Antibiotic for parenteral use from the group of Karabapenems, has a bactericidal action (suppresses the synthesis of the bacterial cell wall), easily penetrates the bacterial cell wall, is resistant to the action of most beta-lactamases.
Unlike imipenem, it practically does not break down in the renal tubules with dehydropeptidase-1 (it does not need to be combined with cilastatin, a specific inhibitor of dehydropeptidase-1) and, accordingly, no nephrotoxic degradation products are formed,has a high affinity for proteins that bind penicillin.
Bactericidal and bacteriostatic concentrations practically do not differ.
It interacts with receptors-specific penicillin-binding proteins on the surface of the cytoplasmic membrane, inhibits the synthesis of the peptidoglycan layer of the cell wall, suppresses transpeptidase, promotes the release of autolytic enzymes of the cell wall, which eventually causes its damage and death of bacteria.
The spectrum of antibacterial activity of meropenem includes the majority of clinically significant Gram-positive and Gram-negative aerobic and anaerobic strains of bacteria:
Gram-positive aerobes:
Enterococcus faecalis (including vancomycin-resistant strains). Staphylococcus aureus(penicillinase-inducing and penicillinase-producing [methicillin-sensitive]); Streptococcus agalactiae, Streptococcus pneumoniae (only penicillin-sensitive); Streptococcus pyogenes. Streptococcus spp. groups viridans.
Gram-negative aerobes:
Escherichia coli, Haemophilus influenzae (penicillinase-inducing and penicillin-producing), Klebsiella pneumoniae, Neisseria meningitidis. Pseudomonas aeruginosa, Proteus mirabilis.
Anaerobic bacteria:
Bacteroides fragilis, Bacteroides thetaiotaomicron, Peptostreptococcus spp.
Meropenem is effective in vitro with respect to the microorganisms listed below, however, its clinical effectiveness in diseases caused by these pathogens has not been proven:
Gram-positive aerobes:
Staphylococcus epidermidis (penicillinase-inducing and penicillinase-producing [methicillin-sensitive]).
Gram-negative aerobes:
Acinetobacter spp., Aeromonas hydrophila, Campylobacter jejuni, Citrobacter-diversus, Citrobacter ffeundii, Enterobacter cloacae, Haemophilus influenzae (ampicillin-resistant, penicillinase-sparing strains), Hafnia alvei, Klebsiella oxytoca, Moraxella catarrhalis (penicillinase-inducing and penicillin-producing), Morganella morganii, Pasteurella multocida, Proteus vulgaris. Salmonella spp., Serratia marcescens. Shigella spp., Yersinia enterocolitica.
Anaerobic bacteria:
Bacteroides distasonis, Bacteroides ovatus, Bacteroides uniformis, Bacteroides ureolyticus, Bacteroides vulgatus, Clostridium difficile, Clostridium perfringens, Eubacterium lentum, Fusobacterium spp., Prevotella bivia, Prevotella intermedia, Prevotella melaninogenica, Porphyromonas asaccharolytica, Propionibacterium acnes.