Self-administration of meropenem bolus 1 gram

This leaflet is for patients who have been advised to take an antibiotic called meropenem to treat their infection and have chosen to self-administer this medication with the support of the outpatient parenteral antibiotic therapy (OPAT) team.

What is meropenem?

Meropenem is an antibiotic of the beta-lactam group. It is a medicine which is used in a wide range of bacterial infections. Meropenem will always be administered intravenously (into a vein) and must not be taken by mouth.

Are there any side effects?

The most common (more than one in 100 patients and less than one in 10 patients) side effects are:

• headache
• diarrhoea, nausea, vomiting
• rash, itching

If you experience any of the above side effects or any others please inform one of the OPAT team. You will have regular blood tests in clinic whilst you are being treated with meropenem to check for any problems.

How do I administer it?

The OPAT nurse and ward nursing team will ensure you are happy and safe to administer meropenem following the procedure below.

Equipment per dose

• One: 20ml syringe
• One: red blunt needles
• Two: small Clinell wipes
• Two: 10ml ampoule of ‘water for injection’.
• Two: 10ml pre-filled syringes of sodium chloride 0.9% (normal saline) solution
• One: disinfectant spray
• One: sharps bin
• One : vial of meropenem in powder form [1gram (g) strength]

Actions

Always remember to check the dose and expiry date of meropenem, ‘water for injection’ and normal saline (sodium chloride 0.9%) solution.

1. Wash your hands and clean the preparation surface with disinfectant spray and assemble the necessary equipment. Your preparation surface should be a non-porous surface which is clear of clutter (eg a kitchen top or work desk).
2. Prepare sodium chloride 0.9% flushes
3. Prepare medication

• Clean the top of the ‘water for injection’ ampoules and allow 20 seconds to dry before opening them.
• Draw up the contents of both the “water for injections” ampoules into a 20ml syringe using the red needle.
• Slowly inject the ‘water for injection’ into the vial of meropenem 1g powder and agitate the vial until the powder is fully dissolved. Keep the needle and syringe attached to the vial.
• Withdraw all of the mixed solution into the syringe – tilt the vial to the side if necessary.
• Remove the needle from the syringe and place in the sharps bin.
• Remove any air from the syringe – tap the syringe with your finger or tap the side of the syringe on a clean surface to move air bubbles to the top. Do not touch the tip of the syringe.
• Return the filled syringe to the original packet to keep it clean.

4. Administering medication

• Clean the bio-connector on the PICC line with a small Clinell wipe and allow 20 seconds to dry.
• Flush the line with 10ml of sodium chloride 0.9% solution using the pulse (push-pause) technique as demonstrated by the ward nurses and OPAT team.
• Administer meropenem via the syringe in a smooth continuous motion over five minutes. Ensure a clock or timer is used.
• Flush the PICC line with 10ml of sodium chloride 0.9% solution using the pulse technique.

Potential problems

You should let the OPAT team know if any of the following happen:

• You feel unwell after administering the antibiotic.
• The antibiotic or the flush cannot be administered easily through the PICC line.
• You may have injected a large amount of air.
• If the PICC line feels sore/uncomfortable, or a discharge is coming from the PICC entry site.