Given the persisting inconsistency between current guidelines for treatment of pneumonia and the available evidence, we undertook to update this systematic review. Holes in Coverage. Early initiation of therapy is imperative. Thanks so much for the comment!...I'm humbled by your kind words! active against Gm + and gm - and average to excellent atypical coverage . Common side effects include nausea, diarrhea, constipation, headache, rash, and pain at the site of injection.In 2017 the FDA granted approval for the combination of As with other ß-lactams antibiotics, the effectiveness of treatment depends on the amount of time during the dosing interval that the meropenem concentration is above the minimum inhibitory concentration for the bacteria causing the infection.In 2016, a synthetic peptide-conjugated PMO (PPMO) was found to inhibit the expression of O=C3N2\C(=C(\S[C@H]1C[C@@H](C(=O)N(C)C)NC1)[C@H](C)[C@@H]2[C@H]3[C@H](O)C)C(=O)OInChI=1S/C17H25N3O5S/c1-7-12-11(8(2)21)16(23)20(12)13(17(24)25)14(7)26-9-5-10(18-6-9)15(22)19(3)4/h7-12,18,21H,5-6H2,1-4H3,(H,24,25)/t7-,8-,9+,10+,11-,12-/m1/s1 Side Effects. 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. Like all carbapenems, meropenem has wonderful tissue penetration. Corynebacterium jeikeium. Bactericidal against: B. fragilis, Enterobacteriaceae, Pseudomonas & gram-positive organisms. SE . You are very welcome, Maria! It’s scary to think that bacteria are developing resistance to even our most powerful antibiotics (ie, carbapenem-resistant Enterobacteriaceae, or CRE). All fluoroquinolones have atypical coverage (but Cipro – relatively weaker against Chlamydia and Mycoplasma, but good vs Legionella).
MRSA (ORSA) Stentrophomonas maltophilia. Meropenem, sold under the brandname Merrem among others, is a broad-spectrum antibiotic used to treat a variety of bacterial infections. Acyclovir (Zovirax) inhibits activity of both HSV-1 and HSV-2. It may also prevent recurrent outbreaks. Bacteristatic against: Listeria & E. faecalis. Ciprofloxacin (PO and IV) Spectrum: best gram negative coverage of FQs, but virtually no gram positive coverage.

Penetrates into CSF (esp meropenem & imipenem) Cover gram-positives & gram-negatives & anaerobes. Carbapenems Used for Severe Life Threatening Infections. Thank you so much! All fluoroquinolones have excellent bioavailability (except Norfloxacin), so use PO whenever possible. E. faecium (VRE) Legionella / atypicals. 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! It has affinity for viral thymidine kinase and, once phosphorylated, causes DNA chain termination when acted on by DNA polymerase. To address the lack of MRSA coverage, I often write for meropenem with Most recently, a novel antibiotic called Vabomere (combination of VABOrbactam and MERopenem) was FDA approved to treat complicated pyelonephritis and urinary tract infections. GI distress. Black box . 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).
It also covers Pseudomonas (unlike ertapenem) and is less likely to lower the seizure threshold compared to imipenem. tendo imflammaiton and or rupture - risk with concurrent corticosteroid use, organ trasplant patients, and pts> 60 years of age . photosensitivity, hyp and hyperglycemia , sz, crystalluria, QT prolongation. Meropenem is used for gram-negative bacillary meningitis; imipenem is not used in meningitis because it may cause seizures. Stanford's CA-1 guide is wonderful!...I'm a Harvard-trained cardiothoracic anesthesiologist and intensive care doctor working in the Texas Medical Center with interests in ultrasonography, mechanical circulatory support, and all things tech. 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 … Most seizures occur in patients who have central nervous system abnormalities or renal insufficiency and who are given inappropriately high doses. Intra-Abdominal & Pelvic Infections. In the previous version of this review we showed that there was no advantage to the atypical arm. Rash. Only Meropenem is rapidly metabolized by kidneys. It is given by injection into a vein. Patients experience less pain and faster resolution of cutaneous lesions when used within 48 h of rash onset. Allergy: low incidence (<1%) of immunologic cross-reactivity …

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