Introduction:
- Cell wall synthesis inhibitor
- Bacteriocidal (kills the bacteria)
- Synthetic B-Lactam antibiotic
Available Drugs:
- Imipenem
- Meropenem
- Doripenem
- Irtapenem
Covers:
- Gram +ve cocci
- Gram -ve cocci
- Gram +ve bacilli
- Gram -ve bacilli
- Anaerobes [ তার মানে Meropenem দিলে anaerobic coverage এর জন্যে metronidazole দেওয়া লাগবে না। ]
+ Specially:
- Pseudomonas aeruginosa
- Listeria
Doesn’t Cover:
- MRSA
- Atypical Bacteria
BTW, Ertapenem একটু দুর্বল প্রজাতির। সে অন্যদের মত শক্ত সামর্থ্য না। It doesn’t cover Pseudomonas, Enterococcus, Acinetobacter.
Dose:
Usual dose 0.5-1 g IV/8 hourly. Renal Excretion. So dose adjustment is necessary in renal impairment.
Renal adjustment For Meropenem:,
CCR > 50 mL/min, 0.5 – 1 g IV 8 hourly
CCR > 26-50 mL/min, 0.5-1 g IV/12 hourly
CCR > 10-25 mL/min, 0.25-0.5 g IV/12 hourly
CCR < 10 mL/min, 0.25-0.5 g IV/24 hourly
Convulsion may occur. Specially if excessive levels of imipenem in patients with renal failure. Less likely for other carbapenems.
Penetrates body tissues and fluids including CSF, when meninges is inflammed. Meropenem reaches CSF even without inflammation.
Reference:
- Lippincott pharmacology
- https://reference.medscape.com/drug/merrem-iv-meropenem-342565#91