Meropenem is an anti-infective drug used in adults and children for infections caused by one or more meropenem sensitive bacteria.Nosocomial infection, mixed infection with g-bacteria, multi-drug resistant bacteria infection and enzyme producing bacteria infection are the preferred drugs.Pneumonia includes nosocomial pneumonia, urinary tract infection, gynecological infection (such as endometritis and pelvic inflammatory disease), skin and soft tissue infection, meningitis, and sepsis.
Meropenem is bactericidal except against Listeria monocytogenes where it is bacteriostatic. It inhibits bacterial wall synthesis like other beta-lactam antibiotics. In contrast to other beta-lactams, it is highly resistant to degradation by beta-lactamases or cephalosporinases. Resistance generally arises due to mutations in penicillin binding proteins, production of metallo-beta-lactamases, or resistance to diffusion across the bacterial outer membrane. Unlike imipenem, it is stable to dehydropeptidase-1 and can therefore be given without cilastatin.
The spectrum of action includes many Grampositive and Gram negative bacteria (including Pseudomonas) and anaerobic bacteria. The overall spectrum is similar to that of imipenem, although meropenem is more active againstEnterobacteriaceae and less active against Gram-positive bacteria. It is also very resistant to extended-spectrum beta lactamases but may be more susceptible to metallo-beta-lactamases. Meropenem is frequently given in the treatment of febrile neutropenia. This condition frequently occurs in patients withhematological malignancies and cancer patients receiving anticancer drugs that cause bone marrow suppression. It is approved for complicated skin and skin structure infections, complicated intra-abdominal infections and bacterial meningitis.