Synergistic photothermal antibacterial therapy enabled by multifunctional nanomaterials: progress and perspectives Materials Chemistry Frontiers RSC Publishing

Many reports have confirmed that a combination of other antibacterial methods with PTT could effectively reduce the side effects on normal cells and enhance the therapeutic effect. In view of the rapid development of synergistic PTT in antibacterial therapy, this review mainly discusses and summarizes the advancements of several synergistic photothermal antibacterial methods within the last five years. The remaining challenges and future opportunities in this field are also highlighted. There is no evidence of an increased risk of any adverse drug reaction in children based on the limited available data. Pharmacokinetic studies performed in patients have not shown significant pharmacokinetic differences versus healthy subjects with equivalent renal function. A population model developed from data in 79 patients with intra-abdominal infection or pneumonia, showed a dependence of the central volume on weight and the clearance on creatinine clearance and age.

• Reconstituted solution of meropenem in 5% glucose (dextrose) solution should be used immediately, i.e. within 30 minutes following reconstitution.
• Meropenem is primarily excreted unchanged by the kidneys; approximately 70 % (50 –75 %) of the dose is excreted unchanged within 12 hours.
• Alternatively, meropenem doses of up to 20 mg/kg may be given as an intravenous bolus over approximately 5 minutes.
• There is no target-based cross-resistance between meropenem and agents of the quinolone, aminoglycoside, macrolide and tetracycline classes.

Hepatic function should be closely monitored during treatment with meropenem due to the risk of hepatic toxicity (hepatic dysfunction with cholestasis and cytolysis) (see section 4.8). If a severe allergic reaction occurs, the medicinal product should be discontinued and appropriate measures taken. The dose for adults and adolescents should be adjusted when creatinine clearance is less than 51 ml/min, as shown below.

Meropenem 1 g powder for solution for injection or infusion

In vitro meropenem shows reduced susceptibility to hydrolysis by human dehydropeptidase-I (DHP-I) compared to imipenem and there is no requirement to co-administer a DHP-I inhibitor. The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. As necessary, expert advice should be sought when the local prevalence of resistance is such that the utility of the agent in at least some types of infections is questionable.

The risk may vary with the underlying infection, age and general status of the patient so that the contribution of the antibiotic to the increase in INR (international normalized ratio) is difficult to assess. It is recommended that the INR should be monitored frequently during and shortly after coadministration of antibiotics with an oral anti-coagulant agent. Meropenem is usually given by intravenous infusion over approximately 15 to 30 minutes (see sections 6.2, 6.3, and 6.6). Alternatively, meropenem doses of up to 20 mg/kg may be given as an intravenous bolus over approximately 5 minutes.

Databases

Meropenem is a white to pale yellow crystalline powder for solution for injection or infusion in vial. No dose adjustment is necessary in http://www.operette-theatremusical.fr/2023/10/04/easy-steps-to-buy-pharmatropin-10-iu-your-guide-to/ patients with hepatic impairment (see section 4.4). The required dose should be administered after completion of the haemodialysis cycle.

• If signs and symptoms suggestive of these reactions appear, meropenem should be withdrawn immediately and an alternative treatment should be considered.
• Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal excretion of meropenem with the effect of increasing the elimination half-life and plasma concentration of meropenem.
• There are limited data to support the administration of these dose adjustments for a unit dose of 2 g.
• Meropenem is a white to pale yellow crystalline powder for solution for injection or infusion in vial.

In recent years, infection caused by drug-resistant bacteria has become a serious public health problem. The exploration of antibacterial therapies other than antibiotics has attracted more and more attention. Photothermal therapy (PTT) has become a promising antibacterial method due to its low invasiveness, low toxicity and avoidance of drug-resistant bacteria. However, when PTT is used alone, it requires a higher temperature to achieve a better antibacterial effect, which will not only kill bacteria, but also cause damage to normal tissues, and even trigger new inflammation.

Meropenem is primarily excreted unchanged by the kidneys; approximately 70 % (50 –75 %) of the dose is excreted unchanged within 12 hours. The measured renal clearance and the effect of probenecid show that meropenem undergoes both filtration and tubular secretion. Meropenem is metabolised by hydrolysis of the beta-lactam ring generating a microbiologically inactive metabolite.

Meropenem 1 g powder for solution for injection or infusion

A study in patients with alcoholic cirrhosis shows no effect of liver disease on the pharmacokinetics of meropenem after repeated doses. A study of 12 patients administered meropenem 1000 mg 8 hourly post-surgically for intra-abdominal infections showed a comparable Cmax and half-life to normal subjects but a greater volume of distribution 27 l. Relative overdose may be possible in patients with renal impairment if the dose is not adjusted as described in section 4.2. Chemical and physical in-use stability for a prepared solution for bolus injection has been demonstrated up to 3 hours at controlled room temperature (15-25°C) or up to 8 hours under refrigerated conditions (2-8°C). From a microbiological point of view, unless the method of opening/reconstitution/dilution precludes the risk of microbiological contamination, the product should be used immediately.

Meropenem exerts its bactericidal activity by inhibiting bacterial cell wall synthesis in Gram-positive and Gram-negative bacteria through binding to penicillin-binding proteins (PBPs). No studies on the effect on the ability to drive and use machines have been performed. However, when driving or operating machines, it should be taken into account that headache, paraesthesia and convulsions have been reported for meropenem. Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal excretion of meropenem with the effect of increasing the elimination half-life and plasma concentration of meropenem. The maximum daily dose of this product is equivalent to ≥27% of the WHO recommended maximum daily intake for sodium. A positive direct or indirect Coombs test may develop during treatment with meropenem.

If signs and symptoms suggestive of these reactions appear, meropenem should be withdrawn immediately and an alternative treatment should be considered. Simultaneous administration of antibiotics with warfarin may augment its anti-coagulant effects. There have been many reports of increases in the anti-coagulant effects of orally administered anti-coagulant agents, including warfarin in patients who are concomitantly receiving antibacterial agents.