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The dose of meropenem administered and the duration of treatment should take into account the type of infection to be treated, including its severity, and the clinical response.
A dose of up to 2 g three times daily in adults and adolescents and a dose of up to 40 mg/kg three times daily in children may be particularly appropriate when treating some types of infections, such as infections due to less susceptible bacterial species (e.g. Enterobacteriaceae, Pseudomonas aeruginosa or Acinetobacter spp.), or very severe infections.
Additional considerations for dosing are needed when treating patients with renal insufficiency (see further as follows).
Adult and adolescents: See Table 3.
Click on icon to see table/diagram/imageMeropenem is usually given by intravenous infusion over approximately 15 to 30 minutes.
Alternatively, doses up to 1 g can be given as an intravenous bolus injection over approximately 5 minutes. There are limited safety data available to support the administration of a 2 g dose in adults as an intravenous bolus injection.
Renal impairment: The dose for adults and adolescents should be adjusted when creatinine clearance is less than 51 ml/min, as shown as follows. There are limited data to support the application of these dose adjustments for a unit dose of 2 g. (See Table 4.)
Click on icon to see table/diagram/imageMeropenem is cleared by haemodialysis and haemofiltration. The required dose should be administered after completion of the haemodialysis cycle.
There are no established dose recommendations for patients receiving peritoneal dialysis.
Hepatic impairment: No dose adjustment is necessary in patients with hepatic impairment.
Elderly patients: No dose adjustment is required for the elderly with normal renal function or creatinine clearance values above 50 ml/min.
Paediatric population: Children under 3 months of age: The safety and efficacy of meropenem in children under 3 months of age have not been established and the optimal dose regimen has not been identified. However, limited pharmacokinetic data suggest that 20 mg/kg every 8 hours may be an appropriate regimen.
Children from 3 months to 11 years of age and up to 50 kg body weight: The recommended dose regimens are shown in the table as follows: See Table 5.
Click on icon to see table/diagram/imageChildren over 50 kg body weight: The adult dose should be administered.
There is no experience in children with renal impairment.
Method of administration: Meropenem is usually given by intravenous infusion over approximately 15 to 30 minutes. Alternatively, meropenem doses of up to 20 mg/kg may be given as an intravenous bolus over approximately 5 minutes. There are limited safety data available to support the administration of a 40 mg/kg dose in children as an intravenous bolus injection.
For instructions on reconstitution of the medicinal product before administration, see Storage.
