Ertapenem

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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