Ertapenem: Difference between revisions

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==General==
==General==
*Type: [[Carbapenems]]
*Type: [[Is DrugClass::Carbapenems]]
*Dosage Forms: IM, IV
*Dosage Forms: IM, IV
*Common Trade Names: Invanz
*Common Trade Names: Invanz
*Has activity against ESBL organisms
*As opposed to [[meropenem]], ertapenem does not cover [[Pseudomonas aeruginosa]]


==Adult Dosing==
==Adult Dosing==
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*1g IM/IV daily for all
*1g IM/IV daily for all
*Intrabdominal infections x 5-14 days
*Intrabdominal infections x 5-14 days
*Skin infections = x 7-14 days
*[[Skin Infections]] = x 7-14 days
*Pneumonia, community aquired x 10-14 days
*[[Pneumonia]], community aquired x 10-14 days
*UTI, complicated = x 10-14 days
*[[UTI]], complicated = x 10-14 days
*Gynecologic = x 3-10 days
*Gynecologic = x 3-10 days
*Prophylaxis, colorectal surg = x 1 dose
*Prophylaxis, colorectal surgery = x 1 dose


==Pediatric Dosing==
==Pediatric Dosing==
===General (3mo-12 years)===
===General (3mo-12 years)===
*30 mg/kg/day IM/IV divided BID x 5-14 days
*30mg/kg/day IM/IV divided BID x 5-14 days
*First Dose: 15 mg/kg IM/IV x 1
*First Dose: 15mg/kg IM/IV x 1
*Max: 1 g/day
*Max: 1 g/day
*For duration, see adult specific indication dosing
*For duration, see adult specific indication dosing
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==Special Populations==
==Special Populations==
*Pregnancy: B
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*Lactation: Safety unknown
*Lactation: Safety unknown
*Renal Dosing
*Renal Dosing
**Adult
**Adult
***CrCl <30: 500mg daily
***Hemodyalisis: give 150mg supplement if maintenance dose <6h prior
**Pediatric
**Pediatric
*Hepatic Dosing
***CrCl <30: decrease dose 50%
**Adult
***Hemodyalisis: give 150mg supplement if maintenance dose <6h prior
**Pediatric
*Hepatic Dosing (Adult & Pediatric)
**No data


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*Hypersensitivity to amide anesthetics (IM only)
*Hypersensitivity to amide anesthetics (IM only)
===Cautions===
*Hypersensitivity to [[Beta-Lactam]]
*[[Seizure]] history
*CNS disorder
*Renal impairment
*Recent antibiotic associated colitis


==Adverse Reactions==
==Adverse Reactions==
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*[[Anaphylaxis]]
*[[Anaphylaxis]]
*Neurotoxicity
*Neurotoxicity
*[{Seizures]]
*[[Seizures]]
*[[C. diff]]
*[[C. diff]]
*Superinfection
*Superinfection
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*Hypertension
*Hypertension
*Tachycardia
*Tachycardia
*Drug rash with eosinophilia
*Drug rash with [[eosinophilia]]


===Common===
===Common===
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*Infusion site reaction
*Infusion site reaction
*[[Nausea and Vomiting]]
*[[Nausea and Vomiting]]
*[[Transaminitis]]
*Transaminitis
*[[Headache]]
*[[Headache]]
*[[Fever]]
*[[Fever]]
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*Edema
*Edema
*Insomnia
*Insomnia
*[[Thrombocytosis]]
*Thrombocytosis
*[[Dyspnea]]
*[[Dyspnea]]
*[[Rash]]
*[[Rash]]
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==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 4h
*Metabolism:  
*Metabolism: CYP450
*Excretion:  
*Excretion: Urine (80%)
*Mechanism of Action:
*Mechanism of Action: Bactericidal
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||'''S'''
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||I
|-
| Gram Negatives||[[N. gonorrhoeae]]||X2
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||'''[[Has ESBL::S]]'''
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||'''S'''
|-
| ||[[Enterobacter]] sp, AmpC pos||'''S'''
|-
| ||[[Serratia]] sp||'''S'''
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||'''S'''
|-
| ||[[Citrobacter diversus]]||'''S'''
|-
| ||[[Citrobacter sp.]]||'''S'''
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||X1
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||'''S'''
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X2
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics]]
*[[Antibiotics]]


==Source==
==References==
<references/>


<references/>
[[Category:Pharmacology]]
[[Category:ID]]

Latest revision as of 19:09, 19 July 2025

General

Adult Dosing

General

  • 1g IM/IV daily x 5-14 days
  • First Dose: 1g IM/IV x 1

Specific Indications

  • 1g IM/IV daily for all
  • Intrabdominal infections x 5-14 days
  • Skin Infections = x 7-14 days
  • Pneumonia, community aquired x 10-14 days
  • UTI, complicated = x 10-14 days
  • Gynecologic = x 3-10 days
  • Prophylaxis, colorectal surgery = x 1 dose

Pediatric Dosing

General (3mo-12 years)

  • 30mg/kg/day IM/IV divided BID x 5-14 days
  • First Dose: 15mg/kg IM/IV x 1
  • Max: 1 g/day
  • For duration, see adult specific indication dosing

General (>13 Years)

See adult dosing

Special Populations

  • Pregnancy Rating: B
  • Lactation: Safety unknown
  • Renal Dosing
    • Adult
      • CrCl <30: 500mg daily
      • Hemodyalisis: give 150mg supplement if maintenance dose <6h prior
    • Pediatric
      • CrCl <30: decrease dose 50%
      • Hemodyalisis: give 150mg supplement if maintenance dose <6h prior
  • Hepatic Dosing (Adult & Pediatric)
    • No data

Contraindications

  • Allergy to class/drug
  • Hypersensitivity to amide anesthetics (IM only)

Cautions

  • Hypersensitivity to Beta-Lactam
  • Seizure history
  • CNS disorder
  • Renal impairment
  • Recent antibiotic associated colitis

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 4h
  • Metabolism: CYP450
  • Excretion: Urine (80%)
  • Mechanism of Action: Bactericidal

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp S
Enterococcus faecalis R
Enterococcus faecium R
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis S
C. jeikeium R
L. monocytogenes I
Gram Negatives N. gonorrhoeae X2
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ S
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos S
Serratia sp S
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii S
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica X1
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces S
Bacteroides fragilis S
Prevotella melaninogenica S
Clostridium difficile X2
Clostridium (not difficile) S
Fusobacterium necrophorum S
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
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