Meropenem powder d / prig. injection solution 0.5g, No. 1

Meropenem is indicated for the treatment in adults and children (over 3 months) of the following infectious and inflammatory diseases caused by one or more pathogens susceptible to meropenem:

Х pneumonia, including nosocomial pneumonia;

Х infections of the urinary system;

Х infections of the abdominal cavity;

Х infectious and inflammatory diseases of the pelvic organs (endometritis);

Х infections of the skin and its structures;

Х meningitis;

Х septicemia

Empiric therapy for adult patients with suspected infection with symptoms of febrile neutropenia alone or in combination with antiviral or antimicrobial drugs. The effectiveness of the drug has been proven both in monotherapy and in combination with other antimicrobial agents in the treatment of polymicrobial infections.

IV for adults, a single dose varies from 500 mg to 2 g, the frequency of administration and the duration of treatment are set individually, depending on the indications and severity of the disease. Children weighing less than 50 kg - 10-12 mg / kg every 8 hours; in children weighing more than 50 kg, doses intended for adults are used.

Powder for the preparation of a solution for intravenous administration from white to white with a yellowish tinge.

1 fl.

meropenem trihydrate 570 mg,

which corresponds to the content of meropenem 500 mg

Excipients: sodium carbonate anhydrous - 104 mg.

• History of hypersensitivity to meropenem or other drugs of the carbapenem group.

• Severe hypersensitivity (anaphylactic reactions, severe skin reactions) to any antibacterial agent with a beta-lactam structure (i.e., penicillins and cephalosporins).

• Children under 3 months of age.

  Carefully

• Simultaneous use with potentially nephrotoxic drugs.

• Patients with complaints from the gastrointestinal tract (diarrhea), especially those suffering from colitis.

pharmachologic effect

Antibiotic of the carbapenem group. More stable with respect to dehydropeptidase I than imipenem. It has a bactericidal effect by disrupting the synthesis of the bacterial cell wall. Has an affinity for penicillin binding proteins (PBPs). Active against most aerobic and anaerobic gram-positive and gram-negative bacteria.

Xanthomonas maltophilia, Enterococcus faecium, methicillin-resistant strains of Staphylococcus spp. Are resistant to meropenem.

It is resistant to the action of ?-lactamases.

Pharmacokinetics

After intravenous or intramuscular injection, it penetrates well into most tissues and body fluids (including cerebrospinal fluid in patients with meningitis). It is metabolized to form one inactive metabolite. T1 / 2 with intravenous administration is 1 hour, with intramuscular administration - 1.5 hours.

Side effect

From the digestive system: abdominal pain, nausea, vomiting, diarrhea, a reversible increase in the level of bilirubin, transaminases, alkaline phosphatase and LDH.

From the side of the blood coagulation system: reversible thrombocytopenia, eosinophilia, neutropenia.

Allergic reactions: itching, rash, urticaria.

From the nervous system: headache, paresthesia.

Effects due to chemotherapeutic action: oral candidiasis, vaginal candidiasis, pseudomembranous colitis.

Local reactions: inflammation, thrombophlebitis, pain at the injection site.

Others: in some cases, positive direct or indirect Coombs' test.

Application during pregnancy and lactation

During pregnancy and lactation (breastfeeding), use is possible only in cases where the expected benefit of therapy to the mother outweighs the possible risk to the fetus or child.

Experimental studies have shown that meropenem is excreted in breast milk.

Application for violations of liver function

With caution, meropenem is prescribed for liver diseases - treatment should be carried out under the control of the level of transaminases and bilirubin.

Application for impaired renal function

In case of impaired renal function, correction of the dosage regimen is required depending on the CC values.

Application in children

Not recommended for use in children under 3 months of age.

special instructions

With caution, meropenem is prescribed for liver diseases, for diseases of the lower respiratory tract caused by Pseudomonas aeruginosa.

In case of impaired renal function, correction of the dosage regimen is required depending on the CC values. For liver diseases, treatment should be carried out under the control of the level of transaminases and bilirubin.

If there is a history of hypersensitivity reactions to penicillins, carbapenems or other beta-lactam antibiotics, hypersensitivity reactions to meropenem may develop. As with the use of other antibiotics, against the background of treatment with meropenem, the likelihood of developing pseudomembranous colitis should be borne in mind.

With caution, meropenem is used as part of a combination therapy with drugs that have nephrotoxic effects.

Not recommended for use in children under 3 months of age.

Drug interactions

Probenecid competes with meropenem for active tubular secretion and, thus, inhibits renal excretion of meropenem, causing an increase in its T1 / 2 and plasma concentration (simultaneous use is not recommended).