Background Meropenem (a carbapenem antibiotic) has broad indications for use, including complicated skin and soft tissue infections, complicated abdominal infections, and bacterial meningitis.1,2,4,5 This study is a retrospective chart review of inpatient cases where this medication was prescribed. The main purpose was to determine the clinical reasoning (therapeutic/prophylactic) for which the medication was prescribed and to determine if treatment was generally successful and the incidence of significant side effects.

Specific Aims: 1) Determine whether the medication was used mainly for therapy vs preventative uses 2) For those patients for whom it was used to treat a specific microbial agent, to determine the outcome of its use (Efficacious = released from hospital (with clinical improvement and/or lab data demonstrating decreased infectivity ) vs Non-efficacious = side effect requiring discontinuation).

Methods Data was collected via a retrospective chart review of patients prescribed Meropenem between August and October of 2023. Data was analyzed for indications of medication prescription and outcomes were determined based on whether patient was discharged with clinical improvement or the medication was discontinued due to adverse side effects. Data collected included the condition for which the patient presented to the hospital, length of stay, treatment type (Meropenem) and dates, patient response, reason for discontinuing medication if applicable, any adverse effects of treatment, and microbiology findings.

Results 87 patients were prescribed meropenem during the period of the study. In 10.5% of patients (n=9), it was prescribed for prophylaxis for to urologic/gastrointestinal surgery and in one patient for empiric treatment of aspiration pneumonia. The remaining 89.5% of patients (n=78) received therapeutic treatment; the majority of these patients (71 patients) had urine, wound and/or blood cultures and labs completed to confirm the appropriate antibiotic usage. Over 60% of patients (n=48) indicated efficacious treatment (course completed, clinical and/or lab improvement and continued course without side effects); 34.6% of patients (n=27) had meropenem discontinued due to narrowing of therapy and only 5% (n=4) experienced severe side effects, requiring premature cessation of Meropenem.

Conclusion Overall, Meropenem was well tolerated and generally was prescribed for culture confirmed infections requiring broad antibiotic coverage. Only 5% of the patients experienced disruptive side effects. Several patients had their antibiotic regimen narrowed, indicating good antibiotic stewardship. Patients who required Meropenem for complex infections were able to tolerate the full course and most cleared their infections without complication while under inpatient stay, or continued with treatment at discharge. Meropenem was generally used within acceptable guidelines of usage from an individual patient safety perspective and from a more universal perspective of antibiotic stewardship.

1. Pryka RD, Haig GM: Meropenem: a new carbapenem antimicrobial. Ann Pharmacother. 1994 Sep;28(9):1045-54.
2. Meropenem: Drug Information. In: UpToDate, Wolters Kluver (Accessed on May 12, 2024)
3. Brown KA, Khanafer N, Daneman N, Fisman DN. Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection. Antimicrob Agents Chemother. 2013 May;57(5):2326-32. doi: 10.1128/AAC.02176-12. Epub 2013 Mar 11. PMID: 23478961; PMCID: PMC3632900.
4. Baldwin CM, Lyseng-Williamson KA, Keam SJ. Meropenem: a review of its use in the treatment of serious bacterial infections. Drugs. 2008;68(6):803-38. doi: 10.2165/00003495-200868060-00006. PMID: 18416587.
5. Matthew E. Levison, Larry M. Bush, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), 2015