"Meropenem": instructions for use, reviews. Drug analogues

Synthetic antibiotics include a group of carbapenems, whose representative is the drug "Meropenem" for parenteral administration. Due to bactericidal and bacteriostatic action of the active ingredient, the drug is able to suppress the growth and multiplication of bacteria that cause various inflammatory diseases.

Description of the medicine

The drug "Meropenem" is considered to be a broad-spectrum antibiotic and is a white or white powder with a yellow shade for the preparation of a solution. Administer intravenously bolus or infusion.

Release it in vials with a volume of 10 and 20 ml. The dosage of the lyophilizate is 0.5 g or 1 g of the drug Meropenem. Tablets and injectable solutions for intramuscular injection using an antibiotic are not produced. There is only one form of release.

Structure of the preparation

As the active ingredient appears meropenem in the form of trihydrate. In the description of the composition, calculated for 1 bottle, the amount of active substance is indicated: meropenem trihydrate at 0.570 g, or 1.140 g, and in terms of free meropenem, 0.5 g or 1 g respectively. The auxiliary substances of the powder include sodium carbonate.

Main analogues and their producers

The original drug based on meropenem is the drug "Meronem" in the form of a powder of 0.5 g. It is used to make an injection solution, which is administered intravenously. This antibiotic is produced by the British company Astra Zeneca Ltd, on the basis of which the composition and dosage of the medicament was developed, preclinical and clinical trials were conducted. The remaining preparations with meropenem are considered generic and reproduced in the likeness of the original.

The generic "Meropenem" analogs are issued both under the trade name, which coincides with the international non-proprietary name, and under commercial, different from the accepted INN. The form of release, dosage and composition of all drugs reproduced in the likeness of "Meronem" coincide, which indicates their interchangeability.

A drug with the trade name "Meropenem" is produced by many pharmaceutical plants around the world. For example, the Indian company "M. J. Biofarm Pvt. Ltd. produces medicament, and packaging is carried out at the Russian enterprise CJSC BIOTEK MIPPDK. Ukrainian companies "Lekhim", "Pharma Life" also produces the antibiotic "Meropenem". Analogues can also contain the name of the manufacturer in their name. There are many examples in world pharmacy. In particular, the drug "Meropenem-Vero" is known. This is a product of the Chinese company Shenzhen Heibin Pharmaceutical Co. Ltd. ".

Medication "Meropenem Jodas" is an Indian analog of a broad-spectrum antibiotic manufactured by Jodas Expo. Produced in the form of powder for the manufacture of injection solutions of 500 mg and 1000 mg.

The Russian company LLC "ABOLmed" produces the drug "Meropenabol" on the basis of the antibacterial agent meropenem. A solution for intravenous administration is prepared from the powder.

The drug "Meropenem Spencer"

This tool is another Indian counterpart produced by Cooper Pharma for Spencer Pharma Yukey Limited, India. It is produced on the basis of meropenem in the form of trihydrate and belongs to the group of carbapenems. The antibiotic Meropenem Spencer has an antibacterial effect against gram-positive and gram-negative bacteria in inflammatory and infectious diseases. Use for parenteral administration.

Pharmacological properties

The main effect of meropenem substance on the instructions for use characterizes the bactericidal action of a wide spectrum, which is associated with the suppression of the formation of the bacterial membrane. The ability to cause the death of aerobes and anaerobes is due to the penetration of the antibiotic through the wall of the microorganism, inertness in relation to beta-lactamases and a significant relationship to the protein formations that bind the penicillin substance.

By binding to protein receptors on the membrane of the cytoplasm of bacteria, reducing the peptidoglycan layer in the cell wall, and suppressing transpeptidase, autolytic enzymes are released into the cell wall, destroying its structure and leading to the death of the parasite.

On what microorganisms does the antibiotic work?

For the drug "Meropenem" instructions for use provides for use against gram-positive aerobes, which include Enterococcus fecalis, Staphylococcy aureus, Streptococcus agalactia, Streptococcus pneumonia with sensitivity to
Penicillin, Streptococcus pyogenesis, Streptococcus viridance.

The antibiotic activity is highly active against Gram-negative aerobes, among which the E. coli, Hemofilus influenza, Klebsiella pneumonia, Neisseria meningitis, Pseudomonas auruginosa, Proteus mirabilis are isolated.
There is meropenem on anaerobic bacteria such as: Bacteroid flagylis, Peptostreptococcus spp.

The efficacy of the drug is confirmed against the following bacteria only by in vitro studies, but there is no evidence of clinical efficacy.
Gram-positive aerobes include Staphylococcus epidermidis with methicillin sensitivity, and Gram-negative aerobes: Acinetobacter spp., Aeromonas hydrophilus, Campylobacter jediuni, Citrobacter diversia, Citroobacter freundi, Enterobacter cloaci, Hafnie, Klebsiella oxytoca, Morakella catarrhalis, Morganella Morgani, Pasterella multocida, Proteus vulgaris , Salmonella spp., Serratia marcesens, Shigella spp., Ursina enterocolitis.

In vitro fights anaerobic bacteria:. Bakteroides distasonis, Bakteroides ovatus, Bakteroides uniformis, Bakteroides ureolitikus, Bakteroides vulgaris, Clostridium difficile, Clostridium perfringens, Eubakterium lentum, Fuzobakterium spp, Prevotella bivia, Prevotella intermedia, Prevotella melaninogenika, Porfiromonas asaharolitika, Propionibakterium aknes.

What the drug treats

Due to the wide spectrum of action of the active substance meropenem, the instructions for use are recommended for use in various infectious and inflammatory diseases as a separate medication or as part of a combination therapy.

These include sensitive to this antibiotic infection, affecting:

• Lower respiratory tracts, manifested by pneumonia, including hospital pneumonia;
• Urinary system in the form of pyelonephritis, pyelitis;
• Skin and soft tissues in the form of erysipelas, pyoderma, secondary infected dermatosis;
• Organs in the small pelvis, including the inflammatory process of the uterine mucosa;
• Organs in the abdominal cavity, including the condition of complicated appendicitis, peritonitis, pelvioperitonitis.

The drug is effective in bacterial meningitis and blood infection. People who have febrile neutropenia use this antibiotic in combination with antiviral or antifungal agents.

Rules for the preparation of solution

Dissolution of the drug requires compliance with aseptic and antiseptic safety measures. Vial bottles with a solution are used once, it is not allowed to mix antibiotics and other drugs at the same time.

Antibiotic "Meropenem" in the form of powder is diluted with sterile injectable water for further intravenous bolus administration. To dissolve 1 g of meropenem, 20 ml of water is used, which corresponds to a concentration of 50 mg per ml. The prepared liquid is usually clear, colorless or with a light yellow tinge.

As a solvent for the drug "Meropenem" you can use 50-200 ml of a compatible infusion solution. They include:

• Solution of sodium chloride 0,9%;
• A solution of dextrose 5% or 10%.

Before intravenous administration, the diluted liquid is shaken.

Dosage of the drug

For adults, the medication "Meropenem" instructions for use provides for a dose of 500 mg, which is repeated after 8 hours. According to this scheme, pneumonia, urinary tract infections, infectious and inflammatory diseases of the organs in the small pelvis, infections of the skin and muscle tissue are treated.

Hospital pneumonia, peritonitis, septicemia, signs of bacterial infection in patients with neutropenia febrile require an antibiotic 3 times a day for 1 g. For meningitis, a dose of 2 g after 8 hours is recommended.

Depending on the degree of severity and type of infectious disease of the patient, the dosing and the duration of the treatment are selected by the doctor.

Usually, the duration of the manipulations depends on the mode of administration. Intravenous bolus feeding of the diluted solution is carried out for about 5 minutes, and intravenous infusion - from 15 to 30 minutes. Medication "Meropenem" is not administered intramuscularly.
Chronic renal failure requires correction of dosing in accordance with the clearance of creatinine :

• At 26-50 ml per minute the dose is from 500 mg to 2 g, every 12 hours;
• At 10-25 ml per minute the dose is from 250 mg to 1 g, every 12 hours;
• Less than 10 ml per minute, the dose ranges from 250 mg to 1 g, every 24 hours.

Elderly patients with normal kidney function and creatinine clearance above 50 mL per minute are not required to be dosed. Hepatic failure is not a cause for dose adjustment.

During hemodialysis, the removal of meropenem occurs, so the drug is administered at the end of the procedure. This is especially true for prolonged treatment to restore the effective concentration of antibiotic in the blood.
In childhood from 3 months to 12 years, 10-20 mg of the drug per kg of body weight are used intravenously at intervals of 8 hours. Dosage depends on the causative agent of the infection, its sensitivity to the antibiotic and the course of the disease.
If children under 12 years of age weigh more than 50 kg, they are prescribed adult doses of the drug.

Therapy meropenem children with impaired renal function has not been studied.
In the treatment of meningitis, 40 mg per kg of body weight is used after 8 hours.

To whom is contraindicated treatment

It is important to know that not everyone can use the drug, especially when there is an increased hypersensitivity to this antibiotic or similar beta-lactam antibacterial agents in the past.

Small children under 3 months are not prescribed a drug "Meropenem." The patients' testimonies testify to the practice of using it with drugs that have toxic effects on the kidneys and diseases of the digestive tract.
During pregnancy, the drug is not used, except cases when the benefit of the antibiotic exceeds the harmful effect on the development of the unborn child. Breastfeeding during treatment is also not recommended by doctors.

Side effects

About the drug "Meropenem" reviews indicate the possible development of unwanted effects in different parts of the body.

The nervous system and sensory organs can react to an antibiotic with the manifestation of a headache, dizziness, a feeling of numbness in the area, a feeling of tingling and creeps, a strong emotional excitement, a violation of consciousness, epileptiform seizures, seizures.

On the cardiovascular system, the organs of hematopoiesis the drug has a negative effect associated with both an increase in the number of eosinophils and platelets in the plasma of peripheral blood, and with a decrease in platelet and leukocyte cells, hemoglobin level, a decrease in the hematocrit size and the number of neutrophils leading to agranulocytosis, Thromboplastin and prothrombin time.

Some patients noted changes associated with the organs of the gastrointestinal tract, manifested by pain in the abdominal cavity, nausea, vomiting, diarrhea, constipation, digestive disorders, jaundice. It is also possible to increase the level of bilirubin in the blood plasma, increase the activity of enzymes alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase. In rare cases, the state of pseudomembranous colitis develops, or the candidiasis lesions appear on the mucous membrane of the oral cavity.

There are cases of violations affecting the genitourinary system. They include: difficulty urinating, swollen condition of soft tissues, abnormalities in the kidneys associated with hyperkreatininemia, increased urea levels in the blood, hematuria, thrush.

The action of the antibiotic can cause various allergic manifestations. They are manifested by itching, rash, hives, multiforme erythema exudative, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, anaphylactic shock.

Among other adverse reactions, there are reports of leaching potassium from the body, increasing blood volume in the systemic circulation, positive direct or indirect antiglobulin test of Coombs. Local reactions from intravenous administration are associated with inflammation, phlebitis, thrombophlebitis, painful sensations and swelling at the site of the injection.

Some patients associate hallucinations, depression, increased excitability, insomnia, heart failure, cardiac arrest, tachycardia, bradycardia, heart muscle infarction, blood pressure changes, dyspnoea, fainting and anxiety, although there is no definite role for meropenem in these symptoms .