Meropenem
antibiotic
Third-party optionBy the Layer Nutrition editorial team · How the atlas classifies the 664 molecules
What this medicine is for
Meropenem belongs to the category "antibiotic". Antibiotics treat infections caused by bacteria. They are taken as a course, for a defined period, to the end of the prescription.
For Meropenem, in practice: Treats a bacterial infection. It is used rather occasionally or as a short course, to get through an episode.
Under which brands it is found
In France, about 13 reimbursable presentations containing Meropenem are recorded. It comes under various trade names and in generic form.
- Meronem
- Meropenem Acs Dobfar
- Meropenem Arrow
- Meropenem Arrow Lab
- Meropenem Bradex
- Meropenem Hikma
- Meropenem Kalceks
- Meropenem Panpharma
- and other presentations
Generics and the original brand are equivalent for the active substance; only the appearance, the name or the excipients may differ.
On the plate: potassium and vitamin K
Meropenem can lower the potassium in your blood, and like any broad-spectrum antibiotic it alters the gut flora that helps make vitamin K. Food helps support both of these intakes, alongside your treatment.
Potassium keeps the nerves working, lets muscles contract, maintains a steady heart rhythm and carries nutrients into the cells. It is found in leafy greens such as spinach, in root vegetables such as carrot and potato, and in citrus fruit such as orange. Spreading these foods across the day covers a good share of your needs.
Vitamin K comes mainly from leafy green vegetables, kale, spinach and chard, as well as from cruciferous vegetables, broccoli, Brussels sprouts and cauliflower. Part of it is also produced by the bacteria in the digestive tract, the ones the antibiotic disrupts. Putting these vegetables on your plate regularly supports both intakes at once.
How meropenem works
Meropenem belongs to the carbapenem family, a subgroup of the beta-lactams. It destroys bacteria, an action described as bactericidal, by blocking the construction of their wall. In practice, it binds to the penicillin-binding proteins (PBPs), in particular PBPs 2, 3 and 4 in Escherichia coli and Pseudomonas aeruginosa. These proteins assemble the envelope of the bacterium: by neutralising them, it prevents the bacterium from building its wall, which eventually gives way.
Two properties explain its broad range of action. It penetrates the wall of most Gram-positive and Gram-negative bacteria. It also stays stable against hydrolysis by most beta-lactamases, the enzymes that bacteria produce to deactivate beta-lactams. This resistance keeps it active where other antibiotics lose their activity.
Why meropenem is prescribed
Meropenem targets serious bacterial infections, most often managed in hospital. Its indications include complicated skin and soft tissue infections, complicated intra-abdominal infections, and bacterial meningitis in children from 3 months of age. Its broad spectrum lets it cover a wide variety of bacteria, which matters when the germ responsible has not yet been identified.
It is one of the reserve antibiotics, brought in when the infection is severe or when the bacteria resist other treatments. The choice of the molecule rests with the physician, who decides according to the infected site, the severity of the condition and the germ identified. This strategic place explains why it is not used for ordinary infections.
How it is given
Meropenem is administered only intravenously, never by mouth. The usual schedule is one administration every 8 hours, that is three times a day. Each dose is given as an infusion of about 15 to 30 minutes, or as a slow injection, a bolus of 3 to 5 minutes. Because it is injected directly into the blood, taking it does not depend on meals, and its binding to plasma proteins stays low, around 2 %.
The close spacing of the doses is due to its pharmacology: its plasma half-life is close to one hour in adults with normal kidney function, so the concentration must be renewed often to remain effective between two doses. The treatment most often takes place in a hospital setting, under nursing supervision. It is not stopped on one's own initiative, even when the symptoms improve, because stopping early favours relapse and resistance.
The effects to know about
Clinical trials have quantified the frequency of adverse effects. The most common are anaemia in 5.5 % of patients, diarrhoea in 4.8 %, nausea or vomiting in 3.6 % and inflammation at the injection site in 2.4 %. Next come headache in 2.3 %, skin rash in 1.9 %, constipation in 1.4 % and itching in 1.2 %.
Laboratory abnormalities sometimes accompany the treatment. A drop in blood potassium may be seen, known as hypokalaemia, a decrease in platelets, a thrombocytopenia reported in patients with kidney failure without clinical bleeding, a rise in eosinophils and variations in the blood cell lines. These parameters are read on a blood test, which makes it possible to spot them and adjust the management.
Seizures and Clostridium difficile diarrhoea
The central nervous system calls for particular attention. Seizures and other neurological effects have been reported, with a seizure rate of 0.7 % in immunocompetent adults treated for infections located outside the central nervous system. This risk is concentrated in people with pre-existing neurological disorders, bacterial meningitis or kidney failure.
Like almost all antibiotics, meropenem can trigger diarrhoea linked to the bacterium Clostridium difficile, which takes advantage of the imbalance in the gut flora caused by the treatment. Its intensity varies greatly, from mild diarrhoea to a colitis that can become serious. Diarrhoea that persists or worsens, during or after the treatment, should be reported to the physician.
Interactions and monitoring
Two interactions call for vigilance. Combined with valproic acid or divalproex, two antiepileptics, meropenem causes their blood concentrations to fall, which can reopen the door to epileptic seizures: in this situation, an antibiotic other than a carbapenem is preferable. Probenecid, for its part, slows the renal excretion of meropenem and raises its concentrations, so this combination is not recommended.
Monitoring is organised around three areas. Kidney function is checked to adjust the dose, an adjustment needed as soon as creatinine clearance falls to 50 mL/min or less, because the kidney eliminates about 70 % of the dose unchanged within 12 hours. Added to this are neurological monitoring, because of the risk of seizures, and follow-up of the complete blood count and platelets during prolonged treatments.
Sources
Related molecules
To explore in the « Anti-infectives » family and its neighbours.
See the whole « Anti-infectives » family · Back to the atlas
Supplements to consider
Beyond the plate, a single isolated nutrient can be worth discussing, to confirm with your doctor or pharmacist. Here is which one and in which form.
Probiotics
Probiotics are live micro-organisms, mainly lactobacilli and bifidobacteria. The CFU count and the number of strains are among the selection criteria; gastro-resistant capsules protect the bacteria from stomach acidity.
Preferred form gastro-resistant capsules, several strains, CFU count stated
Frequently asked questions
What are the side effects of meropenem?
Among the common effects, the package leaflet lists nausea, vomiting, diarrhea and skin rashes, and more rarely headaches, tingling or seizures. For the full list and what applies to you, refer to the leaflet and talk to your doctor or pharmacist.
Does meropenem interact with other medications?
The package leaflet notes that meropenem can reduce the effectiveness of valproic acid, an epilepsy medication, and that probenecid can raise its blood concentration. Tell your doctor or pharmacist about all your treatments and follow the leaflet.
How is meropenem given?
Meropenem is an antibiotic from the carbapenem family, given by injection or infusion, usually in a hospital setting. The regimen and duration are set by the doctor: refer to the leaflet and to the care team.
Can you drink alcohol while taking meropenem?
Public sources report no significant documented interaction between meropenem and alcohol, but alcohol is still not advised during an infection. For your own situation, refer to the leaflet and seek advice from your doctor or pharmacist.
Can meropenem disrupt your gut flora?
Like other antibiotics, meropenem works by killing bacteria, and studies link antibiotic treatments to a temporary imbalance of the gut flora, sometimes causing diarrhea. Restoring bacterial balance after treatment is a widely documented topic in nutrition.
Which probiotics should you consider to support gut flora during antibiotic treatment?
Reviews, including a Cochrane review, link taking probiotics to a reduced risk of antibiotic-associated diarrhea. The most studied strains in this context are Lactobacillus rhamnosus GG and the yeast Saccharomyces boulardii, taken separately from the antibiotic. Ask your doctor or pharmacist for advice before combining them.
Ces réponses portent sur le volet nutritionnel. Pour toute question sur votre médicament, la notice et votre médecin ou pharmacien font foi.