美羅培南
Meropenem
別名: Merrem I.V. · Meronem · Meropen · Optinem · Zeropenem · ICI-194660 · SM-7338
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Bacteremia/sepsis | 24 mg/kg IV q24h (once daily) or 12 mg/kg SC q8h | IV/SC | q24h or q8h | — | 🌎 NA |
| UTI | 12 mg/kg SC q12h | SC | q12h | — | 🌎 NA |
| CNS infections | 40 mg/kg IV or SC q8h | IV/SC | q8h | — | 🌎 NA |
| Systemic infections | 12 mg/kg q8h SC or 24 mg/kg IV q24h (once daily) | SC/IV | q8h or q24h | — | 🌎 NA |
| Urinary tract infections | 12 mg/kg q12h SC | SC | q12h | — | 🌎 NA |
| Susceptible infections (Small dogs) | 125 mg (total dose) q8h IV or SC | IV/SC | q8h | — | 🌎 NA |
| Susceptible infections (Medium dogs) | 250 mg q8h IV or SC | IV/SC | q8h | — | 🌎 NA |
| Susceptible infections (Large dogs >100 lbs) | 500 mg q8h IV or SC | IV/SC | q8h | — | 🌎 NA |
- CNS infections: Extrapolated from children; maximum dose per administration is 2 grams.
- Susceptible infections (Small dogs): If serum creatinine greater than 4, may be given q12h.
- Susceptible infections (Medium dogs): If serum creatinine greater than 4, may be given q12h.
- Susceptible infections (Large dogs >100 lbs): If serum creatinine greater than 4, may be given q12h.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Bacteremia/sepsis | 24 mg/kg IV q24h (once daily) or 12 mg/kg SC q8h | IV/SC | q24h or q8h | — | 🌎 NA |
| UTI | 12 mg/kg SC q12h | SC | q12h | — | 🌎 NA |
| CNS infections | 40 mg/kg IV or SC q8h | IV/SC | q8h | — | 🌎 NA |
| Systemic infections | 12 mg/kg q8h SC or 24 mg/kg IV q24h (once daily) | SC/IV | q8h or q24h | — | 🌎 NA |
| Urinary tract infections | 12 mg/kg q12h SC | SC | q12h | — | 🌎 NA |
| Susceptible infections | 125 mg (total dose) q8h IV or SC | IV/SC | q8h | — | 🌎 NA |
| Susceptible infections | 8 mg/kg IV or SC q8h | IV/SC | q8h | — | 🌎 NA |
- CNS infections: Extrapolated from children; maximum dose per administration is 2 grams.
- Susceptible infections: If serum creatinine greater than 4, may be given q12h.
羊
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Pharmacokinetic data | IM injection | IM | — | — | 🌎 NA |
- Pharmacokinetic data: Rapidly absorbed, bioavailability equal to IV dosing.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
美羅培南 (Meropenem) 是一種廣效的合成碳青黴烯類抗生素，結構上與亞胺培南 (imipenem) 相似。在獸醫學中，它被視為對抗嚴重且具抗藥性感染的「最後防線」抗生素。
主要特點包括：
- 廣效性： 對許多革蘭氏陰性菌（特別是腸桿菌科）和厭氧菌高度有效。與亞胺培南相比，對革蘭氏陽性菌的活性較低。
- 安全性： 與亞胺培南不同，美羅培南不需與西司他丁 (cilastatin) 合併使用，且引發癲癇的風險顯著較低，對於患有中樞神經系統 (CNS) 疾病的病患更為安全。
- 給藥方式： 必須經由腸胃外途徑（靜脈注射或皮下注射）給藥。其優勢在於能比亞胺培南更快速且以較小體積給藥。
臨床要點： 為了落實良好的抗生素管理，美羅培南應嚴格保留用於已證實具抗藥性的感染（例如多重抗藥性大腸桿菌或綠膿桿菌），或當首選藥物（如氨基醣苷類）因腎功能不全而有禁忌時使用。
作用機轉
Meropenem is a bactericidal beta-lactam antibiotic.
- It readily penetrates the bacterial cell envelope and binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall.
- Binding to PBPs → inhibition of bacterial cell wall synthesis → weakening of the peptidoglycan network → cell lysis and death.
- Resistance mechanism: Meropenem is highly resistant to degradation by most beta-lactamases, including penicillinases and cephalosporinases. Furthermore, it is stable against renal dehydropeptidase-I, eliminating the need for a protective enzyme inhibitor like cilastatin.
安全性與警告
禁忌症
- Hypersensitivity to meropenem or other carbapenems
- History of anaphylaxis after receiving any beta-lactam antibiotic
不良反應
- Slight hair loss over SC injection sites
- Nausea (reported in humans)
- Vomiting (reported in humans)
- Diarrhea (reported in humans)
注意事項
Warnings and Precautions:
- Antimicrobial Stewardship: Use should be limited or avoided unless absolutely necessary to prevent the development of resistant bacterial strains that might infect humans.
- Hypersensitivity: Use with caution in patients with known allergies to penicillins or cephalosporins due to potential cross-reactivity.
- Pregnancy/Lactation: FDA Category B in humans (likely safe). It is considered likely safe to use during lactation.
- Renal Impairment: While safer than aminoglycosides, dosage adjustments (e.g., extending the dosing interval) may be necessary in severe renal failure (e.g., serum creatinine > 4 mg/dL).
藥物交互作用
In vitro evidence of synergy against Pseudomonas aeruginosa
May increase serum concentrations and elimination half-life of meropenem
監測
- Clinical efficacy (resolution of infection signs)
- Injection site monitoring (for SC administration)
藥物動力學
半衰期
吸收
After SC injection in dogs, bioavailability is 84%. In ewes, IM injection bioavailability is equal to intravenous dosing (~100%).
分佈
Widely distributed in body tissues and fluids, including CSF and bile. In dogs, volume of distribution (Vd) is ~0.37 L/kg with ~12% protein binding. In ewes, Vd is 0.06 L/kg with ~43% protein binding. Human protein binding is very low (~2%).
代謝
One inactive metabolite has been identified, but the majority of the drug is not metabolized.
排除
Primarily eliminated via renal mechanisms (tubular secretion and glomerular filtration). In dogs, clearance is ~6.5 mL/min/kg. In humans, 70% of a dose is recovered unchanged in the urine over 12 hours.
過量
Overdoses of meropenem are unlikely to cause significant toxicity in patients with normal renal function.
- In human trials, massive doses (2 grams every 8 hours) failed to demonstrate any significant adverse effects.
- Management: Should an overdose occur, the drug can be discontinued or the next dose delayed by a few hours. If necessary (e.g., in severe renal failure), meropenem can be removed via hemodialysis.
可用產品
劑型
- Powder for solution for injection
人用標示
- Meropenem Powder for solution for Injection: 500 mg & 1 gram in 20 mL, & 30 mL vials (Merrem I.V., generic)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store powder at controlled room temperature (20-25°C; 69-77°F). Reconstituted with sterile water (up to 50 mg/mL): stable for 2 hours at room temperature; up to 12 hours refrigerated. Diluted in normal saline or sterile water (1-20 mg/mL): stable up to 48 hours refrigerated. For SC use in veterinary patients (diluted to 20 mg/mL in 0.9% NaCl): protect from light, stable up to 96 hours refrigerated; once brought to room temperature, use within 6 hours. Freezing is generally not recommended by the manufacturer, though some studies show stability at -20°C for 14 days with 10% potency loss.
飼主須知
美羅培南是一種強效抗生素，通常保留用於嚴重且具抗藥性的感染。
- 給藥方式： 由於治療的感染通常較為嚴重，您的寵物多半會在住院期間接受此藥物。然而，對於某些情況（如具抗藥性的泌尿道感染），獸醫師可能會指導您在家中進行皮下注射。
- 注射技巧： 如果在家中進行注射，請確保您了解正確的注射技巧。您可能會注意到注射部位有輕微的脫毛現象，這通常是無害的。
- 儲存方式： 請嚴格遵守獸醫師的儲存指示，因為泡製後的液態美羅培南保存期限很短，且通常需要冷藏。
- 完成療程： 即使您的寵物看起來已經完全康復，也請務必完成整個抗生素療程，以防止細菌捲土重來並產生更強的抗藥性。
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