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Synergistic photothermal antibacterial therapy enabled by multifunctional nanomaterials: progress and perspectives Materials Chemistry Frontiers RSC Publishing

Synergistic photothermal antibacterial therapy enabled by multifunctional nanomaterials: progress and perspectives Materials Chemistry Frontiers RSC Publishing

There are limited data to support the administration of these dose adjustments for a unit dose of 2 g. Alternatively, doses up to 1 g can be given as an intravenous bolus injection over approximately 5 minutes. There are limited safety data available to support the administration of a 2 g dose in adults as an intravenous bolus injection.

  • Doses of 500, 1000 and 2000 mg doses infused over 30 minutes give mean Cmax values of approximately 23, 49 and 115 μg/ml respectively, corresponding AUC values were 39.3, 62.3 and 153 μg.h/ml.
  • There are limited safety data available to support the administration of a 40 mg/kg dose in children as an intravenous bolus injection.
  • The safety and efficacy of meropenem in children under 3 months of age have not been established and the optimal dose regimen has not been identified.
  • Meropenem should not be used in breast-feeding women unless the potential benefit for the mother justifies the potential risk to the baby.
  • The maximum daily dose of this product is equivalent to ≥27% of the WHO recommended maximum daily intake for sodium.

Any unused medicinal product or waste material should be disposed of in accordance with local requirements. A solution for infusion is prepared by dissolving the drug product meropenem in either 0.9% sodium chloride solution for infusion or 5% glucose (dextrose) solution for infusion to a final concentration of 1 to 20 mg/ml. A solution for bolus injection is prepared by dissolving the drug product meropenem in sterile water for injection to a final concentration of 50 mg/ml. In healthy subjects the mean plasma half-life is approximately 1 hour; the mean volume of distribution is approximately 0.25 l/kg (11-27 l) and the mean clearance is 287 ml/min at 250 mg falling to 205 ml/min at 2 g. Doses of 500, 1000 and 2000 mg doses infused over 30 minutes give mean Cmax values of approximately 23, 49 and 115 μg/ml respectively, corresponding AUC values were 39.3, 62.3 and 153 μg.h/ml.

Meropenem 1 g powder for solution for injection or infusion

There are limited safety data available to support the administration of a 40 mg/kg dose in children as an intravenous bolus injection. The safety and efficacy of meropenem in children under 3 months of age have not been established and the optimal dose regimen has not been identified. However, limited pharmacokinetic data suggest that 20 mg/kg every 8 hours may be an appropriate regimen (see section 5.2). The dose of meropenem administered and the duration of treatment should take into account the type of infection to be treated, including its severity, and the clinical response. Histological evidence of renal tubular damage was seen in mice and dogs only at doses of 2000 mg/kg and above after a single administration and above and in monkeys at 500 mg/kg in a 7-day study.

  • It is recommended that the INR should be monitored frequently during and shortly after coadministration of antibiotics with an oral anti-coagulant agent.
  • However, limited pharmacokinetic data suggest that 20 mg/kg every 8 hours may be an appropriate regimen (see section 5.2).
  • Hepatic function should be closely monitored during treatment with meropenem due to the risk of hepatic toxicity (hepatic dysfunction with cholestasis and cytolysis) (see section 4.8).
  • Meropenem may be used in the management of neutropenic patients with fever that is suspected to be due to a bacterial infection.
  • If not used immediately in-use storage times and conditions are the responsibility of the user.

As a precautionary measure, it is preferable to avoid the use of meropenem during pregnancy. No specific medicinal product interaction studies other than probenecid were conducted. The concomitant use of meropenem and valproic acid/sodium valproate/valpromide is not recommended (see section 4.5). Severe hypersensitivity (e.g. anaphylactic reaction, severe skin reaction) to any other type of betalactam antibacterial agent (e.g. penicillins or cephalosporins).

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Meropenem is primarily excreted unchanged by the kidneys; approximately 70 % (50 –75 %) of the dose is excreted unchanged within 12 hours. The measured renal clearance and the effect of probenecid https://orajt.com/promising-results-tamoxifen-shows-effective/ show that meropenem undergoes both filtration and tubular secretion. Meropenem is metabolised by hydrolysis of the beta-lactam ring generating a microbiologically inactive metabolite.

  • Chemical and physical in-use stability for a prepared solution for bolus injection has been demonstrated up to 3 hours at controlled room temperature (15-25°C) or up to 8 hours under refrigerated conditions (2-8°C).
  • Many reports have confirmed that a combination of other antibacterial methods with PTT could effectively reduce the side effects on normal cells and enhance the therapeutic effect.
  • Meropenem is usually given by intravenous infusion over approximately 15 to 30 minutes (see sections 6.2, 6.3, and 6.6).
  • There are limited safety data available to support the administration of a 2 g dose in adults as an intravenous bolus injection.

Meropenem exerts its bactericidal activity by inhibiting bacterial cell wall synthesis in Gram-positive and Gram-negative bacteria through binding to penicillin-binding proteins (PBPs). No studies on the effect on the ability to drive and use machines have been performed. However, when driving or operating machines, it should be taken into account that headache, paraesthesia and convulsions have been reported for meropenem. Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal excretion of meropenem with the effect of increasing the elimination half-life and plasma concentration of meropenem. The maximum daily dose of this product is equivalent to ≥27% of the WHO recommended maximum daily intake for sodium. A positive direct or indirect Coombs test may develop during treatment with meropenem.

However, bacteria may exhibit resistance to more than one class of antibacterials agents when the mechanism involved include impermeability and/or an efflux pump(s). Localised clusters of infections due to carbapenem-resistant bacteria have been reported in the European Union. Meropenem should not be used in breast-feeding women unless the potential benefit for the mother justifies the potential risk to the baby. There are no or limited amount of data from the use of meropenem in pregnant women.

The potential effect of meropenem on the protein binding of other medicinal products or metabolism has not been studied. However, the protein binding is so low that no interactions with other compounds would be expected on the basis of this mechanism. This medicinal product contains 90 mg sodium per dose, equivalent to 4.5% of the WHO recommended maximum daily intake of 2 g sodium for an adult.

After infusion over 5 minutes Cmax values are 52 and 112 μg/ml after 500 and 1000 mg doses respectively. When multiple doses are administered 8-hourly to subjects with normal renal function, accumulation of meropenem does not occur. There is no target-based cross-resistance between meropenem and agents of the quinolone, aminoglycoside, macrolide and tetracycline classes.

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If not used immediately in-use storage times and conditions are the responsibility of the user. In this case, the prepared solution if stored under refrigeration (i.e. 2-8°C) should be used within 1 hour after it has left the refrigerator. In repeat dose studies of up to 6 months duration only minor effects were seen including a decrease in red cell parameters in dogs. Effects were seen in acute toxicity studies in rodent at doses exceeding 1000 mg/kg. Meropenem is cleared by haemodialysis with clearance during haemodialysis being approximately 4 times higher than in anuric patients.

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