Meropenem is the formulary workhorse, restricted to ID, Critical Care(i.e. Pulmonology, Trauma), ED, Pediatrics (Hospitalists, Oncology/St Jude, Critical Care). Meropenem may be verified if Infectious Disease is also consulted.

If a non-approved physician prescribes meropenem, contact the physician to discuss alternative therapy.

Meropenem use SHOULD satisfy at least one criteria for use below:

- Treatment for infections caused by multi-drug resistant organisms that are susceptible to meropenem and other options expose the patient to unacceptable safety risks or for treatment for infections caused by extended-spectrum beta-lactamase producing organisms when ertapenem is not an option due to the need to cover for suspected or confirmed Pseudomonas aeruginosa or  Acinetobacter baumanii.

- Complicated intra-abdominal infections where other beta-lactem agents are not appropriate due to the intolerance or resistance.

- Empiric therapy for severe infections (including neutropenic fever) in the presence of a severe hypersensitivity reaction (type 1 hypersensitivity reaction or severe delayed reaction) to beta-lactams when other options are not appropriate.

- Empiric therapy for health-care associated infection in patient with prior infection by a mutli-drug resistant Gram-negative organism.

- Escalation of therapy due to lack of response/documented clinical worsening (e.g., increase in white blood cell count, persistent fever) or intolerance to initial broad-spectrum antibiotic

Orders for meropenem are automatically converted to an Extended-Infusion Regimen (3 hours).  (Exception: Doses given in the emergency departement, peri-op OR/PACU, or other procedural areas).  Prescribers may elect to continue standard 30-minute infusions by specifying NO SUB.

Automatic renal adjustment per guidelines. See Antimicrobial Dosing Guideline and Renal Adjustment Policy (Adult) for more information.  CrCl calculation policy available here.

Reviewed: January 26, 2010,

Updated: June 25, 2013 (Merrem), and 25 May 2016, and 26 Sept 2017, 28 April 2020 (extended infusion), 26 July 2022 (use criteria)

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