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Gram-Negative Bacteria

Merrem I.V. is active against Gram-negative bacteria

When facing difficult-to-treat Gram-negative bacteria…

Merrem I.V. maintains in vitro activity against Pseudomonas aeruginosa^3-5

Merrem I.V. maintains in vitro activity against difficult to treat gram negative bacteria like Pseudomonas aeruginosa

*n=number of isolates
^†Data from US MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) database provided by AstraZeneca, which tracks trends in microbial susceptibility to Merrem I.V. in US medical centers using carbapenem agents.

In vitro activity does not necessarily correlate with clinical effectiveness.

Merrem I.V. is active in vitro against Gram-negatives^‡

100% susceptibility	Haemophilus influenzae^6§ (n=199)
100% susceptibility	Proteus mirabilis^5// (n=147)
100% susceptibility	Escherichia coli^5// (n=491)
95% susceptibility	Klebsiella pneumoniae^7// (n=366)

^‡n=number of isolates
^§Data from the SENTRY Program 2000, which collected isolates from 30 medical centers in North America (US, 25; Canada, 5).
^//Data from US MYSTIC database 2005

In vitro activity does not necessarily correlate with clinical effectiveness.

Merrem I.V. demonstrates in vitro activity against a wide range of Gram-negative pathogens, but the clinical significance of these data is unknown¹

Aerobic and facultative Gram-negative microorganisms¹

Acinetobacter species
Aeromonas hydrophila
Campylobacter jejuni
Citrobacter diversus
Citrobacter freundii
Enterobacter cloacae
Haemophilus influenzae (ampicillin-resistant, non-ß-lactamase-producing isolates)
Hafnia alvei
Klebsiella oxytoca
Moraxella catarrhalis (ß-lactamase- and non-ß-lactamase-producing isolates)
Morganella morganii
Pasteurella multocida
Proteus vulgaris
Salmonella species
Serratia marcescens
Shigella species
Yersinia enterocolitica

The safety and effectiveness of Merrem I.V. in treating clinical infections due to these microorganisms have not been established in adequate and well controlled trials.

Indications for MERREM I.V.

Merrem I.V. is indicated as single-agent therapy for the treatment of:

Complicated appendicitis and peritonitis caused by susceptible isolates of viridans group streptococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Bacteroides fragilis, B. thetaiotaomicron, and Peptostreptococcus species.
Complicated skin and skin structure infections caused by susceptible isolates of Staphylococcus aureus (beta-lactamase and non-beta-lactamase-producing, methicillin-susceptible isolates only), Streptococcus pyogenes, S. agalactiae, viridans group streptococci, Enterococcus faecalis (excluding vancomycin-resistant isolates), P. aeruginosa, E. coli, Proteus mirabilis, B. fragilis, and Peptostreptococcus species.
Pediatric (≥3 months of age) bacterial meningitis caused by susceptible isolates of S. pneumoniae*, Haemophilus influenzae (beta-lactamase and non-beta-lactamase-producing isolates), and Neisseria meningitidis.

* The efficacy of meropenem as monotherapy in the treatment of meningitis caused by penicillin nonsusceptible isolates of S. pneumoniae has not been established.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Merrem I.V. and other antibacterial drugs, Merrem I.V. should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

Important Risk Information for MERREM I.V.

Merrem I.V. is contraindicated in patients with known hypersensitivity to any component of the product, or to other drugs in the same class, or in patients who have demonstrated anaphylactic reactions to beta-lactams.
Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving therapy with beta-lactams. These reactions are more likely to occur in individuals with a history of sensitivity to multiple allergens.
There have been reports of individuals with a history of penicillin hypersensitivity who have experienced severe hypersensitivity reactions when treated with another beta-lactam.
Seizures and other CNS adverse experiences have been reported during treatment with Merrem I.V.
Co-administration of carbapenems, including meropenem, to patients receiving valproic acid or divalproex sodium may reduce serum valproic acid concentrations to below the therapeutic range, increasing the risk of breakthrough seizures. Increasing the dose of valproic acid or divalproex sodium may not be sufficient to overcome this interaction. Antibacterials other than carbapenems should be considered in patients whose seizures are well controlled on valproic acid or divalproex sodium. If administration of Merrem I.V. is necessary, supplemental anticonvulsant therapy should be considered.
Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Merrem I.V., and may range in severity from mild diarrhea to fatal colitis. CDAD must be considered in all patients who present with diarrhea following antibiotic use.
The most common adverse events reported across clinical trials with Merrem I.V. were diarrhea, nausea/vomiting, headache, constipation, anemia, and pain. These events occurred in 3% to 8% of patients.

Please click here for full Prescribing Information(PDF - 1.3MB).

Important Pages:
Dosing with MERREM I.V.
Complicated Skin and Skin Structure Infections

This product information is intended for US health care professionals only.

Merrem I.V. is a registered trademark of the AstraZeneca group of companies.

Gram-Negative Bacteria

Merrem I.V. is active against Gram-negative bacteria

Merrem I.V. maintains in vitro activity against Pseudomonas aeruginosa3-5

Merrem I.V. is active in vitro against Gram-negatives‡

Merrem I.V. demonstrates in vitro activity against a wide range of Gram-negative pathogens, but the clinical significance of these data is unknown1