Meropenem is more stable to renal dehydropeptidase I than imipenem and administration with cilastatin, which inhibits this enzyme, is not required. Meropenem may have less potential to induce seizures than imipenem. Hypersensitivity reactions such as skin rashes, urticaria, eosinophilia, fever, and, rarely, anaphylaxis may occur. Gastrointestinal effects include nausea, vomiting, diarrhoea, tooth or tongue discoloration, and altered taste. Superinfection with non-susceptible organisms such as Enterococcus faecium
, strains of Pseudomonas aeruginosa
with acquired resistance, and Candida
may also occur. Pseudomembranous colitis may develop. Erythema multiforme, exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported rarely. Increases in liver enzymes and abnormalities in haematological parameters, including a positive Coombs' test, have been noted in Imipenem.