A Comprehensive Monograph on Meropenem: Pharmacology, Clinical Efficacy, and Safety

Section 1: Introduction and Drug Identification

1.1. Overview

Meropenem is a potent, broad-spectrum antibiotic administered intravenously and classified within the carbapenem subclass of β-lactam agents.[1] As a "small molecule" drug, it represents a critical tool in the modern medical armamentarium for combating severe and complex bacterial infections, particularly those acquired in hospital settings.[3] Its clinical utility extends to a wide array of life-threatening conditions, including complicated intra-abdominal infections, complicated skin and skin structure infections, bacterial meningitis, sepsis, and pneumonia.[1] Marketed under primary brand names such as Merrem, Meronem, and others globally, Meropenem is often reserved as a last-resort therapy when infections are caused by multidrug-resistant (MDR) pathogens that have developed resistance to other classes of antibiotics, such as penicillins and cephalosporins.[1] This strategic positioning underscores its importance in critical care medicine but also places it at the forefront of the global challenge of antimicrobial resistance, necessitating stringent antibiotic stewardship to preserve its efficacy for future generations.[5]

1.2. Chemical and Physical Properties

Meropenem is chemically defined as a carbapenemcarboxylic acid and is classified by the U.S. Food and Drug Administration (FDA) as a penem antibacterial agent.[7] In its commercial form, it is supplied as a sterile, white to light yellow or off-white crystalline powder for reconstitution.[1] This formulation is not pure meropenem but rather a carefully prepared blend of meropenem trihydrate and anhydrous sodium carbonate.[1] The sodium carbonate serves as an essential buffering agent, enhancing the drug's stability in solution after it is reconstituted for intravenous administration. The molecular formula of meropenem is