19% of candidates passed this question.

Meropenem is a commonly used drug in ICU and information required to do well in this question is directly applicable to everyday practice.

1. Mechanism of action was generally well answered and covered by candidates.
2. The spectrum of activity required a statement of its broad spectrum including some examples of this.
3. Indications for use were asking candidates to indicate the types of infections meropenem is preferred particularly as it is not usually the first antibiotic of choice, for example, hospital acquired infections, multi-microbial and necrotising infections, failure of first line therapy, melioidosis or any other reasonable example.
4. This section required an explanation of how critical illness changes the way meropenem is handled and hence the need to adjust dosage not necessarily just a list of the general pharmacokinetics of meropenem.

A comprehensive answer included the increased dosage required in high cardiac output states as high GFR ie. burns, sepsis due to the renal handling, or the effect of renal impairment.

The changes to the volume of distribution for meropenem are seen in critical illness and the relative lack of concern in hepatic failure and thus the limited need to dose reduce in these circumstances.