Ertapenem

Indications
 Parenteral
Community-acquired pneumonia
Adult: 1 g once daily IM or IV infusion over 30 minutes.
Renal impairment: For patients undergoing haemodialysis: An additional 150 mg should be given after the session if the 500 mg dose is given in the 6-hr period before dialysis.
CrCl (ml/min)Dosage Recommendation
≤30 and end-stage renal failure500 mg daily.

Parenteral
Intra-abdominal infections
Adult: 1 g once daily IM or IV infusion over 30 minutes.
Renal impairment: For patients undergoing haemodialysis: An additional 150 mg should be given after the session if the 500 mg dose is given in the 6-hr period before dialysis.
CrCl (ml/min)Dosage Recommendation
≤30 and end-stage renal failure500 mg daily.

Parenteral
Skin and skin structure infections
Adult: 1 g once daily IM or IV infusion over 30 minutes.
Renal impairment: For patients undergoing haemodialysis: An additional 150 mg should be given after the session if the 500 mg dose is given in the 6-hr period before dialysis.
CrCl (ml/min)Dosage Recommendation
≤30 and end-stage renal failure500 mg daily.

Parenteral
Urinary tract infections
Adult: 1 g once daily IM or IV infusion over 30 minutes.
Renal impairment: For patients undergoing haemodialysis: An additional 150 mg should be given after the session if the 500 mg dose is given in the 6-hr period before dialysis.
CrCl (ml/min)Dosage Recommendation
≤30 and end-stage renal failure500 mg daily.

Intravenous
Prophylaxis of surgical infections
Adult: 1 g as a single dose, to be given 1 hr before the start of the surgery.
Renal impairment: Dose reduction may be needed.

Special Populations: Dose reduction in renal impairment.
Contraindications
 Hypersensitivity; lactation.
Warnings / Precautions
 Hypersensitivity to penicillins, cephalosporins or other β-lactams (possibility of cross-sensitivity). Renal impairment; CNS disorders e.g. epilepsy. Pregnancy.
Adverse Reactions
 GI effects, injection-site reactions, raised platelet count; less frequently dry mouth, taste disturbances; hypotension, chest pain, oedema, pharyngeal discomfort, dyspnoea, dizziness, sleep disturbances, confusion, asthenia, seizures, vaginitis, raised glucose; headache; hypersensitivity reactions; antibiotic-associated colitis; dysphagia, cholecystitis; liver disorder; arrhythmia; increase in blood pressure; syncope; nasal congestion; cough; wheezing; CNS effects; pelvic peritonitis; renal impairment; muscle cramp, scleral disorder; blood disorders, hypoglycaemia; electrolyte disturbances. Local site reactions such as pain and thrombophlebitis may occur.
Potentially Fatal: Pseudomembranous colitis, Stevens-Johnson syndrome.
Drug Interactions
 Valproate; oestrogens. Renal excretion inhibited by probenecid.
See Below for More ertapenem Drug Interactions
Lab Interactions
 Changes in LFTs and haematological parameters, including a positive Coombs' test.
Mechanism of Actions
 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 β-lactamases.
Distribution: >90% bound to plasma proteins. Distributes into breast milk.
Metabolism: Part metabolised by hydrolysis of its β-lactam ring by dehydropeptidase I to an open-ringed metabolite.
Excretion: About 80% of a dose is excreted in the urine as both unchanged drug and metabolite and 10% is excreted in faeces.
ATC Classification
 J01DH03 - ertapenem ; Belongs to the class of carbapenems. Used in the systemic treatment of infections.
Available As
  • Ertapenem 1000 mg

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