Ertapenem

Ertapenem is an antibiotic belonging to the carbapenem group that fights bacteria. It is used to treat severe infections of the skin, lungs, stomach, urinary tract, blood and brain (eg. meningitis). It works by killing the bacteria that cause these problems.

Ertapenem is commonly used to treat seriously ill patients admitted to the hospital. This medicine is given by drip or by direct injection into a vein, under the supervision of a healthcare professional.

Ertapenem is an antibiotic. It kills bacteria by preventing them from forming the bacterial protective covering (cell wall) which is needed for them to survive.

• Complicated Intra-Abdominal Infections
• Complicated Skin and Skin Structure Infections (including diabetic foot infections)
• Community Acquired Pneumonia
• Complicated Urinary Tract Infections (including pyelonephritis)
• Acute Pelvic Infections (including postpartum endomyometritis, septic abortion, post-surgical gynecological infections)
• Bacterial Septicaemia
• Prophylaxis of surgical site infection following elective colorectal surgery

Other beta-lactam antibiotics

Carbapenem Antibiotic

Ertapenem for Injection is a sterile, synthetic, long-acting, parenteral, 1-β methyl-carbapenem that is structurally related to beta-lactam antibiotics, such as penicillins and cephalosporins, with activity against a wide range of Gram-positive and Gram-negative aerobic and anaerobic bacteria. It exhibits a bactericidal mode of action.

Ertapenem acts similarly to penicillins by bacterial cell wall inhibition. It is active against many gram-negative and aerobic and anaerobic organisms. It is stable to hydrolysis by beta-lactamases.

Adult Dose (>12 years):

• Most infections: 1 g/day IV/IM for 3-14 days.
• Community-Acquired Pneumonia/Complicated UTI: 1 g/day IV/IM up to 14 days.
• Complicated Skin Infections: 1 g/day IV/IM for 7-14 days (diabetic foot up to 4 weeks).
• Acute Pelvic Infections: 1 g/day IV/IM for 3-10 days.
• Prophylaxis (Elective Colorectal Surgery): 1 g IV single dose 1 hour prior to incision.

Child Dose (3-12 years): 15 mg/kg IV/IM q12hr (max 1 g/day).

Renal Dose: CrCl >30 mL/min: No adjustment; CrCl <30 mL/min or ESRD: 500 mg/day IV; Dialysis: 500 mg/day IV (supplemental 150 mg if given within 6 hr of dialysis).

Your doctor or nurse will give you this medicine. Kindly do not self administer. Administered as IV infusion (30 min) or IM injection.

If you miss a dose of Ertapenem, please consult your doctor.

Common Side Effects:

• Injection site reactions (pain, swelling, redness)
• Diarrhea
• Nausea
• Vomiting
• Headache
• Infused vein complication/Phlebitis

Other Side Effects: Dizziness, somnolence, insomnia, seizure, confusion, hypotension, dyspnoea, oral candidiasis, C. difficile-associated diarrhea, abdominal pain, taste perversion, asthenia/fatigue, candidiasis, fever.

Precautions:

• Ertapenem may cause side effects which could affect your ability to drive (dizziness and sleepiness).
• Usually only given in the hospital for serious infections.
• Inform your doctor if allergic to penicillin or taking seizure medication.
• Diarrhea, severe stomach pain or blood in stools: inform doctor.
• Your doctor may monitor your liver and kidney function during treatment.
• Prolonged use may result in overgrowth of non-susceptible organisms.
• Pseudomembranous colitis has been reported.

Contraindications:

• Hypersensitivity (beta-lactams)
• Anaphylactic reactions (penicillins/cephalosporins)
• Lactation
• IM administration: hypersensitivity to amide-type local anesthetics

Drug Interactions:

• Probenecid: Competes for active tubular secretion, increases elimination half-life (19%) and systemic exposure (25%).
• Valproic Acid: Decreased serum levels; increased risk of seizures.

Food Interactions: Consuming alcohol with Ertapenem does not cause any harmful side effects.

Use in Pregnancy: Category B. Animal studies revealed no evidence of harm to the fetus. No adequate studies in pregnant women. Should be used only if potential benefit justifies potential risk to mother and fetus.

Use in Lactation: Ertapenem is excreted in human milk. Caution should be exercised when administered to a nursing woman.

Pediatric Use: Safety and effectiveness in children 3 months-17 years established. Children <3 months: Safety and efficacy not established.

Geriatric Use: Substantially excreted by kidney; elderly may have decreased renal function; monitor renal function.

Renal Impairment: CrCl >30 mL/min: No adjustment; CrCl <30 mL/min: 500 mg/day.

Hepatic Impairment: Pharmacokinetics in patients with hepatic impairment not established.

Overdose: No specific information on treatment of overdosage. 3 g daily for 8 days did not result in significant toxicity. In overdose, discontinue and give supportive treatment. Can be removed by haemodialysis.

Storage: For injection: Store at 2-8°C. Keep away from light.

Ertapenem