meropenem cost uk

1. The identification and antimicrobial susceptibility tests on any such isolate must be repeated and if the result is confirmed the isolate sent to a reference laboratory. For medical inquiries or to report an adverse event, other safety-related information, or product complaints for a company product, please contact Medical Information. Some of these include meningitis, intra-abdominal infection, pneumonia, sepsis, and anthrax. Meropenem is usually given by intravenous infusion over approximately 15 to 30 minutes (see sections 6.2, 6.3, and 6.6). Limited post-marketing experience indicates that if adverse reactions occur following overdose, they are consistent with the adverse reaction profile described in section 4.8, are generally mild in severity and resolve on withdrawal or dose reduction. Small amounts of meropenem have been reported to be excreted in human milk. When multiple doses are administered 8-hourly to subjects with normal renal function, accumulation of meropenem does not occur. 1 Meropenem breakpoints for Streptococcus pneumoniae and Haemophilus influenzae in meningitis are 0.25 mg/l (Susceptible) and 1 mg/l (Resistant). This medicinal product must not be mixed with other medicinal products except those mentioned in section 6.6. IMPACT - SPECULATIVE . Use normal dose every 12 hours if eGFR 26–50 mL/minute/1.73 m 2.. Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2.. Use half normal dose every 24 hours if eGFR less than 10 mL/minute/1.73 m 2. The threshold analysis showed that meropenem would be the dominant strategy until the cost of imipenem plus cilastatin was reduced to 4.08 or less (72 in the base-case), or until its daily cost was increased to 158.25 or more (85.25 in the base-case). Diagn Microbiol Infect Dis. Caution is required if probenecid is co-administered with meropenem. There is no experience in children with renal impairment. The concomitant use of meropenem and valproic acid/sodium valproate/valpromide is not recommended (see section 4.5). Meropenem Prices. Meropenem is already marketed in the UK; a 10 vial pack of 500mg powder for solution for injection costs £77. VABOMERE ® (meropenem and vaborbactam) is indicated for the treatment of patients 18 years of age and older with complicated urinary tract infections (cUTI) including pyelonephritis caused by the following susceptible microorganisms: Escherichia coli, Klebsiella pneumoniae, and … Intravenous bolus injection administration. 2 Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. Author information: (1)Kellogg College, University of Oxford, Oxford, UK. Seizures have infrequently been reported during treatment with carbapenems, including meropenem (see section 4.8). The most frequently reported adverse reactions occurring in ≥3% of patients treated with VABOMERE were headache, phlebitis/infusion site reactions, and diarrhea. Cost-minimization analysis of imipenem/cilastatin versus meropenem in moderate to severe infections at a tertiary care hospital in Saudi Arabia . London (UK). The use of OPAT to deliver meropenem as a continuous infusion in the “hospital in the home” setting has many advantages. The solution should be shaken before use. VABOMERE® (meropenem and vaborbactam) is indicated for the treatment of patients 18 years of age and older with complicated urinary tract infections (cUTI) including pyelonephritis caused by the following susceptible microorganisms: Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae species complex. Meropenem is cleared by haemodialysis and haemofiltration. 1. The cost for meropenem intravenous powder for injection 500 mg is around $41 for a supply of 10 powder for injection, depending on the pharmacy you visit. Review appropriate cUTI patients for VABOMERE treatment, VABOMERE® has 32-fold more in vitro activity than meropenem alone1*, Meropenem and vaborbactam weredesigned to work together2,3. By Imraan Joosub, Andy Gray, Analyn Crisostomo and Abdul Salam. 5 Non-species related breakpoints have been determined using PK/PD data and are independent of MIC distributions of specific species. However, the protein binding is so low that no interactions with other compounds would be expected on the basis of this mechanism. Pooled analysis from the two phase III TANGO 1 and TANGO 2 trials for meropenem/vaborbactam showed that mortality at 28 days was 25% in treatment-arm vs. 44% for best available therapy (43.7% reduction). -- = Susceptibility testing not recommended as the species is a poor target for therapy with the drug. † The pharmacokinetics of meropenem in neonates requiring anti-infective treatment showed greater clearance in neonates with higher chronological or gestational age with an overall average half-life of 2.9 hours. Meropenem is a carbapenem-type antibiotic that works by stopping the growth of bacteria. Meropenem was provided by Molekula (Gillingham, Dorset, UK), whereas amoxicillin and clavulanate were bought from Sigma-Aldrich (Poole, Dorset, UK). For the full list of excipients, see section 6.1. Pharmacotherapeutic group: antibacterials for systemic use, carbapenems, ATC code: J01DH02, Pharmacokinetic/Pharmacodynamic (PK/PD) relationship. Meropenem is usually given by intravenous infusion over approximately 15 to 30 minutes (see sections 6.2, 6.3 and 6.6). After infusion over 5 minutes Cmax values are 52 and 112 μg/ml after 500 and 1000 mg doses respectively. Get PDF (494 KB) Cite . The most commonly reported meropenem-related laboratory adverse events were thrombocytosis (1.6%) and increased hepatic enzymes (1.5-4.3%). When suggestions are available use up and down arrows to review and ENTER to select. Haemodialysis will remove meropenem and its metabolite. Find its price or cost, dose, when to use, how to use, side effects, adverse effects, substitutes. 4.7 Effects on ability to drive and use machines No studies on the effect on the ability to drive and use machines have been performed. Direct antiglobulin test (Coombs test) seroconversion. The cost of Carbavance is not yet known. A positive direct or indirect Coombs test may develop during treatment with meropenem. In healthy subjects the mean plasma half-life is approximately 1 hour; the mean volume of distribution is approximately 0.25 l/kg (11-27 l) and the mean clearance is 287 ml/min at 250 mg falling to 205 ml/min at 2 g. Doses of 500, 1000 and 2000 mg doses infused over 30 minutes give mean Cmax values of approximately 23, 49 and 115 μg/ml respectively, corresponding AUC values were 39.3, 62.3 and 153 μg.h/ml. steven.j.edwards@astrazeneca.com This study compared the cost-effectiveness of meropenem with that of imipenem plus cilastatin in the treatment of severe infections in hospital intensive care in the UK. Non species related breakpoints are based on the following dosages: EUCAST breakpoints apply to meropenem 1000 mg x 3 daily administered intravenously over 30 minutes as the lowest dose. There is no evidence of an increased risk of any adverse drug reaction in children based on the limited available data. steven.edwards@kellogg.ox.ac.uk BACKGROUND: Treating patients admitted to critical care with severe pneumonia requires timely intervention with an effective antibiotic. Alternatively, meropenem doses of up to 20 mg/kg may be given as an intravenous bolus over approximately 5 minutes. Meropenem is generally well tolerated by the central nervous system. Bluish lips or skin 2. chills 3. cold, clammy skin 4. confusion 5. dizziness 6. fainting 7. fast heartbeat 8. fast, weak pulse 9. fever 10. itching, skin rash 11. lightheadedness 12. rapid, shallow breathing 13. sweating The base case also predicts NHS resource savings valued at £6,091 in Year 1, increasing to £15,228 in Year 5. Launch of Vaborem™ helps address the need for new products to combat multidrug-resistant Gram-negative bacteria. Prescribing VABOMERE in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of. To bookmark a medicine you must sign up and log in. If signs and symptoms suggestive of these reactions appear, meropenem should be withdrawn immediately and an alternative treatment should be considered. Monte Carlo simulation based on a population PK model showed that a dose regimen of 20 mg/kg 8 hourly achieved 60%T>MIC for P. aeruginosa in 95% of pre-term and 91% of full term neonates. The constituted solutions should not be frozen. Standard aseptic techniques should be used for solution preparation and administration. No specific medicinal product interaction studies other than probenecid were conducted. Continue typing to refine. From a microbiological point of view, unless the method of opening/reconstitution/dilution precludes the risk of microbiological contamination, the product should be used immediately. Isolates may be reported as R without prior testing. Treatment of patients with bacteraemia that occurs in association with, or is suspected to be associated with, any of the infections listed above. Children from 3 months to 11 years of age and up to 50 kg body weight, Severe pneumonia including hospital and ventilator-associated pneumonia. All reports received were consistent with events observed in the adult population. Currently, there is a lack of stability data on meropenem at various concentrations in elastomeric infusion devices for use in outpatient parenteral antimicrobial therapy (OPAT). This information is intended for use by health professionals. Description: Meropenem (SM 7338) is an ultra-broad spectrum injectable antibiotic. In individuals with normal renal function, rapid renal elimination will occur. References: However, bacteria may exhibit resistance to more than one class of antibacterial agents when the mechanism involved include impermeability and/or an efflux pump(s). Animal studies indicate that meropenem is well tolerated by the kidney. Meropenem should not be used in breast-feeding women unless the potential benefit for the mother justifies the potential risk to the baby. There are limited safety data available to support the administration of a 40 mg/kg dose in children as an intravenous bolus injection. Further, prolonged storage of reconstituted meropenem in elastomeric infusion devices may be required in rural or remote administration sites where several days’ supply may be needed. Tel 1-844-MED-MLNT (1-844-633-6568)1-844-MED-MLNT (1-844-633-6568), ©2020 Melinta Therapeutics, Inc.  All rights reserved. The sole metabolite of meropenem had a similar profile of toxicity in animal studies. No studies on the effect on the ability to drive and use machines have been performed. As with other antibacterial drugs, prolonged use of VABOMERE may result in overgrowth of nonsusceptible organisms. Furthermore, the report also provides the qualitative results of diverse market … In vitro: Meropenem has an antibacterial spectrum which is broadly similar to that of imipenem but, whilst slightly less active against staphylococci and enterococci, it is more active against Pseudomonas aeruginosa, all Enterobacteriaceae and Haemophilus influenzae. Localised clusters of infections due to carbapenem-resistant bacteria have been reported in the European Union. penicillins or cephalosporins). The cost of 1 day's treatment with 2 g (2 vials) every 8 hours is £106.68. For ordering information, please click here. Meropenem is a clinically important antibacterial reserved for treatment of multi-resistant infections. Treating physicians should refer to national and/or international consensus documents regarding the treatment of glanders and melioidosis. By continuing to browse the site you are agreeing to our policy on the use of cookies. Burgess OS, Hall RG II. Alternatively, meropenem doses of up to 20 mg/kg may be given as an intravenous bolus over approximately 5 minutes. Average Wholesale Prices (AWP) for Commonly-Used Intravenous Antibiotics, by dose, per day (source: Bartlett, J. et al, Johns Hopkins Antibiotic Guide, 2005) 2. Start typing to retrieve search suggestions. Meropenem, sold under the brandname Merrem among others, is a broad-spectrum antibiotic used to treat a variety of bacterial infections. There was no evidence of mutagenic potential in a conventional test battery and no evidence of reproductive toxicity including teratogenic potential in studies in rats up to 750 mg/kg and in monkeys up to 360 mg/kg. Broncho-pulmonary infections in cystic fibrosis, Complicated skin and soft tissue infections, Management of febrile neutropenic patients. Data on file: Melinta Therapeutics, Inc. They are for use only for organisms that do not have specific breakpoints. • Broncho-pulmonary infections in cystic fibrosis, • Complicated skin and soft tissue infections. Due to the rapid onset and the extent of the decrease, co-administration of valproic acid/sodium valproate/valpromide with carbapenem agents is not considered to be manageable and therefore should be avoided (see section 4.4). Case reports in the literature have shown that. All methicillin-resistant staphylococci are resistant to meropenem. varies across the European Union. A study of 12 patients administered meropenem 1000 mg 8 hourly post-surgically for intra-abdominal infections showed a comparable Cmax and half-life to normal subjects but a greater volume of distribution 27 l. Meropenem is cleared by haemodialysis with clearance during haemodialysis being approximately 4 times higher than in anuric patients. Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness. Continue, 2. Author information: (1)AstraZeneca UK Ltd, Luton, UK. 2004;49(1):41-46. Powder for solution for injection or infusion. Resistance to penems of Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp. Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal excretion of meropenem with the effect of increasing the elimination half-life and plasma concentration of meropenem. Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp. A solution for bolus injection is prepared by dissolving the drug product in water for injection to a final concentration of 50 mg/ml. Each vial contains meropenem trihydrate equivalent to 500 mg anhydrous meropenem. Consideration should be given to official guidance on the appropriate use of antibacterial agents. There was no evidence of increased sensitivity to meropenem in juveniles compared to adult animals. The Meropenem Trihydrate Market report is a collection of useful information, quantitative and qualitative estimation by industry experts, the contribution from industry connoisseurs and industry accomplices across the value chain. As with all beta-lactam antibiotics, serious and occasionally fatal hypersensitivity reactions have been reported (see sections 4.3 and 4.8). VABOMERE [package insert]: Melinta Therapeutics, Inc. VABOMERE is contraindicated in patients with known hypersensitivity to any components of VABOMERE (meropenem and vaborbactam), or to other drugs in the same class or in patients who have demonstrated anaphylactic reactions to beta-lactam antibacterial drugs. To email a medicine you must sign up and log in. The selection of meropenem to treat an individual patient should take into account the appropriateness of using a carbapenem antibacterial agent based on factors such as severity of the infection, the prevalence of resistance to other suitable antibacterial agents and the risk of selecting for carbapenem-resistant bacteria. Meropenem was FDA-approved in the United States in July of 1996 and is used today for a variety of infections including pneumonia, bacteremia, osteomyelitis, urinary tract infection, and meningitis. Do not freeze the reconstituted solution. As a precautionary measure, it is preferable to avoid the use of meropenem during pregnancy. There is no target-based cross-resistance between meropenem and agents of the quinolone, aminoglycoside, macrolide and tetracycline classes. Therefore, this study aimed to … Meromac (2g) - 1 Injection (Meropenem) drug information. Histological evidence of renal tubular damage was seen in mice and dogs only at doses of 2000 mg/kg and above after a single administration and above and in monkeys at 500 mg/kg in a 7-day study. If not used immediately in-use storage times and conditions are the responsibility of the user. Discontinuation of therapy with meropenem and the administration of specific treatment for Clostridium difficile should be considered. 14. Meropenem-vaborbactam (Vabomere) Meropenem is a carbapenem antibiotic and vaborbactam is a beta-lactamase inhibitor. Glanders and melioidosis: Use of meropenem in humans is based on in vitro B.mallei and B. pseudomallei susceptibility data and on limited human data. Reconstituted solution of the product in 5% dextrose solution should be used immediately. In repeat dose studies of up to 6 months duration only minor effects were seen including a decrease in red cell parameters in dogs. Pharmacoeconomic analyses of meropenem from a health payer perspective in the UK, US and Russia predicted that meropenem is a cost-effective therapy relative to other antibacterials, including imipenem/cilastatin or conventional combination antibacterial treatments in the treatment of serious bacterial infections in intensive care units. The Menarini Group Launches Vaborem™ (meropenem-vaborbactam) in the UK during World Antibiotic Awareness Week 2019. There are no established dose recommendations for patients receiving peritoneal dialysis. Chemical and physical in-use stability for a prepared solution for infusion using 0.9% sodium chloride solution has been demonstrated for 3 hours at up to 25°C or 24 hours under refrigerated conditions (2-8°C). For storage conditions after reconstitution of the medicinal product, see section 6.3. 2 g x 3 daily was taken into consideration for severe infections and in setting the I/R breakpoint. Bloodstream Infections. Concomitant use with valproic acid/sodium valproate/valpromide. Additional considerations for dosing are needed when treating patients with renal insufficiency (see further below). There are limited safety data available to support the administration of a 2 g dose in adults as an intravenous bolus injection. Meronem is indicated for the treatment of the following infections in adults and children aged 3 months and older (see sections 4.4 and 5.1): • Severe pneumonia, including hospital and ventilator-associated pneumonia. Decreases in blood levels of valproic acid have been reported when it is co-administered with carbapenem agents resulting in a 60-100 % decrease in valproic acid levels in about two days. To reduce the development of drug-resistant bacteria and maintain the effectiveness of VABOMERE and other antibacterial drugs, VABOMERE should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. If you are a US Healthcare Professional, click OK to continue. This site is intended for US Healthcare Professionals. analysis, which revealed that in 99% of cases meropenem dominated imipenem plus cilastatin. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity (see section 5.3). Pooled analysis from the TANGO 1 and TANGO 2 trials were released by The Medicines Company. 2010 vabomere-meropenem-vaborbactam-1000130 Drugs Drugs meropenem/vaborbactam 2002 966919-overview Diseases & Conditions Severe hypersensitivity (e.g. Until there is evidence regarding clinical response for confirmed isolates with MIC values above the current resistant breakpoint they should be reported resistant. The tables below provide general recommendations for dosing. Symptomatic treatments should be considered. anaphylactic reaction, severe skin reaction) to any other type of beta-lactam antibacterial agent (e.g. Therefore, it is important to consider this diagnosis in patients who present with diarrhoea during or subsequent to the administration of meropenem (see section 4.8). The required dose should be administered after completion of the haemodialysis cycle. In the table below all adverse reactions are listed by system organ class and frequency: very common (≥ 1/10); common (≥ 1/100 to <1/10); uncommon (≥ 1/1,000 to <1/100); rare (≥ 1/10,000 to <1/1,000); very rare (< 1/10,000); not known (cannot be estimated from the available data). A solution for infusion is prepared by dissolving the drug product in either 0.9% sodium chloride solution for infusion or 5% dextrose solution for infusion to a final concentration of 1 to 20 mg/ml. Seizures and other adverse Central Nervous System (CNS) experiences have been reported during treatment with meropenem, which is a component of VABOMERE. Date of first authorisation/renewal of the authorisation. The intravenous formulation was well tolerated in animal studies. Impact on Patients and Carers Reduced mortality/increased length of survival Reduced symptoms or disability Treatment with meropenem had an expected cost of £19,026 and QALYs were 4.768. †In vitro activity does not necessarily correlate with clinical efficacy. Alternatively, doses up to 1 g can be given as an intravenous bolus injection over approximately 5 minutes. If a severe allergic reaction occurs, the medicinal product should be discontinued and appropriate measures taken. Hypersensitivity to any other carbapenem antibacterial agent. Antibiotic-associated colitis and pseudomembranous colitis have been reported with nearly all anti-bacterial agents, including meropenem, and may range in severity from mild to life threatening. Use in patients with liver disease: patients with pre-existing liver disorders should have liver function monitored during treatment with meropenem. Species for which acquired resistance may be a problem, $ Species that show natural intermediate susceptibility, £ Find its price or cost, dose, when to use, how to use, side effects, adverse effects, substitutes. 6 The beta-lactam susceptibility of streptococcus groups A, B, C and G is inferred from the penicillin susceptibility. This medication is given by injection into a vein as directed by your doctor, usually every 8 hours. Tuesday, November 19th 2019, London 07:30. However, when driving or operating machines, it should be taken into account that headache, paraesthesia and convulsions have been reported for meropenem. Meronem 500 mg: This medicinal product contains 45 mg sodium per 500 mg vial, equivalent to 2.25% of the WHO recommended maximum daily intake of 2 g sodium for an adult. agranulocytosis, haemolytic anaemia, thrombocytopenia, neutropenia, leukopenia, eosinophilia, anaphylaxis (see sections 4.3 and 4.4), angioedema, diarrhoea, abdominal pain, vomiting, nausea, antibiotic-associated colitis (see section 4.4), transaminases increased, blood alkaline phosphatase increased, blood lactate dehydrogenase increased, toxic epidermal necrolysis, Stevens Johnson syndrome, erythema multiforme (see section 4.4), urticaria, drug reaction with eosinophilia and systemic symptoms, acute generalised exanthematous pustulosis (see section 4.4), blood creatinine increased, blood urea increased, General disorders and administration site conditions, thrombophlebitis, pain at the injection site. 3. As necessary, expert advice should be sought when the local prevalence of resistance is such that the utility of the agent in at least some types of infections is questionable. Serious and occasionally fatal hypersensitivity (anaphylactic) reactions and serious skin reactions have been reported in patients receiving therapy with. Close adherence to the recommended dosage regimens is urged, especially in patients with known factors that predispose to convulsive activity. Vabomere® (meropenem and vaborbactam) is available for your patients and our wholesalers remain stocked with all of the products in our portfolio. Hypersensitivity to the active substance or to any of the excipients listed in section 6.1. For instructions on reconstitution of the medicinal product before administration, see section 6.6. This site uses cookies. Any unused product or waste material should be disposed of in accordance with local requirements. Introduction. The medicinal product is supplied in pack sizes of 1 or 10 vials. Medicinal products that inhibit peristalsis should not be given. Thus, meropenem was the dominant strategy as it was both less expensive and more effective. The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. The IV LD50 of meropenem in rodents is greater than 2000 mg/kg. Dose (based on “unit” dose range of 500 mg or 1 g or 2 g, see table above). 9/2020  PP-VAB-US-0184. These result from reduced cost of adverse events. Before initiating therapy with meropenem, careful inquiry should be made concerning previous hypersensitivity reactions to beta-lactam antibiotics. Interaction studies have only been performed in adults. 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. A dose of up to 2 g three times daily in adults and adolescents and a dose of up to 40 mg/kg three times daily in children may be particularly appropriate when treating some types of infections, such as infections due to less susceptible bacterial species (e.g. Resistance rate ≥ 50% in one or more EU countries. 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. Meronem 500 mg: anhydrous sodium carbonate. Global Meropenem Trihydrate Market Size, Status And Outlook 2020-2021. In a review of 4,872 patients with 5,026 meropenem treatment exposures, meropenem-related adverse reactions most frequently reported were diarrhoea (2.3%), rash (1.4%), nausea/vomiting (1.4%) and injection site inflammation (1.1%). Severe cutaneous adverse reactions (SCAR), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), erythema multiforme (EM) and acute generalised exanthematous pustulosis (AGEP) have been reported in patients receiving meropenem (see section 4.8). Prescribers are advised to take into account the local prevalence of resistance in these bacteria to penems. In patients with renal impairment, thrombocytopenia has been observed in patients treated with meropenem, but no clinical bleeding has been reported. Meronem (1 gm) 1gm - 1 Vial Injection (Meropenem) drug information. Chemical and physical in-use stability for a prepared solution for bolus injection has been demonstrated for 3 hours at up to 25°C or 12 hours under refrigerated conditions (2-8°C). The following table of pathogens listed is derived from clinical experience and therapeutic guidelines. Prices are for cash paying customers only and are not valid with insurance plans. Meronem may be used in the management of neutropenic patients with fever that is suspected to be due to a bacterial infection. The rising incidence of resistance to currently available antibiotics among pathogens, particularly Gram-negative pathogens, in complicated intra-abdominal infections (cIAIs) has become a challenge for clinicians. Qualitative and quantitative composition, 4.2 Posology and method of administration, 4.4 Special warnings and precautions for use, 4.5 Interaction with other medicinal products and other forms of interaction, 4.7 Effects on ability to drive and use machines, 6.6 Special precautions for disposal and other handling, 9. In vitro killing of parenteral beta-lactams against standard and high inocula of extended-spectrum beta-lactamase and non-ESBL producing Klebsiella pneumoniae. Background: The rising incidence of resistance to currently available antibiotics among pathogens, particularly Gram-negative pathogens, in complicated intra-abdominal infections (cIAIs) has become a challenge for clinicians. It is given by injection into a vein.. Common side effects include nausea, diarrhea, constipation, headache, rash, and pain at the site of injection. Hypersensitivity reactions were reported in patients treated with VABOMERE in the clinical trials. There is no dose adjustment necessary (see section 4.2). In meropenem-resistant bacteria of the family Enterobacteriales, NDM-1 is considerably more common than IMP-1, despite both metallo-β-lactamases (MBLs) hydrolysing meropenem with almost identical kinetics. Meronem is licensed for children over 3 months of age. Relative overdose may be possible in patients with renal impairment if the dose is not adjusted as described in section 4.2. Patients who have a history of hypersensitivity to carbapenems, penicillins or other beta-lactam antibiotics may also be hypersensitive to meropenem. meropenem/vaborbactam would lead to an overall cost of [commercial in confidence figure removed] in Year 1, increasing to [commercial in confidence figure removed] in Year 5. EUCAST clinical MIC breakpoints for meropenem (2013-02-11, v 3.1), Haemophilus influenzae1, 2 and Moraxella catarrhalis2, Gram-positive anaerobes except Clostridium difficile. To view the changes to a medicine you must sign up and log in. Hepatic function should be closely monitored during treatment with meropenem due to the risk of hepatic toxicity (hepatic dysfunction with cholestasis and cytolysis) (see section 4.8). 3 Susceptibility of staphylococci to carbapenems is inferred from the cefoxitin susceptibility. The acquisition cost of meropenem alone is £17.78 (excluding VAT) for 1 vial containing 1 g of powder for solution for injection (Drug Tariff, October 2019). Severe pneumonia including hospital and ventilator-associated pneumonia. Meropenem is usually given by intravenous infusion over approximately 15 to 30 minutes (see sections 6.2, 6.3, and 6.6).

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