Adults: The dosage and duration of therapy shall be established depending on type and severity of infection and the condition of the patient. The recommended daily dosage in different infections is as follows: \n
\n \n \nInfection | \nDosage | \n
\n \nPneumonia,UTI,gynaecological,infections such as endometritis, skin and soft tissue infections | \n500 mg IV every 8 hours | \n
\n \nNosocomial pneumonia, peritonitis, presumed infections in neutropenic patients and septicaemia | \n1 g IV every 8 hours | \n
\n \nMeningitis | \n2 g IV every 8 hours | \n
\n \n
\nLike other antibiotics, caution may be required in using Meropenem as monotherapy in critically ill patients with known or suspected lower respiratory tract infections caused by Pseudomonas aeruginosa. Regular sensitivity testing is recommended when treating Pseudomonas aeruginosa infections. Adults with impaired renal function Dosage should be reduced in patients with creatinine clearance less than 51 ml/min, as scheduled below: \n
\n \n \nCreatinine Clearance(ml/min) | \nDose (based on unit doses of 500 mg, 1 g, 2 g every 8 hours) | \nFrequency | \n
\n \n26 to 50 \n10 to 25 < 10 | \none unit dose \none-half unit dose \none-half unit dose | \nevery 12 hours \nevery 12 hours \nevery 24 hours | \n
\n \n
\nMeropenem is cleared by haemodialysis. If continued treatment with Meropenem is necessary, it is recommended that the unit dose (based on the type and severity of infection) is administered at the completion of the haemodialysis procedure to restore therapeutically effective plasma concentration. There is no experience with peritoneal dialysis. Adults with hepatic insufficiency No dosage adjustment is necessary in patients with impaired hepatic metabolism. Elderly No dosage adjustment is required for the elderly with normal renal function or creatinine clearance value above 50 ml/min. Children For infants and children over 3 months to 12 years of age: The usual recommended intravenous dose is 10 - 40 mg/kg every 8 hours depending on type and severity of infection, the susceptibility of the pathogen and the condition of the patient. In children over 50 kg weight, adult dosage should be used. Febrile episodes in neutropenic patients: The dose should be 20 mg/kg every 8 hours. In meningitis: The dose should be 40 mg/kg every 8 hours. Method of administration Meropenem can be given as an intravenous bolus injection over approximately 5 minutes or by intravenous infusion over approximately 15 to 30 minutes using the specific available diluents. Preparation of solution: Intravenous bolus administration : Reconstitute Aropen IV injection (500 mg or 1 g) with sterile water for injection. Shake to dissolve and to obtain solution which is clear and colorless or pale yellow. Amount of water for injection would be as follows : \n
\n \n \nVial Size | \nWater for injection (ml) | \nApproximate Average Concentration (mg/ml) | \n
\n \n500 mg | \n10 | \n50 | \n
\n \n1 g | \n20 | \n50 | \n
\n \n
\nIntravenous infusion administration : Meropenem for intravenous infusion may be directly constituted with a compatible infusion fluid and then further diluted (50 to 200 ml) with the compatible infusion fluid, as needed. Compatible fluids : 0.9% Sodium Chloride Solution, 5% or 10% Glucose Solution, 5% Glucose Solution with 0.02% Sodium Bicarbonate, 0.9% Sodium Chloride and 5% Glucose Solution, 5% Glucose with 0.225% Sodium Chloride Solution, 5% Glucose with 0.15% Potassium Chloride Solution, 2.5% or 10% Mannitol Solution. Compatibility of Meropenem with other drugs has not been established. Freshly prepared solutions of Meropenem should be used whenever possible. After reconstitution Meropenem with sterile water for injection is stable at room temperature for 8 hrs and under refrigerator for 18 hrs at 4° C. Solutions of intravenous Meropenem should not be frozen.