14 days: 20 mg/kg/dose Q12h
    • > 14 days: 20 mg/kg/dose Q8h
  • > 2 kg:
    • 0 - 14 days: 20 mg/kg/dose Q8h
    • > 14 days: 30 mg/kg/dose Q8h
  • Suspected meningitis: 40 mg/kg/dose Q8H
Side Effects: 
  • CVS: hypotension
  • Hematologic: leukopenia, neutropenia
  • Hepatic: transient increased AST, ALT, alkaline phosphatase, LDH and bilirubin
  • Local: phlebitis
  • Renal: elevated urea and serum creatinine
Parameters to Monitor: 
  • BP
  • CBC
  • Liver function tests
  • BUN and serum creatinine
  • Injection site
Reconstitution and Stability: 

Meropenem 1 g

  • Add 20 mL SWFI. Take 8 mL (400 mg) and add to 12 mL 0.9% NaCl
  • Final Concentration: 20 mg/mL
Compatibility: 

- Solutions Compatible: D5W, D10W, 0.9% NaCl, dextose-saline combinations

- Y-site Compatible: dobutamine, dopamine, fluconazole, furosemide, heparin (up to 1 unit/mL), KCl (up to 40 mmol/L), milrinone, morphine, norepinephrine, phenobarbital, SMOF, TPN, vancomycin

- Incompatible: acyclovir, amphotericin B, metronidazole, sodium bicarbonate

Notes: 
  • Contains 3.92 mmol of sodium per gram of meropenem
References: 

- Pineda LC, Watt KM. new Antibiotic Dosing in Infants. Clin Perinatol 2015 Mar; 42 (1): 167-76

- Taketomo CK, Hodding JH, Kraus DM. Pediatric & Neonatal Dosage Handbook 22thEdition. Hudson: Lexi-Comp Inc.; 2015

- Trissel LA. Handbook on Injectable Drugs. 17th Edition. Bethesda: American Society of health-System Pharmacists; 2013

- van den Anker JN, Pokorna P, Kinzing-Schippers M et al.  Meropenem Pharmacokinetics in The Newborn. Antimicrob Agents Chemother Sept 2009; 53 99) 3871-79

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