The tables below provide general recommendations for dosing. BACKGROUND: Hospitalized neonates are exposed to antibiotic-resistant bacterial pathogens and develop nosocomial infections. Multiple Dose Pharmacokinetic Study of Meropenem in Young Infants (<91 days) with Suspected or Complicated Intra-abdominal Infections Sponsor: NICHD Product Meropenem Objectives: a. OBJECTIVE: To compare the clinical and microbiologic efficacy and safety of prolonged infusions versus conventional dosing of meropenem in neonates with Gram-negative late-onset sepsis (GN-LOS). u dzieci) można podawać we wstrzyknięciu i.v. Except two, all cases responded well and survived. Four hundred forty-six patients (397 pediatric patients 3 months to less than 17 years of age) were enrolled in 4 separate clinical trials and randomized to treatment with meropenem (n=225) at a dose of 40 mg/kg every 8 hours or a comparator drug, i.e., cefotaxime (n=187) or ceftriaxone (n=34), at the approved dosing regimens. In vivo bactericidal activity of meropenem against Escherichia coli and Pseudomonas aeruginosa is plotted as a function of the percentage of the dosage interval that drug concentrations remained higher than the MIC for each organism. Meropenem has been extensively evaluated in treating bacterial meningitis in children but few studies have been comparative. Meropenem. Meropenem Merrem ® - Renal dosing. Meropenem doses of 10, 20, and 40 mg/kg were administered as single doses (30-min intravenous infusion) on a random basis. In addition, there is significant variation in antibiotic dosing, including meropenem, in neonatal intensive care units (NICUs) . Use half normal dose every 24 hours if eGFR less than 10 mL/minute/1.73 m 2. Prolonged infusion instead of infusion over 30 minutes has been suggested to result in higher microbiologic efficacy. Oral dosing for chest infections in neonates without IV access (providing there have been no previous resistant gram negative bacteria isolated): dose as per BNFc (click icon to the left). Dose should be automatically adjusted by the pharmacist to 2g q8hr and modified to 500mg q6hr if the new culture yields an organism with a lower MIC. November 2019; Clinical and Translational Science 13(2) DOI: 10.1111/cts.12710. Please consult a pediatric pharmacist for individualized dosing recommendations in infants with renal impairment. > 7 d: q 6-8 hr. Oxacillin. Blood was obtained for determining the meropen … Each panel depicts one age/size group of subjects, as defined in Table 1. Reference(s) National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. dawki 2 g (40 mg/kg mc. CFU, colony-forming units. In this circumstance, meropenem in combination with an aminoglycoside should be administered for the entire course of therapy. Meropenem 40 mg/kg/dose q8h (max: 2 g/dose) Vancomycin IV Life threatening penicillin allergy: Aztreonam 40 mg/kg/dose q6h (max: 2 g/dose) + Vancomycin IV If an organism is ... *These guidelines are not intended for use in neonatal patients who have … When prescribed ensure the concentration (125/31) is clearly written on the prescription. Full blood count with long term use. It's FREE to register and you'll have access to drug information and much more. To characterize meropenem single-dose and multiple-dose PK in subjects with suspected or complicated intra-abdominal infections. If there is any question about the indication for meropenem, the prescriber should be contacted for clarification. 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. Lek jest wskazany także u pacjentów z bakteriemią związaną z którymkolwiek z ww. r microbiologic efficacy. b. 20 mg/kg/dose IV every 8 hours. Meropenem was given over a variable period from 10-21 days at a dose of 20 mg/kg/dose 12th hourly for babies less than 7 days and 8 hourly for babies above 7 days old. Dane dotyczące podania we wstrzyknięciu i.v. We describe the added value of therapeutic drug monitoring by presenting the case of a preterm infant with severe NEC treated with meropenem. A RCT reported a prolonged infusion (4 hours) of meropenem (20 mg/kg/dose every 8 hours and 40 mg/kg/dose every 8 hours in meningitis and Pseudomonas infection) in 102 neonates with gram-negative late onset infection is associated with higher rate of clinical improvement, It is critically important that all sources of information be leveraged to optimize dose selection for neonates. u dzieci) są ograniczone. Search worldwide, life-sciences literature Use normal dose every 12 hours if estimated glomerular filtration rate 26–50 mL/minute/1.73 m 2.. Use half normal dose every 12 hours if estimated glomerular filtration rate 10–25 mL/minute/1.73 m 2.. Use half normal dose every 24 hours if estimated glomerular filtration rate less than 10 mL/minute/1.73 m 2. 37 The dose of meropenem Kelly C. Wade, Daniel K. Benjamin Jr., in Infectious Diseases of the Fetus and Newborn (Seventh Edition), 2011. Mezlocillin & Piperacillin. Meropenem is predominantly excreted by renal route. Drug dosing in neonates should be based on integrated knowledge concerning the disease to be treated, the physiological characteristics of the neonate, and the pharmacokinetics (PK) and pharmacodynamics (PD) of a given drug. The dose of meropenem is 20 mg/kg by slow intravenous infusion once every 12 hours in the first week of life and once every 8 hours for infants older than this. Objective: To compare the clinical and microbiologic efficacy and safety of prolonged infusions versus conventional dosing of meropenem in neonates with Gram-negative late-onset sepsis (GN-LOS). The tables below provide general recommendations for dosing. Meropenem was studied in 200 neonates and infants less than 3 months of age. 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. METHODS: Neonates <2 months of age received a single dose of meropenem at 10 or 20 mg/kg. Distributions of steady state, intra‐dosage plasma meropenem concentrations in infants and children receiving currently recommended dosage regimens compared with target serum drug concentrations. Limited data are available regarding the neonatal pharmacokinetics of meropenem, a broad spectrum carbapenem antibiotic. These dosing guidelines are intended for use at UCSF Benioff Children's Hospitals. Elimination half life is longest in preterm babies and decrease with increasing age. † Use the dose for age ≤ 7 days until 14 days of age if the birth weight is < 1000 g. Use normal dose every 12 hours if eGFR 26–50 mL/minute/1.73 m 2. Meropenem has not been sufficiently studied for safety and efficacy in neonates, and is not recommended unless an extended spectrum β lactamase producing organism is identified. Listeria monocytogenes and the rest had fulminant sepsis. Schmutzhard et al randomized 56 adults with bacterial meningitis to meropenem (n = 28), cefotaxime (n = 17) or ceftriaxone (n = 11). Prescription drug information for thousands of brand, generic, and OTC medicines is available to registered members only. Meropenem - Neonatal Page 2 of 3 Meropenem - Neonatal Dose Adjustment Dose and frequency adjustment may be required in cases of impaired renal function. We studied meropenem in 23 pre-term (gestational age, 29 to 36 weeks) and 15 full-term (gestational age, 37 to 42 weeks) neonates. Europe PMC is an archive of life sciences journal literature. Dosing based on gestational age and serum creatinine (see Table: Vancomycin Dosage for Neonates) * The need to administer a test dose of amphotericin B is controversial. Meropenem (Table 37–10) was approved by the FDA for use in children older than 3 months of age on the basis of extensive pediatric investigations across a wide range of infections, including meningitis and complicated abdominal infections [1, 494]. Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2. Podawać i.v. Maintenance dose: 7.5 mg/kg IV q12 h. anaerobic infections; begin maintenance dose 48 h after load in preterm infants & after 24 h in term infants. Loading dose: 15 mg/kg IV. 25 mg/kg/dose IV / IM < 7d: q 12 hr.
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