Meropenem

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Short Infusion Dosing (PREFERRED)

Indication > 50mL/min 26 - 50 mL/min 10 - 25 mL/min < 10mL/min
Standard Dosing 1 g IV q8h 1 g IV q12h 500 mg IV q12h 500 mg IV q24h
Meningitis, Cystic Fibrosis 2 g IV q8h 2 g IV q12h 1 g IV Q12h 1 g IV q24h

Extended Infusion Dosing (if recommended by ID, ID pharmacy, or clinical pharmacy for select populations)

Indication > 50mL/min 26 - 50 mL/min < 26 mL/min
Loading Dose* 1 g x1 (over 30 minutes) 1 g x1 (over 30 minutes) Use short infusion
Maintenance: Standard Dosing 1 g IV q8h (over 3 hours) 1 g IV q12h (over 3 hours) Use short infusion
Maintenance: Meningitis**, Cystic Fibrosis 2 g IV q8h (over 3 hours) 2 g IV q12h (over 3 hours) Use short infusion

*Recommended to start maintenance dose 4 hours after loading dose 
**Extended infusion data in meningitis are limited and may require further discussion with ID/ASP providers 

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication

Intermittent Hemodialysis

Continuous Hemodialysis (CVVHD)
Standard Dosing 500 mg IV x1 now, then qPM 1 g IV q8h*
Cystic Fibrosis 1000 mg IV x1 now, then qPM 2 g IV q12h*^
Meningitis 1000 mg IV x1 now, then qPM 2 g IV q12h^

*May infuse over 3 hours (extended infusion dosing) if recommended by ID, ID pharmacy, or clinical pharmacy for select populations. A loading dose (over 30 minutes) may be considered when initiating therapy in select patients. If a loading dose is given, start maintenance dose 4 hours after loading dose. Note that extended infusion data in meningitis is limited and may require further discussion with ID/ASP providers.

^If CVVHD flow rate exceeds 2 L/hr, discuss with ID/ASP pharmacy.

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

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