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Gram-Positive Bacteria

When facing problem pathogens…Merrem I.V. is active in vitro against Gram-positives*

100% susceptibility	Methicillin-susceptible Staphylococcus aureus (MSSA) (ß-lactamase- and non-ß-lactamase-producing, methicillin-susceptible isolates only)^5† (n=326)
98.9% susceptibility	Streptococcus agalactiae (Group B)^7‡ (n=91)
97.9% susceptibility	Streptococcus pyogenes (Group A)^7§ (n=47)
92.5% susceptibility	Viridans group streptococci^7‡ (n=40)
90.4% susceptibility	Streptococcus pneumoniae^7§ (n=83)
75.3% susceptibility	Enterococcus faecalis (excluding vanocomycin-resistant isolates)^7§ (n=97)

*n=number of isolates
^†Data from US MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) database 2005 provided by AstraZeneca, which tracks trends in microbial susceptibility to Merrem I.V. in US medical centers using carbapenem agents.
^‡Data from North American MYSTIC database 2003.
^§Data from North American MYSTIC database 2005.

In vitro activity does not necessarily correlate with clinical effectiveness.

Merrem I.V. demonstrates in vitro activity against the following Gram-positive pathogens, but the clinical significance of these data is unknown¹

Aerobic and facultative gram-positive microorganisms¹

Staphylococcus epidermidis (ß-lactamase-producing, methicillin-susceptible isolates only)

Staphylococcus epidermidis (non-ß-lactamase-producing, methicillin-susceptible isolates only)

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.