vabomere (meropenem; vaborbactam). earliest submission - 2017, rempex pharmaceuticals (affiliate of novartis). 3 death related events.

Meropenem 😭😭 Didn't do a drug sensitivity testing for TB 🤦‍♂️.. Had they done that they'd hv known its not TB 🤦‍♂️

Cases/Incidents -Patient getting repeated injection for renal colic pain... later got to know it was Meropenem ( not a pain killer!) - A child misdiagnosed as TB, on ATT for a year... final dx- lymphoma :( - Woman driving up bike for cataract surgery of her father in law💪🏍️

Meropenem and Large-volume resuscitation. *Subtherapeutic meropenem levels after large-volume resuscitation are primarily driven by an acute increase in the drug's Volume of Distribution. Meropenem is a hydrophilic molecule. When a critically ill patient undergoes massive fluid resuscitation, two major pharmacokinetic shifts occur: 1. Fluid Loading: The infused crystalloids and colloids expand the extracellular fluid (ECF) space. Because meropenem is highly water-soluble, it distributes heavily into this enlarged fluid compartment. 2. Capillary Leak: The systemic inflammatory response (e.g., in sepsis) disrupts endothelial integrity. This causes fluid to shift out of the blood vessels and into the interstitial space (third spacing), which vastly increases the apparent volume of distribution. **Because the drug is spread across a much larger total body water compartment, its concentration in the blood drops, even if the patient's kidney function remains unchanged and drug clearance is perfectly normal. ●Strategies.... 1. Extended or Continuous Infusions: Administering meropenem over a longer period (e.g., a 3-hour or 4-hour extended infusion) rather than a rapid 30-minute bolus helps maintain effective plasma concentrations despite an increased volume of distribution. 2. Optimized Dosing: Standard regimens (e.g., 500 mg or 1 g every 8 hours) are often insufficient in fluid-overloaded patients. Intensified regimens, such as 2 g every 8 hours, are frequently recommended for severe infections to achieve target drug levels. 3. Loading Dose: An initial loading dose is usually required to instantly push the drug concentration above the MIC, counteracting the dilution caused by large-volume resuscitation. pmc.ncbi.nlm.nih.gov/article…

Patient was deteriorating on meropenem. Initially scheduled for CCK in 6-8 weeks but since deteriorating the placed a drain and cultured the bile

So patient def had sx. Originally scheduled for CCK in 6-8 weeks but clinically was deteriorating even on Meropenem so a drain was installed and during the procedure they cultured the bile. Now we tailored the ATB with ceftri-ampi and treating 7 days because of complicated case

How Covid was treated in 2012. 6 patients. All patients: ganciclovir antiviral, acyclovir antiviral, methylprednisolone steroid, meropenem antibiotic, vancomycin antibiotic, caspofungin antifungal, fluconazole antifungal. Patients 2, 3, 4: mechanical ventilation. Patients 2 and 4: warfarin antithrombotic, low molecular weight heparin antithrombotic. Patient 4: thymectomy performed on June 27, 2012 and survived. Patients 1, 2, and 3 deceased. 
Patients 4, 5, and 6 survived.

Estudo MERINO (2018): piperacilina-tazobactam inferior ao meropenem em bacteremia por ESBL. Se ESBL confirmada em infecção grave, trocar para carbapenêmico.

Você escala de piperacilina-tazobactam pra meropenem «porque não melhorou». Cobre Pseudomonas, Enterobacterales sensíveis e anaeróbios. Mas não cobre ESBL de forma confiável. Segue o fio… 🧵

Meropenem vancomycin caspofungin tmp-smx ganciclovir

I never unbox anything since this year start🥹 Na so so IV ceftriaxone, Astymin, meropenem, giving sets, packs of gloves and new syringes I Dey unbox every single day 😫😫 No be so my 20s suppose dey o😂😂, I need to unbox a new phone, shoes, bags like right now😂😂😂

Empiric treatment of neonatal meningitis commonly includes: A. Ceftriaxone Vancomycin B. Ampicillin Gentamicin/Cefotaxime C. Meropenem alone D. Azithromycin Amikacin

If by "these two antibiotics" you mean Meropenem Colistin, the reason they are commonly used in critically ill ICU patients is: 1. They cover highly resistant Gram-negative bacteria Critically ill patients often develop infections caused by: Acinetobacter baumannii Klebsiella pneumoniae Pseudomonas aeruginosa These organisms may be resistant to multiple antibiotics. 2. Meropenem is a broad-spectrum "workhorse" antibiotic Covers many Gram-negative and Gram-positive organisms Good tissue penetration Commonly used empirically in severe sepsis and septic shock 3. Colistin is a "salvage" or last-line antibiotic Active against many multidrug-resistant (MDR) and carbapenem-resistant Gram-negative pathogens Often reserved for infections where other options are limited 4. Combination therapy may provide synergy In severe infections due to carbapenem-resistant organisms: Meropenem may retain partial activity Colistin attacks the bacterial membrane Together they may improve bacterial killing in selected cases Common ICU indications ✅ Ventilator-associated pneumonia (VAP) ✅ Hospital-acquired pneumonia (HAP) ✅ Septic shock ✅ Bloodstream infections ✅ Complicated intra-abdominal infections Teaching pearl > When an ICU patient is deteriorating with suspected MDR Gram-negative sepsis, Meropenem is often the first broad-spectrum agent added, while Colistin is brought in when carbapenem-resistant organisms are suspected or confirmed. 🦠🚨🩺 One important caveat: newer agents such as ceftazidime-avibactam, meropenem-vaborbactam, and cefiderocol are increasingly preferred when available because they can be more effective and less nephrotoxic than colistin-based regimens. 📚

Intriguing point about the impact of volume resuscitation on meropenem levels. The interplay between hydrophilic properties and pharmacokinetics in critically ill patients is critical. With the increased Volume of Distribution, do you see alternative dosing strategies or monitoring methods as beneficial? How do you propose addressing the potential for subtherapeutic levels? This exploration is right up the alley of Sci-Quest, which can create comprehensive biomedical reviews on such topics. #Medicine Discover more at sciqst.com.