Update on the efficacy and tolerability of meropenem in the treatment of serious bacterial infections.
Meropenem is a carbapenem antibiotic approved by the US Food and Drug Administration for the treatment of complicated skin and skin-structure infections, complicated intra-abdominal infections, and pediatric bacterial meningitis (in patients >or=3 months of age). In clinical trials, it also has shown efficacy as initial empirical therapy for the treatment of nosocomial pneumonia. Unlike other beta-lactam antibiotics, including third-generation cephalosporins, carbapenems have shown activity against extended-spectrum beta-lactamase-producing and AmpC chromosomal beta-lactamase-producing bacteria. Compared with imipenem, meropenem is more active against gram-negative pathogens and somewhat less active against gram-positive pathogens, and it does not require coadministration of a renal dehydropeptidase inhibitor. In most comparative trials, clinical and bacteriological response rates with imipenem and meropenem were similar. Compared with clindamycin/tobramycin, meropenem is associated with a reduced length of hospital stay and a shorter duration of therapy among patients with complicated intra-abdominal infections. Meropenem is well tolerated by children and adults and has an acceptable safety profile. Alternative meropenem dosing strategies for the optimization of outcomes are under investigation.
Mohr
John F
JF
University of Texas Health Science Center, Houston, Texas, USA. john.mohr@cubist.com
D018784:Abdominal Abscess / Q000188:drug therapy; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy*; D003428:Cross Infection / Q000188:drug therapy; D006801:Humans; D007223:Infant; D016920:Meningitis, Bacterial / Q000188:drug therapy; D000077731:Meropenem; D011014:Pneumonia / Q000188:drug therapy; D017192:Skin Diseases, Bacterial / Q000188:drug therapy; D013845:Thienamycins / Q000494:pharmacology / Q000627:therapeutic use*
D013845:Thienamycins; D000077731:Meropenem