The solution should be shaken before use . Conclusions Meropenem at concentrations between 6.25 mg/mL and 25 mg/mL as tested is not sufficiently stable to administer as a 24-hour infusion in ambulatory device reservoirs. The protocol consists of a model previously performed in other tissues . 62 The 40 mg/mL solution of meropenem reconstituted in isotonic saline was stable at 25°C for a maximum of 8 hours. is 500 mg given every 8 hours for skin and skin structure infections and 1 gram given every 8 hours for intra-abdominal infections. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Continuous IV Infusion: NOTE: Meropenem has not been FDA-approved for administration as a continuous intravenous infusion. (UW Health Strong Recommendation, Low Quality of Evidence) 4. If the YCD 95% minimum content limit is applied, the infusion period must be reduced to less than 6 hours for body-worn devices, especially at the higher concentration studied (25 mg/mL). 3 0 obj Meropenem by CI was diluted in 100 mL of 0.9% saline solution and injected into a central venous catheter via a volumetric pump (Braum Mesulgen, Mesulgen, Germany) with an infusion dead space of < 2 mL. 1014 0 obj <> endobj When treating complicated skin and skin structure infections caused by P. aeruginosa, a dose of 1 gram every 8 hours is recommended.Meropenem for injection (I.V.) * Extended infusion not applicable to NICU patients. Here, several thought-leaders in the field (Dr. Grupper, Dr. Kuti and Dr. Nicolau) weigh in on the topic. It is given through a needle placed into one of your veins. Background Meropenem exhibits time-dependent antimicrobial activity and prolonged infusion (PI) (extended infusion or continuous infusion, EI or CI) of meropenem can better achieve pharmacodynamics target when comparing with intermittent bolus (IB). Patients not in septic shock may or may not receive their first dose of antibiotic over 30 minutes and may have prolonged infusion started immediately. Microbiologic success is dependent on pharmacokinetic and pharmacodynamic parameters and the organism’s MIC.8 As previously mentioned, the pharmacodynamic target for beta-lactam antibiotics is the time the drug concentration remains above the MIC of the infecting organism. In Summary. Blood samples were drawn from a peripheral vein at the end of the infusion (T1), one hour later (T2), and two hours later (T3). 2.2. Then adjust 500mg IV q6h for renal function = 500mg IV q8hr. Study Protocol. Renal Dosing Adjustment for Pediatric Patients all ages <40kg: • CrCl > 40ml/min = no adjustment protocol does NOT include patients in the neonatal intensive care unit. e Ÿ£ƒBÿ CȑõË5 ÍĜ  cTbàrC˜0ˆÆ>q0¿tŽ= ˜nl'AZ¸Œ@ZX€T;÷O0—á'@€ Þ``c 100 HAP patients, admitted to ICU of Qilu Hospital of Shandong University, … x��][��6�~7�� `1@� �IQ�` ng��3�ij�E2�n������v��Q���CRR/�J�����������#���C���?����kn����˷��\�����|��=��a�����ï�k�����Wɋ�W�?�?����O���˚'������c�{������.�̒:�������4���")�"-���h��er��K��J����g�`�B$oo~���m������Ͼ������#�ez�&ȟ6�n�o�m/X��n�����?n/���a[n:��y���^ԛ������. hÞb```¢ ÉÆ Ā BÌ,@ȱ˜A€ƒA„9x‚à„e‘Œ¼˜X3È7d3Ë0\`è?´hómnÎ@± F†X» Üg˜Ä:ÂÌÝv;¿ìöÛm„[[%[‚%\ ¬á 1 0 obj endstream endobj startxref For intravenous infusion, meropenem vials may be directly constituted with 0.9 % sodium chloride or 5% glucose solutions for infusion. of antibiotic as a 30-minute infusion to reduce the time to a therapeutic concentration. Each vial is for single use only. Further dilute in 50 mL or 250 mL of 0.9% Sodium Chloride Injection and administer over 8 hours. Meropenem to be used for bolus intravenous injection should be reconstituted with sterile water for injection. Place in a 100mL bag of 0.9%NaCl to create a Meropenem concentration of 4mg/100mL (0.04mg/mL). 3v2QåÑɅÖZÜßÃ|l¬b†ÌßڍۇƒÈs Ksül]{¢R>ڔv§$ª3í(2«Þ‡Å¢?oïʲˆk„ƒÈ»¸øͼZ˜ÎtqºIæˆð%˜Î5sßvV. Infusion. For other pediatric patients less than 1 year of age the pharmacist must discuss the dose adjustment with the medical team who initiated the order. The 5 mg/mL aqueous reconstituted solution of meropenem was stable for up to 8 hours in the temperature range between 25°C and 35°C, and for up to 5 hours at 40°C. • One gram of meropenem was administered by intravenous infusion for 30 min. Interview By: Timothy P. Gauthier, Pharm.D., BCPS-AQ ID [Last … %PDF-1.5 stream 1025 0 obj <>stream Label as solution #1. endobj b. Remove 2mL from Solution #2. For intravenous infusion, meropenem vials may be directly reconstituted with 0.9 % sodium chloride or 5% glucose solutions for infusion. Theoretically, therefore, this meropenem regimen should kill KPC-producing bacteria with MICs of 16 μg/ml or less. Meropenem (Meronem ®, AstraZeneca Pharmaceuticals, Belgium) was administered as either II (infusion over 0.5 h) in 30 patients (II group) or EI (infusion over 3 h) in 25 patients (EI group), at a dose of 1 g every 8 h, which is usually recommended in nosocomial pneumonia. áCX©æ °X[H1„ UØêÌÁÑÑ`ÑÁÜàÚÁ–ÑÐÐÑæ2i4¤u°x ¹@A—ˆˆDˆ Tazocin® and Meropenem are beta-lactam antibiotics, whose efficacy is dependent upon time above minimum inhibitory concentration (MIC) in affected tissues. Standard aseptic techniques should be used for solution preparation and administration. For example, a prolonged infusion of high-dose meropenem (2 g q8h, with each dose infused over 3 h) achieves a high likelihood of obtaining a 40% ƒT>MIC against bacteria with MICs of ≤16 μg/ml. Meropenem’s stability was examined at two temperatures 22°C and 33°C to mimic average and high temperature in hospital wards. Objective: To Compare the clinical efficacy and safety of meropenem with a 3-hour extended infusion or conventional 30-minute infusion regimen in treatment of hospital acquired pneumonia (HAP) in intensive care unit (ICU) patients. <> In this retrospective study, we compared intensive care unit (ICU) mortality and clinical response in patients who received meropenem for ≥72 hours administered per EIM protocol of 1 g over 3 hours every 8 hours versus intermittent infusion (IIM) protocol of 500 mg over 30 minutes every 6 hours. * IV push available, however, prolonged infusion is the preferred method of administration ** 30-60 minute infusion on Freedom 60 pump, no IV push available *** 60-90 minute infusion on Freedom 60 pump, no IV push available Factors that prohibit short infusions or IV push antibiotics with OPAT may include (but are not limited to): Label as solution #2 c. Solution #1: Remove 2mL from a 100mL bag of 0.9% NaCl. should be administered by intravenous infusion over approximately 15 minutes to 30 minutes. The results suggest that cefiderocol is a potential option for the treatment of patients with nosocomial pneumonia, including those caused by multidrug-resistant Gram-negative bacteria. PURPOSE Meropenem belongs to the antibiotic class of carbapenems, which are known to be broad-spectrum antibiotics effective against several drug-resistant organisms. endobj endobj Several studies have explored the PK/PD parameters of beta lactam agents with Infusion . 0 2 0 obj Preparation of Solution: 3 g/day continuous IV infusion: Reconstitute a 1 g vial according to manufacturer recommendations. 63 Therefore, continuous infusion of meropenem 3 g/day could be divided into six … %%EOF pseudomonas) How: 1. Extended Infusion Cefepime and Meropenem Tip Sheet What: Cefepime orders are defaulting to 4 hour infusions; Meropenem will default to 3 hours. Hence, administering these antibiotics by continuous infusion should improve the outcomes of … The medicine must be injected slowly, so the needle will need to stay in place for at least 15 to 30 minutes. Doses of 1 gram may also be a… Traditionally, meropenem has been dosed 1 g IV q 8 hrs for serious infections. Meropenem was subsequently assayed using high-performance liquid chromatography (HPLC). %���� hÞÔSÛnÛ0ýý@GJ¾)@a ɚm@7M±ò 9‚#À•[)²¿)9Ù²§½ÖmŠ"uŽäC‰J In the EI group, 18/76 patients (23.7%) received some of the meropenem doses for less than the 4–hour infusion time due to technical reasons; the mean infusion time per dose during the first 2 days of treatment was 3.62 hours (standard deviation, 0.41 hours) in the EI group.
2020 meropenem infusion protocol