Meropenem Administration Timing in Hemodialysis Patients

Rationale for Post-Dialysis Administration

The American Thoracic Society recommends that antituberculosis and antimicrobial medications, such as meropenem, should be given after hemodialysis to avoid drug loss during the dialysis process and to facilitate directly observed therapy in patients with end-stage renal disease 1, 2
Post-dialysis administration of meropenem prevents premature drug removal that would lead to subtherapeutic levels and potentially inadequate treatment of serious infections in hemodialysis patients 1, 2, 3

Increase the dosing interval rather than decreasing the dose to maintain adequate peak concentrations while avoiding toxicity in patients with end-stage renal disease receiving intermittent hemodialysis 1, 2, 3

Consider therapeutic drug monitoring to ensure adequate drug absorption without excessive accumulation, particularly in critically ill patients on hemodialysis 2