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PubMed1992

[Clinical studies of meropenem in pediatric field].

We have carried out clinical studies on meropenem (MEPM, SM-7338), the results are summarized as follows. Treatment with MEPM was made in 13 cases of pediatric bacterial infections including 9 cases of pneumonia and 2 cases of colitis and 1 case each of purulent tonsillitis, and pharyngitis. Results obtained were excellent in 10 cases, good in 3 cases. No significant side effects due to the drug were observed in any cases, except in 1 case each of eosinophilia, elevated gamma-GTP, elevated total bilirubin and elevated GPT.

Adolescent↗
PubMed1992

[Studies on meropenem in the field of pediatrics].

The pharmacokinetics and the clinical effectiveness of meropenem (MEPM) were examined in the field of pediatrics. The results are summarized as follows. 1. A 4-year-6-month-old girl with suppurative meningitis (Haemophilus influenzae) was treated by intravenous drip infusion of MEPM in a daily dose of 29 mg/kg which was divided into 4 dosages, each dosage being infused over 30 minutes, and the drug concentration in cerebrospinal fluid was determined. Upon completion of infusion on the 2nd day of treatment, the drug concentration was 2.52 micrograms/ml, which corresponded to 3.6% of the drug concentration in the blood. 2. MEPM was used in 10 patients, including 3 with suppurative lymphnoditis, 2 with staphylococcal scalded skin syndrome (SSSS) and 1 each with pneumonia, suppurative meningitis, suppurative knee arthritis, facial phlegmon and pyelonephritis. The daily doses ranged from 30 to 117.6 mg/kg, divided into 3 to 4 dosages and administered via intravenous drip infusion over 30 minutes. Clinical responses were evaluated as very good in 7 patients, good in 2 patients and fair in 1 patient, with an efficacy rate of 90%. 3. Isolated pathogens were 2 strains of Staphylococcus aureus, 1 strain of Klebsiella pneumoniae and 3 strains of Haemopilus influenzae. All of the 6 strains were eradicated, with an eradication rate of 100%. 4. In the safety evaluation, none of the patients was observed to have any side effects. Furthermore, no abnormal variations were found in laboratory test data possibly attributable to administration of MEPM.

Bacterial Infections↗
PubMed2005

Meropenem.

Meropenem is a new carbapenem antibacterial agent with wide spectrum of activity against gram-negative, gram-positive and anaerobic organisms. It is stable against most beta-lactamases produced by gram-negative bacteria and has greatest utility in treating severe infections in hospitalized children. It has good CSF penetrability and useful in treatment of childhood meningitis and infections in neutropenic children. Due to concern relating to emergence of resistance, it should be used as a reserve drug in difficult-to-treat infections caused by resistant organisms or when conventional treatment fails.

Bacterial Infections↗
PubMed2005

[In vitro combined effect of meropenem and various antimicrobial agents against beta-lactamase-nonproducing ampicillin-resistant Haemophilus influenzae and penicillin-resistant Streptococcus pneumoniae].

As a basic study of combination therapy for bacterial meningitis, in vitro combined effect of meropenem (MEPM) and various antimicrobial agents against beta-lactamase-nonproducing ampicillin-resistant Haemophilus influenzae (BLNAR) and penicillin-resistant Streptococcus pneumoniae (PRSP) was investigated. The following findings were obtained. 1. In the checker board assay using 23 clinical isolates of BLNAR, MEPM+cefotaxime (CTX), MEPM+ampicillin (ABPC), and MEPM+rifampicin (RFP) showed synergistic effect (21 strains, 6 strains, 4 strains, respectively) or additive effect (2 strains, 17 strains, 19 strains, respectively). 2. In the checker board assay using 19 clinical isolates of PRSP, MEPM+CTX, MEPM+teicoplanin (TEIC), and MEPM+RFP showed synergistic effect (5 strains, 8 strains, 1 strain, respectively), additive effect (14 strains, 11 strains, 17 strains, respectively) or indifference (0 strain, 0 strain, 1 strain, respectively). 3. The time-kill assay with BLNAR demonstrated synergistic bactericidal effect of MEPM+CTX and MEPM+RFP, but not MEPM+ABPC. 4. The time-kill assay with PRSP demonstrated synergistic or additive bactericidal effect of MEPM+CTX, MEPM+TEIC, and MEPM+RFP. 5. There were no antagonistic effect in any combination tested in this study. These findings suggest that combination therapy with MEPM and various antimicrobial agents tested in this study are useful in treating bacterial meningitis caused by BLNAR and PRSP.

Ampicillin↗
PubMed2006

[Clinical effect of continuous infusion of meropenem on bacterial pneumonia in the elderly].

We studied the clinical effect of continuous infusion over 24 hours of meropenem (MEPM) on bacterial pneumonia in the elderly (over 65). The subjects were 26 patients (community-acquired pneumonia: moderate, n = 9; severe, n= 4; hospital-acquired pneumonia: group III, n = 13) whose performance status was 3 or 4. MEPM 1.0g/day was infused continuously for 7-14 days, and its clinical efficacy, bacteriological efficacy, and side effects were examined prospectively. It was effective in 23 of the 26 patients (community-acquired pneumonia: moderate, 8/9; severe, 3/4; hospital-acquired pneumonia: group III, 12/13; efficacy rate: 88.5%). Bactericidal effects were obtained in 3 strains of Klebsiella pneumoniae, 2 strains of Streptococcus pneumoniae, 2 strains of methicillin-sensitive Staphlococcus aureus, 1 strain of Streptococcus agalactiae and 1 strain of Proteus mirabilis, but not in 2 strains of methicillin-resistant S. aureus, 1 strain of Pseudomonas aeruginosa and 1 strain of Serratia marcescens. Mild abnormal laboratory findings were observed in 2 patients: elevation of GPT, gamma-GTP, BUN and elevation of ALP. Based on the above, continuous infusion of MEPM on bacterial pneumonia in the elderly obtained excellent clinical effects. Further study is needed to compare the efficacy of continuous versus intermittent administration of MEPM.

Aged↗
PubMed1995

[In vitro activity of carbapenems (biapenem, imipenem and meropenem) and some other antibiotics against strict anaerobic bacteria].

During 1994, the in vitro antibiotic susceptibility of 306 anaerobic bacteria was performed in 4 hospitals, by the reference agar dilution method. Among the 129 B. fragilis group strains, only two B. fragilis strains were resistant to the three carbapenems and all beta-lactams, even combined with beta-lactamase-inhibitors while metronidazole resistance could not be detected. Evolution in antibiotic resistance rates could be assessed only for piperacillin whose resistance rates increased to 20%. beta-lactamase production was detected respectively for 27% of Prevotella and 17% of Fusobacterium strains. No beta-lactamase activity was seen among Gram positive anaerobes. On the whole anaerobic strains resistance rates were: biapenem, imipenem, meropenem and piperacillin-tazobactam 0.7, amoxicillin-clavulanic acid or metronidazole 2, piperacillin 11.3, amoxicillin 31%, respectively. The three carbapenems demonstrated a good in vitro activity against most anaerobes with few differences between them.

Bacteroides fragilis↗
PubMed1993

[Investigation of meropenem levels in the human bone marrow blood, bone, joint fluid and joint tissues].

A solution of 0.5 g of meropenem (MEPM) in 100 ml of saline was administered to adult patients before the orthopaedic surgery via intravenous drip infusion for 30 minutes. Eleven samples of bone marrow blood, 13 bone, 8 joint fluid and 8 joint tissues obtained from 15 clinical cases were analyzed for MEPM levels. At the same time, blood samples were taken from peripheral veins and serum served as control was analyzed. The concentration of MEPM in the marrow blood at 30 minutes after administration of MEPM reached 15.4 micrograms/ml, which was above 50% of the maximum concentration in serum. Ratios of concentration in bone marrow to that in serum were between 93% and 105% at that time. MEPM levels were 5.74-0.40 micrograms/g in bones, 20.3-4.55 micrograms/ml in joint fluid and 18.2-4.05 micrograms/g in joint tissues at 30 to 75 minutes after administration. In joint fluid and joint tissues, the concentration above 50% of maximum level in serum were maintained for more than an hour. MEPM is thought to be useful for the treatment of bone and joint infections and also prophylaxis of infections in cases of major surgery of skeletal tissue in the field of orthopaedic surgery.

Adult↗
PubMed1996

Meropenem versus tobramycin with clindamycin in the antibiotic management of patients with advanced appendicitis.

BACKGROUND: Meropenem (MP), a new carbapenem antibiotic, has excellent antimicrobial activity against the enteric flora commonly encountered in acute appendicitis. Although similar to imipenem, it may have clinical advantages. STUDY DESIGN: We compared patients with advanced appendicitis (gangrenous or perforated) treated with 1,000 mg MP every eight hours with those given the combination of tobramycin 5 mg/kg/day at eight hour intervals and clindamycin 900 mg every eight hours. Both treatments were given intravenously. Patients were randomized to either group of the double-blind study. RESULTS: Of 129 evaluable cases, 63 received MP and 66 received both tobramycin and clindamycin (T/C). The two groups were similar in age, sex, and severity of disease. The mean number of days of postoperative fever (MP = 3.1 +/- 1.7 SD compared to T/C = 4.4 +/- 2.2 SD, p < or = 0.01), days of antibiotic therapy (MP = 6.1 +/- 1.6 SD compared to T/C = 7.3 +/- 2.2 SD, p = 0.01), and therefore hospital stay (MP = 8.0 +/- 3.5 SD compared to T/C = 9.4 +/- 2.6 SD, p < 0.01) were significantly better for patients treated with MP. No difference was found between the numbers of failures in each group (MP = 5 compared to T/C = 6). CONCLUSIONS: This study demonstrates a small but significant reduction (approximately one day) in post-operative fever, duration of antibiotic treatment, and hospital stay for patients treated with MP compared to those treated with T/C.

Adult↗
PubMed1996

[Antimicrobial activities of meropenem against clinically isolated strains].

In order to evaluate antimicrobial activity of meropenem (MEPM), minimum inhibitory concentrations (MICs) of MEPM and control drugs were determined against clinical isolates in 1993. The results were as follows; 1. Antimicrobial activities of MEPM against Gram-positive bacteria were stronger than those of cephems (CEPs), were approximately equal to those of panipenem (PAPM), and were weaker than those of imipenem (IPM). 2. Carbapenems showed strong antimicrobial activities against Enterobacteriaccae, glucose non-fermentative Gram-negative rods and Bacteroides fragilis group that were multiple drug resistant including the third generation CEPs. Antimicrobial activities of MEPM against these organisms were stronger than those of IPM and PAPM. 3. MIC-ranges of MEPM against Enterobacteriaceae and Haemophilus influenzae were lower than those of IPM and PAPM. We observed that MEPM had better permeability into the cells of H. influenzae, higher affinities to 3 to 5 different penicillin-binding protein and high stability against beta-lactamase than those of IPM and PAPM.

Bacteria↗
PubMed1996

[Antimicrobial activities of meropenem against clinically isolated strains. The result against strains isolated from blood and cerebrospinal fluid].

In order to evaluate the antimicrobial activity of meropenem (MEPM), minimum inhibitory concentrations (MICs) of MEPM and control drugs were determined against clinical isolates from blood and cerebrospinal fluid that were obtained from January, 1993 to December, 1994. The results are summarized as follows; 1. The MIC-range, 50% MIC (MIC50) and 90% MIC (MIC90) of MEPM were equal to those of imipenem (IPM) and panipenem (PAPM) against Streptococcus pneumoniae including benzylpenicillin (PCG)-insensitive or -resistant S. pneumoniae, Streptococcus agalactiae and Listeria monocytogenes which are Gram-positive strains, and were stronger than those of ampicillin (ABPC) and cefotaxime (CTX). 2. The MIC-range, MIC50 and MIC90 of these 3 drugs of carbapenems (MEPM, IPM and PAPM) were different against Escherichia coli and Haemophilus influenzae which are Gram-negative strains. The MIC90 of MEPM was < or = 0.025 microgram/ml and those of IPM and PAPM were 0.2 microgram/ml against E. coli. The MIC90 of MEPM was 0.1 microgram/ml, that of IPM was 25 micrograms/ml and that of PAPM was 6.25 micrograms/ml against H. influenzae. Thus, the antimicrobial activity of MEPM was stronger than those of IPM and PAPM. The MIC90's of IPM and PAPM against H. influenzae were high with the MIC of IPM at 12.5 approximately 25 micrograms/ml and the MIC of PAPM at 3.13 approximately 12.5 micrograms/ml against 3 IPM-resistant strains among 17 isolates. 3. The MIC90 of ABPC was 0.39 microgram/ml and that of CTX was 0.1 microgram/ml against 20 strains of S. pneumoniae including 6 strains of PCG-insensitive or resistant S. pneumoniae. The MIC90 of ABPC and CTX were higher than those of 3 carbapenem drugs. There were E. coli of 8 strains with ABPC-high resistance (the MIC of ABPC was > 100 micrograms/ml) and 2 strains for which MIC of CTX were 0.39 microgram/ml and 3.13 micrograms/ml. It was found that 29.4% of H. influenzae were beta-lactamase producing strains. 4. It appeared that antimicrobial activities of carbapenems, particularly MEPM were strong against clinical isolates from blood and cerebrospinal fluid. MEPM will be first choice drug by empiric therapy in infections including sepsis and purulent meningitis.

Ampicillin↗
PubMed1997

[Meropenem against bacteria carriers of wide spectrum TEM beta-lactamases: evolutive aspects].

The so-called wide spectrum beta-lactamases (WSBLs) are able to hydrolyze wide spectrum cephalosporins or monobactamics such as cefotaxime, ceftriaxone, ceftazidime, cefepime, cefpiroma or aztreonam. The natural wide spectrum beta-lactamases are mutational variants of TEM-1 consisting in the substitution of one of more amino acids within seven well defined positions in the molecule. Given the expected extremely low frequency for the simultaneous production of double or triple mutations, it is plausible that one of the mutational changes has been independently selected. A plurimutational remodelling of the TEM-beta-lactamase molecule is successively produced with the consequent appearance of highly effective ESBLs. Mutagenesis techniques allow clean molecular variants to be produced and allow the mutational effects under homogeneous conditions of bacterial strain, the plasmid implicated or the genic promotor to be studied. Meropenem remains active versus all the wide spectrum beta-lactamases referred in the 2be group of Bush, Jacoby and Medeiros as well as the new beta-lactamases produced in vitro by directed mutagenesis.

Escherichia coli↗
PubMed1997

[The role of meropenem in the treatment of pneumonia in the critical patient].

Pneumonia in critical ill patients, most of them associated with insaturation of an artificial a way and the use of mechanical ventilation, involves important morbi/mortality in the Intensive Care Units. Knowledge of pathogenesis, risk factors, and implicated microorganisms in developing of this major infectious complication, in the context of infections which rise in the critically ill patients, allow us to apply prophylaxis measures which could decrease its incidence, and establish antimicrobial therapy, which permit us to cover all the etiologic possibilities. Availability in the arsenal of the powerful antimicrobial, of a new carbapenemic, meropenem, and based on the different studies and clinic assays, allow to recommend its use with warranties and efficacy, in the empirical or's in concretely those due to Pseudomonas aeruginosa, enterobacteriaceae, (in general or producers of ample spectrum beta-lactamases), and Acinetobacter spp., in monotherapy or combined therapy, with aminoglycosides.

Clinical Protocols↗
PubMed1999

Biodegradability of cefotiam, ciprofloxacin, meropenem, penicillin G, and sulfamethoxazole and inhibition of waste water bacteria

Most antibiotics are metabolized only incompletely by patients after administration and enter the municipal sewage with the patients' excretions. Little is known about their biodegradability in aquatic environments and their role with respect to growing bacterial resistance. Therefore, the biodegradability of some clinically important antibiotic drugs as a very first step of an environmental risk assessment was investigated with the OECD closed bottle test (CBT). To assess toxicity of the test compounds against aquatic bacteria (1) a growth inhibition test (GIT) with Pseudomonas putida was conducted; (2) a toxicity control was used in the CBT; and (3) the colony-forming units (CFUs) were monitored in the test vessels. Theoretical concentrations of the test substances in hospital effluents were calculated and compared with minimum inhibitory concentrations for susceptible pathogenic bacteria. None of the test compounds met the criteria for ready biodegradability. Only penicillin G was biodegradable to some degree (27%), even when the test was prolonged from 28 to 40 days (35%). The inhibition concentrations measured in the GIT were in the same range or lower than the 50% minimum inhibitory concentrations (MIC50) known for susceptible pathogenic bacteria. CFU monitoring revealed high toxicity for sulfamethoxazole, whereas ciprofloxacin had a weak but significant effect; only for meropenem a weak but significant effect was measured in the toxicity control of the CBT. MIC50 published for susceptible pathogenic bacteria were for all compounds in the same range as the concentrations expected for hospital effluents. Therefore, antibiotic drugs emitted into municipal sewage may affect the biological process in sewage treatment plants (STPs), and they may persist in the aquatic environment and contribute to the increasing resistance of pathogenic bacteria.http://link.springer-ny. com/link/service/journals/00244/bibs/37n2p158.html

Journal Article↗
PubMed2026

A leakage-aware genomic prediction pipeline for meropenem resistance in Klebsiella pneumoniae using transformer-based resistome representation learning.

MOTIVATION: Antimicrobial resistance (AMR) in Klebsiella pneumoniae, particularly to carbapenems such as meropenem, is a major global health problem. Machine learning is increasingly used to predict resistance from genomic markers; however, many models fail to capture high-level gene-gene interactions and may exhibit inflated performance due to lineage-biased prediction. Existing genomic prediction models largely rely on flat feature representations that fail to capture epistatic gene interactions, and commonly suffer from inflated performance estimates due to phylogenetic data leakage. To address these limitations simultaneously, a leakage-aware hybrid TabTransformer-CatBoost pipeline was developed, combining self-attention-based resistome representation learning with gradient boosting classification under clade-aware data partitioning. A self-attention encoder converts sparse gene presence-absence profiles into contextualized latent embeddings, which are subsequently classified using gradient boosting to capture lineage-aware AMR patterns. RESULTS: The proposed architecture outperformed classical baselines including Logistic Regression, Random Forest, XGBoost, and optimized CatBoost models. Internal accuracy reached 92.59% for the Chained Hybrid configuration (area under the receiver operating characteristic curve, AUROC = 0.8670, F1&#x2009;=&#x2009;0.8537). Performance gains primarily originated from the embedding stage, as confirmed by ablation analysis. External validation across independent multinational cohorts (n&#x2009;=&#x2009;305) demonstrated generalizability (AUROC = 0.8105; F1&#x2009;=&#x2009;0.7552). Permutation testing produced near-zero Matthews Correlation Coefficient (MCC)&#x2009;=&#x2009;0.0091, indicating predictions reflect genuine biological signal rather than noise. These results establish attention-based genomic embedding with gradient boosting as a scalable, interpretable, and leakage-aware framework for clinical AMR prediction. AVAILABILITY AND IMPLEMENTATION: The source code for the TabTransformer-CatBoost framework, including preprocessing pipelines and pre-trained embeddings, is available at https://github.com/SibelKervanci/kp-meropenem-tabtransformer.

Journal Article↗
PubMed1994

Susceptibilities of 177 penicillin-susceptible and -resistant pneumococci to FK 037, cefpirome, cefepime, ceftriaxone, cefotaxime, ceftazidime, imipenem, biapenem, meropenem, and vancomycin.

MICs of six extended-spectrum cephalosporins (cefotaxime, ceftriaxone, ceftazidime, FK 037, cefpirome, cefepime), three carbapenems (imipenem, meropenem, biapenem), and vancomycin for 49 penicillin-susceptible (S), 77 penicillin intermediate-resistant (I), and 51 penicillin-resistant (R) pneumococci were determined by agar dilution. Compared with ceftazidime (MICs for 90% of strains tested [MIC90s] of 2.0, 16.0, and 16.0 micrograms/ml for S, I, and R strains, respectively), all other cephalosporins yielded lower MICs (MIC90s of 0.06 to 0.125, 0.5 to 1.0, and 1.0 to 2.0 micrograms/ml against S, I, and R strains, respectively). All three carbapenems were very active, with MIC90s, even for R strains, of < or = 1.0 micrograms/ml. All strains were susceptible to vancomycin (MIC90 of 0.5 micrograms/ml).

Cephalosporins↗
PubMed1992

[Clinical evaluation of meropenem in children].

Meropenem (MEPM) was evaluated for its efficacy and safety. The following results were obtained. MEPM was given to 12 patients with infections: 5 with pneumonia, 1 with bacterial meningitis, 2 with pharyngitis, 4 with skin and soft tissue infections. Therapeutic responses were "excellent" in 5, "good" in 4 and "fair" in 3, with an efficacy rate of 75%. Adverse reactions were not noted. No abnormalities were shown in laboratory data. It has been concluded that MEPM is a useful drug for the treatment of bacterial infections in children.

Adolescent↗