Synthetic antibiotics include a group of carbapenems, a representative of which is the drug "Meropenem" for parenteral administration. Due to the bactericidal and bacteriostatic action of the active component, the drug is able to inhibit the growth and reproduction of bacteria that cause various inflammatory diseases.
Drug description
The medicine "Meropenem" is considered a broad-spectrum antibiotic and is a white or white with a yellow tint powder for the preparation of a solution. Enter intravenously bolus or infusion.
They release it in bottles with a volume of 10 and 20 ml. The dosage of the lyophilisate is 0.5 g or 1 g of the drug "Meropenem." Tablets and injectable solutions for intramuscular administration using an antibiotic are not produced. There is only one form of release.
The composition of the drug
The active component is meropenem in the form of a trihydrate. In the description of the composition, calculated on 1 bottle, the amount of the active substance is indicated: meropenem trihydrate at 0.570 g, or 1.140 g, and in terms of free meropenem at 0.5 g or 1 g, respectively. Powder excipients include sodium carbonate.
The main analogues and their manufacturers
The original drug based on meropenem is the drug "Meronem" in the form of a powder of 0.5 g. It is used to make an injection solution that is administered intravenously. This antibiotic is produced by the English company Astra Zeneca Ltd., on the basis of which the composition and dosage of the drug are developed, preclinical and clinical trials are conducted. The remaining preparations with meropenem are considered generic and reproduced in the likeness of the original.
Generic Meropenem analogues are produced both under a trade name that matches the international nonproprietary name, and under a commercial name other than that adopted by INN. The release form, dosage and composition of all drugs reproduced in the likeness of the Meronem drug are the same, which indicates their interchangeability.
The drug under the trade name "Meropenem" is produced by many pharmaceutical plants around the world. For example, the Indian company M. J. Biopharm Pvt. Ltd. " produces medicine, and the packaging is carried out at the Russian company ZAO BIOTEK MFPDK. Ukrainian companies Lekhim, Pharma Life also produce the antibiotic Meropenem. Analogs in their name may also contain the name of the manufacturer. There are many examples in world pharmacy. In particular, the drug "Meropenem-Vero" is known. This is a product of the Chinese company Shenzhen Haibin Pharmaceutical Co. Ltd. "
The medicine "Meropenem Jodas" is an Indian analogue of a broad-spectrum antibiotic, produced by Jodas Expoim LLC. Available in powder form for the manufacture of an injection solution of 500 mg and 1000 mg.
The Russian company ABOLmed LLC produces the medicine Meropenabol based on the antibacterial meropenem. A solution for intravenous administration is prepared from the powder.
The drug "Meropenem Spencer"
This tool is another Indian counterpart manufactured by Cooper Pharma for Spencer Pharma Ukey Limited, India. It is produced on the basis of meropenem in the form of a trihydrate and belongs to the group of carbapenems. Antibiotic Meropenem Spencer exhibits an antibacterial effect against gram-positive and gram-negative bacteria in inflammatory and infectious diseases. Used for parenteral administration.
Pharmacological properties
Instructions for use characterize the main effect of the substance meropenem on the broad-spectrum bactericidal effect, which is associated with the suppression of the formation of a bacterial membrane. The ability to cause the death of aerobes and anaerobes is due to the penetration of the antibiotic through the wall of the microorganism, inertness towards beta-lactamases and a significant relationship to protein formations that bind penicillin substances.
By binding to protein receptors on the membrane of the cytoplasm of bacteria, reducing the peptidoglycan layer in the cell wall and inhibiting transpeptidase, autolytic enzymes are released in the cell wall, destroying its structure and leading to the death of the parasite.
What microorganisms does the antibiotic act on?
For the drug "Meropenem", the instructions for use provide for the use against gram-positive aerobes, which include Enterococcus feces, Staphylococcus aurelus, Streptococcus agalactia, Streptococcus pneumonia with sensitivity to
penicillin, streptococcus pyogenesis, streptococcus viridans.
The antibiotic is highly active against gram-negative aerobes, among which E. coli, Haimofilus influenza, Klebsiella pneumonia, Neisseria meningitidis, Pseudomonas aeruginosa, Proteus mirabilis are distinguished.
Meropenem acts on anaerobic bacteria, such as: Bacteroides flagilis, Peptostreptococcus spp.
The effectiveness of the drug is confirmed against the following bacteria only by in vitro studies, but there is no data on clinical efficacy.
Gram-positive aerobes include Staphylococcus epidermidis with methicillin sensitivity, and Gram-negative aerobes: Acinetobacter spp., Aeromonas hydrophile, Campylobacter jejuni, Citrobacter sabotage, Citrobacter freundi, Enterobacter cloaclebella catlarhellarlafellarlafaerlauglerlafellarlafaerlauglerlafellorfaella, Morgelellarlafellorhalafellarlafellorhalafelorlafellarlafaellarfaella, Morgelaella khelaellaergelaella, Morgelella kharlabellerlafaellarlafaerlauglerlafelorhella , Salmonella sp.p., Serratia marcescens, Shigella spp., Ursinia enterocolitis.
In vitro fights anaerobic bacteria: Bakteroides distasonis, Bakteroides ovatus, Bakteroides uniformis, Bakteroides ureolitikus, Bakteroides vulgaris, Clostridium difficile, Clostridium perfringens, Eubakterium lentum, Fuzobakterium spp, Prevotella bivia, Prevotella intermedia, Prevotella melaninogenika, Porfiromonas asaharolitika, Propionibakterium aknes..
What heals the drug
Due to the wide spectrum of action of the active substance by meropenem, the instructions for use recommend that it be used as a separate medication or as part of combination therapy for various infectious and inflammatory diseases.
These include infections sensitive to this antibiotic, affecting:
- lower parts of the respiratory tract, manifested by pneumonia, including hospital pneumonia;
- urinary system in the form of pyelonephritis, pyelitis;
- skin and soft tissues in the form of erysipelas, pyoderma, secondary infected dermatosis;
- organs in the pelvis, including the inflammatory process of the uterine mucosa;
- organs in the abdominal cavity, including the state of complicated appendicitis, peritonitis, pelvic peritonitis.
The drug is effective in bacterial meningitis and blood infection. People with febrile neutropenia use this antibiotic in combination with antiviral or antifungal agents.
The rules for preparing the solution
Dissolution of the drug requires compliance with aseptic and antiseptic safety measures. Vials with a solution are used once; simultaneous mixing of an antibiotic and other drugs is not allowed.
Antibiotic Meropenem in powder form is diluted with sterile injectable water for further intravenous bolus administration. To dissolve 1 g of meropenem, 20 ml of water is used, which corresponds to a concentration of 50 mg per 1 ml. The prepared liquid is usually transparent, colorless or with a light yellow tint.
As a solvent of the drug "Meropenem" you can use 50-200 ml of a compatible infusion solution. These include:
- sodium chloride solution 0.9%;
- 5% or 10% dextrose solution.
Before intravenous administration, the diluted liquid is shaken.
Drug dosage
For adults, the medicine "Meropenem" instructions for use provides a dose of 500 mg, which is repeated after 8 hours. According to this scheme, pneumonia, infections of the urinary system, infectious and inflammatory diseases of the organs in the small pelvis, infections of the skin and muscle tissue are treated.
Hospital pneumonia, peritonitis, septicemia, signs of bacterial infection in patients with febrile neutropenia require the use of an antibiotic 3 times a day for 1 g. With meningitis, a dose of 2 g after 8 hours is recommended.
Depending on the severity and type of infection of the patient, the doctor selects the dosage and duration of treatment.
Typically, the duration of the manipulation depends on the route of administration. An intravenous bolus delivery of the diluted solution is carried out for about 5 minutes, and an intravenous infusion from 15 to 30 minutes. Medication "Meropenem" is not administered intramuscularly.
Chronic renal failure requires dosage adjustment in accordance with creatinine clearance :
- at 26-50 ml per minute, the dose is from 500 mg to 2 g, every 12 hours;
- at 10-25 ml per minute, the dose is from 250 mg to 1 g, every 12 hours;
- less than 10 ml per minute, the dose is from 250 mg to 1 g, every 24 hours.
For elderly patients with normal kidney function and with creatinine clearance above 50 ml per minute, dosage is not necessary. Hepatic failure is not a reason for dose adjustment.
During hemodialysis, meropenem is excreted, so the drug is administered at the end of the procedure. This is especially true for long-term treatment to restore an effective concentration of an antibiotic in the blood.
In children from 3 months to 12 years old, they use intravenously 10-20 mg of the drug per 1 kg of weight with an interval of 8 hours. Dosage depends on the causative agent of the infection, its sensitivity to the antibiotic and the course of the disease.
If in children under 12 years of age body weight exceeds 50 kg, they are prescribed adult doses of the drug.
Meropenem therapy in children with impaired renal function has not been studied.
In the treatment of meningitis, 40 mg per 1 kg of weight is used after 8 hours.
Who is contraindicated in treatment
It is important to know that not everyone can use the drug, especially when there is an increased hypersensitivity to this antibiotic or similar beta-lactam antibacterial agents in the past.
Small children under 3 months of age are not prescribed Meropenem medication. Reviews of patients indicate the practice of using it with drugs that have a toxic effect on the kidneys, and with diseases of the digestive tract.
During pregnancy, the drug is not used, with the exception of cases where the benefit of the antibiotic exceeds the harmful effects on the development of the unborn child. Breastfeeding during treatment is also not recommended by doctors.
Side effects
About the drug "Meropenem" reviews indicate the possible development of undesirable consequences in different parts of the body.
The nervous system and sensory organs can respond to an antibiotic with a headache, dizziness, numbness, tingling sensation and goosebumps, severe emotional arousal, impaired consciousness, epileptiform seizures, and seizures.
The drug has a negative effect on the cardiovascular system and hematopoiesis, associated with both an increase in the number of eosinophils and platelets in the plasma of peripheral blood, and a decrease in platelet and leukocyte cells, hemoglobin levels, a decrease in the hematocrit and the number of neutrophils leading to agranulocytosis, and thromboplastin and prothrombin time.
Some patients noted changes associated with the organs of the gastrointestinal tract, manifested by pain in the abdominal cavity, nausea, vomiting, diarrhea, constipation, indigestion, jaundice. It is also possible to increase the level of bilirubin in blood plasma, an increase in the activity of the enzymes alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase. In rare cases, a condition of pseudomembranous colitis develops, or lesions of candidiasis appear on the mucous membrane of the oral cavity.
Cases of disorders affecting the genitourinary system are known. These include: difficulty urinating, an edematous state of soft tissues, impaired renal function associated with hypercreatininemia, an increase in blood urea, hematuria, and thrush.
The action of an antibiotic can cause various allergic manifestations. They are manifested by itching, rash, urticaria, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, anaphylactic shock.
Among other adverse reactions there are reviews of leaching potassium from the body, increasing blood volume in the systemic circulation, a positive direct or indirect Coombs antiglobulin test. Local reactions from intravenous administration are associated with inflammation, phlebitis, thrombophlebitis, pain and swelling at the injection site.
Some patients associate hallucination, depression, irritability, insomnia, heart failure, cardiac arrest, tachycardia, bradycardia, heart muscle infarction, blood pressure drops, shortness of breath, fainting and anxiety, although the role of meropenem in these symptoms is not clearly established with the antibiotic side effects. .