Meropenem
A broad-spectrum carbapenem given intravenously for severe infections: intra-abdominal, skin, pneumonia and meningitis.
Drug card
- Class
- Carbapenem
- How it works
- Binding many penicillin-binding proteins to stop cell wall synthesis
- Used for
- Complicated intra-abdominal infections
- Complicated skin and soft tissue infections
- Bacterial meningitis
- Severe and ventilator-associated pneumonia
- Known for
- Seizures
- Its name
- -penem means a carbapenem antibiotic
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does meropenem work?
Meropenem binds several PBPs in both Gram-positive and Gram-negative organisms. It covers aerobes and anaerobes, including Pseudomonas, Klebsiella and Bacteroides, but not MRSA, and it only inhibits Listeria. Kidney dehydropeptidase-I breaks it down less than imipenem, so no cilastatin is needed.
Uses
What is meropenem used for?
- Complicated intra-abdominal infections
- Complicated skin and soft tissue infections
- Bacterial meningitis
- Severe and ventilator-associated pneumonia
- Fever in high-risk neutropenia
- Complicated urinary tract infections
Side effects
Side effects of meropenem
- SeizuresKnown forSerious
- Diarrhea
- Nausea and vomiting
- Headache
- Constipation
- Rash
- Inflammation at the injection site
- Allergic reactions, including anaphylaxisSerious
- C. difficile colitisSerious
- Severe skin reactions (SJS, TEN, DRESS, AGEP)Serious
- Oral thrush
- Raised liver enzymes and jaundice
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Valproate: meropenem lowers valproic acid levels and can cause breakthrough seizures; another antibiotic is preferred.
- The dose is cut when creatinine clearance falls to 50 mL/min or below; low platelets can occur in kidney impairment.
- Anaphylaxis to any beta-lactam is a contraindication.
- Probenecid raises meropenem levels, so the two are not given together.
Good to know: WHO lists it as a Watch antibiotic, a stewardship priority, for complicated intra-abdominal infection, high-risk febrile neutropenia and meningitis in newborns.
Remember it
A way to remember it
Carbapenems crash valproate: give the two together and valproate levels fall, so seizures can break through.
Carbapenems appear to block the step that turns valproate's glucuronide back into valproate, so its level drops below range, and a higher valproate dose may not fix it. Carbapenems can also cause seizures themselves, especially in kidney impairment or brain disease.
Written for biofideX
Its name
-penem means carbapenem antibiotic
Meropenem, imipenem and ertapenem share it. WHO defines -penem as penicillin-like beta-lactams changed in the five-membered ring.
- Every drug name stem
Its class
Carbapenems
Carbapenems are beta-lactams that reach their targets in most Gram-positive as well as Gram-negative bacteria and bind several penicillin-binding proteins, stopping cell wall synthesis so the bacteria die. Bacteria resist them by losing porins, pumping the drug out, altering PBPs or making carbapenemases, beta-lactamases such as metallo-beta-lactamases that break carbapenems down.
Easily mixed up with penicillins, cephalosporins and beta-lactamase inhibitors.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Meropenem for injection: label (DailyMed)
- Meropenem 1g powder for solution for injection/infusion: SmPC (emc)
- Meropenem (NCI Thesaurus)
- WHO Model List of Essential Medicines, 24th list (2025) (WHO)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Antibiotics: the cell wall
Meropenem is one of 12 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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