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Meropenem, sold under the brand name Merrem among others, is an intravenous carbapenem antibiotic used to treat a variety of bacterial infections. [3]
The β-lactam core structures. (A) A penam.(B) A carbapenam.(C) An oxapenam.(D) A penem.(E) A carbapenem.(F) A monobactam.(G) A cephem.(H) A carbacephem.(I) An oxacephem. This is a list of common β-lactam antibiotics—both administered drugs and those not in clinical use—organized by structural class.
Meropenem is somewhat less potent than imipenem against gram-positive pathogens, and somewhat more potent against gram-negative infections. Unlike imipenem, which produced an unacceptable rate of seizures in a phase 2 trial, meropenem is effective for the treatment of bacterial meningitis. [24]
The production of a β-lactamase by a bacterium does not necessarily rule out all treatment options with β-lactam antibiotics. In some instances, β-lactam antibiotics may be co-administered with a β-lactamase inhibitor. For example, Augmentin (FGP) is made of amoxicillin (a β-lactam antibiotic) and clavulanic acid (a β-lactamase inhibitor).
Meropenem: Merrem: Cephalosporins (First generation) Cefadroxil: Duricef: Good coverage against Gram-positive infections. Gastrointestinal upset and diarrhea; Nausea (if alcohol taken concurrently) Allergic reactions; Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls ...
In general, carbapenem, a β-lactam antibiotic, targets cells by inhibiting transpeptidases (penicillin-binding proteins). This prevents synthesis of peptidoglycan, a necessary structural component, leading to cell lysis. Resistance to carbapenem among Enterobacteriaceae and other gram-negative bacteria can be acquired through several mechanisms.
Similar to doripenem, meropenem and biapenem, ertapenem has slightly better activity against many Gram-negative bacteria than other carbapenems such as imipenem. In contrast to imipenem, doripenem and meropenem, it is not active against Enterococcus, Pseudomonas and Acinetobacter species. [8] [14]
The activity of meropenem/vaborbactam against P. aeruginosa and A. baumannii was found to be similar to that of meropenem alone. In fact, in these species, meropenem resistance is largely mediated by mechanisms that are not antagonized by vaborbactam (e.g., outer-membrane impermeability, upregulation of efflux systems, and production of class B ...