Carbapenems in dogs: can meropenem be used?
9-year-old diabetic dog with recurrent cystitis. Urine culture by cystocentesis grows extended-spectrum beta-lactamase (ESBL)-producing E. coli. A colleague suggests treating with meropenem, to which it is susceptible.
Which statement about the use of meropenem is correct?
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A. It can be used under the cascade if susceptibility testing shows it is the only active drug
Since the European list of antimicrobials reserved for humans came into force, the cascade does not allow their use in animals, even when supported by susceptibility testing.
B. It is category B, so justification by susceptibility testing is enough
Category B includes fluoroquinolones and third- and fourth-generation cephalosporins, not carbapenems, which are category A.
C. It can be used if the dog is hospitalised and the owner signs a consent form
Neither hospitalisation nor owner consent alters a legal prohibition based on protecting public health.
D. It is category A and on the list of antimicrobials reserved for human medicine: it cannot be used in animals in the EU
Correct. Commission Implementing Regulation (EU) 2022/1255 reserves carbapenems for treating human infections. Other active options must be sought, after first confirming that the bacteriuria really is causing clinical signs.
lightbulb Key takeaway
With a multidrug-resistant bacterium, first check whether treatment is needed (subclinical bacteriuria is not treated), correct predisposing factors (poorly controlled diabetes) and apply hygiene measures: these dogs can transmit ESBL bacteria to other animals and to people in the household.
References: Reglamento de Ejecución (UE) 2022/1255 · EMA Categorisation of antibiotics for use in animals (AMEG) 2019
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.