Meropenem pharmacokinetics

The pharmacokinetics of meropenem in pediatric patients 2 years of age and oider are essentiaiiy simiiar to those in aduits. In infants and chiidren 2 months to 12 years of age, no age- or dose-dependent effects on pharmacokinetic parameters were observed. Mean haif-iife was 1.13 hours, mean voiume of distribution at steady state was 0.43 L/kg, mean residence time was 1.57 hours, ciearance was 5.63 mL/min/kg and renai ciearance was 2.53 mL/min/kg. The eiimination haif-iife is siightiy proionged (1.5 hours) in pediatric patients 3 months to 2 years of age. 

Fuji R, Yoshioka H, Fujita K, Maruyama S, Sakata H, Inyaku F, Chiba S, Tsutsumi H, Wagatsuma Y, Fukushima N, et al. [Pharmacokinetic and clinical studies with meropenem in the pediatric field. Pediatric Study Group of Meropenem.] Jpn J Antibiot 1992 45(6) 697-717. 

Ishida Y, Matsumoto F, Sakai O, Yoshida M, Shiba K. The pharmacokinetic study of meropenem effect of probenecid and hemodialysis. JC/2emt r(1993)5(Suppl 1), 124-6. 

Clause D, Decleire P-Y, Vanbinst R, Soyer A, Hantson P. Pharmacokinetic interaction between valproic acid and meropenem. Intensive Care Med (2005) 31, 1293—4. 

Fig. 5.32). The pharmacokinetics of meropenem closely resemble that of the imipenem/cUastatin combination, and its nephro-and neuro-toxicity is correspondingly low. 

Carbapenems An old Chinese man with epilepsy had seizures when meropenem was added to treatment with valproate [407 ]. In a retrospective study of six critically ill patients taking valproate who concurrently received meropenem (n = 4), imipenem (n = 1), or ertapenem (n = 1) mean plasma valproate trough concentrations fell by 58% and estimated mean valproate clearance increased by 191% compared with values obtained while they were not receiving a carbapenem five patients had generalized seizures during concurrent valproate -b carbapenem treatment, including two with no prior history of seizures [408 ]. Meropenem is an enzyme inducer. Because of this pharmacokinetic interaction, concurrent use of these medications should be avoided. 

Krueger, W.A., Bulitta, J., Kinzig-Schippers, M., Landersdorfer,C., Holzgrabe, U., Naber, K.G., Drusano, G.R. and Sorgel, R, Evaluation by monte carlo simulation of the pharmacokinetics of two doses of meropenem administered intermittently or as a continuous infusion in healthy volunteers. Antimicrob. Agents Chemother., 49(5), 1881-1889 (2005). 

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