Meropenem

Meropenem

Chemical structure of Meropenem

Meropenem is a broad-spectrum antibiotic used to treat a variety of bacterial infections. It belongs to the carbapenem class of beta-lactam antibiotics, which are known for their ability to resist degradation by most beta-lactamase enzymes produced by bacteria. This makes meropenem particularly effective against a wide range of Gram-positive and Gram-negative bacteria, including those that are resistant to other antibiotics.

Mechanism of Action

Meropenem works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which are essential for the cross-linking of the peptidoglycan layer. This inhibition leads to the weakening of the cell wall and ultimately causes bacterial cell death. The broad-spectrum activity of meropenem is due to its high affinity for multiple PBPs and its ability to penetrate the outer membrane of Gram-negative bacteria.

Clinical Uses

Meropenem is used to treat a variety of serious infections, including:

• Intra-abdominal infections
• Bacterial meningitis
• Skin and soft tissue infections
• Pneumonia, including hospital-acquired pneumonia
• Sepsis

It is often reserved for severe infections or when other antibiotics have failed, due to its broad-spectrum activity and effectiveness against resistant organisms.

Administration and Dosage

Meropenem is administered intravenously, typically in a hospital setting. The dosage and duration of treatment depend on the type and severity of the infection, as well as the patient's renal function. It is important to adjust the dose in patients with renal impairment to avoid accumulation and potential toxicity.

Side Effects

Common side effects of meropenem include:

• Nausea
• Vomiting
• Diarrhea
• Rash

Serious side effects, although rare, can include allergic reactions, seizures, and Clostridioides difficile infection.

Resistance

3D model of Meropenem

While meropenem is resistant to many beta-lactamases, some bacteria have developed mechanisms to resist its effects. These include the production of carbapenemase enzymes, which can hydrolyze meropenem, and changes in bacterial porin channels that reduce drug uptake. The emergence of carbapenem-resistant Enterobacteriaceae (CRE) is a significant concern in healthcare settings.

Related Pages

• Antibiotic resistance
• Beta-lactam antibiotics
• Carbapenem-resistant Enterobacteriaceae
• Penicillin-binding proteins

Vial of Meropenem for injection

Conclusion

Meropenem is a powerful antibiotic used to treat severe bacterial infections, particularly those caused by resistant organisms. Its broad-spectrum activity and resistance to many beta-lactamases make it a valuable tool in the fight against bacterial infections. However, the emergence of resistant strains highlights the need for careful use and ongoing research into new antimicrobial agents.