Doripenem: Difference between revisions

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==General==
==General==
*Type:  
*Type: [[Is DrugClass::Carbapenems]] (broad-spectrum beta-lactamase)
*Dosage Forms:
*Dosage Forms: IV
*Common Trade Names:  
*Common Trade Names: Doribax


==Adult Dosing==
==Adult Dosing==
===Intra-abdominal [[infection]], complicated===
*500mg IV q8h x5-14 days
===[[UTI]], complicated===
*500mg IV q8h x10 days
===[[Anthrax]], systemic===
*500mg IV q8h for at least 2 wk as part of multi-drug regimen


==Pediatric Dosing==
==Pediatric Dosing==
===[[Anthrax]], systemic===
*Neonates >32 weeks gestation
**20-30 mg/kg/day IV divided q8-12h for two weeks as part of multi-drug regimen
*1+ month old
**120 mg/kg/day IV divided q8h for at least two weeks as part of multi-drug regimen
***Max: 1 g/dose


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*Lactation:
*Lactation: May use while breastfeeding
*Renal Dosing
*Renal Dosing
**Adult
**Adult
***CrCl 30-50: 250mg IV q8h
***CrCl 10-30: 250mg IV q12h
***CrCl <10: Not defined
***HD: Not defined
**Pediatric
**Pediatric
***May be required, but specifics not defined
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult
***No adjustment
**Pediatric
**Pediatric
***May be required, but specifics not defined


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*Anaphylactic reaction to [[beta-lactams]]
*Inhalational use
*Ventilator-associated [[pneumonia]]
*Caution:
**Hypersensitivity to [[beta-lactams]]
**Hypersensitivity to multiple allergens
**Renal impairment
**CNS disorder
**[[Seizure]] history or risk
**Recent abx-associated colitis


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Hypersensitivity Reaction
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]], Toxic epidermal necrolysis
*[[Seizures]]
*C. diff associated [[diarrhea]]
*[[Pneumonia]], interstitial


===Common===
===Common===
*[[Headache]]
*[[Nausea]], [[Diarrhea]]
*[[Anemia]]
*[[Phlebitis]], [[rash]], [[pruritus]]
*ALT, AST Elevation
*[[Candidiasis]], vuvlovaginal


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 1h
*Metabolism:  
*Metabolism: Kidney minimally
*Excretion:  
*Excretion: Urine 85% (70% unchanged), feces <1%
*Mechanism of Action:
*Mechanism of Action: Inhibits cell wall synthesis


==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
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| ||[[Klebsiella]] sp||'''S'''
| ||[[Klebsiella]] sp||'''S'''
|-
|-
| ||E. coli/Klebsiella ESBL+||'''S'''
| ||E. coli/Klebsiella ESBL+||'''[[Has ESBL::S]]'''
|-
|-
| ||E coli/Klebsiella KPC+||R
| ||E coli/Klebsiella KPC+||R
Line 108: Line 149:
| ||[[Acinetobacter sp.]]||I
| ||[[Acinetobacter sp.]]||I
|-
|-
| ||[[Pseudomonas aeruginosa]]||'''S'''
| ||[[Pseudomonas aeruginosa]]||'''[[Has Antipseudomonal::S]]'''
|-
|-
| ||[[Burkholderia cepacia]]||I
| ||[[Burkholderia cepacia]]||I
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===Key===
===Key===
{{Template:Antibacterial Spectra Key}}
{{Template:Antibacterial Spectra Key}}
==See Also==
==See Also==


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


[[Category:Drugs]]
[[Category:Pharmacology]]
[[Category:ID]]

Latest revision as of 19:21, 19 July 2025

General

  • Type: Carbapenems (broad-spectrum beta-lactamase)
  • Dosage Forms: IV
  • Common Trade Names: Doribax

Adult Dosing

Intra-abdominal infection, complicated

  • 500mg IV q8h x5-14 days

UTI, complicated

  • 500mg IV q8h x10 days

Anthrax, systemic

  • 500mg IV q8h for at least 2 wk as part of multi-drug regimen

Pediatric Dosing

Anthrax, systemic

  • Neonates >32 weeks gestation
    • 20-30 mg/kg/day IV divided q8-12h for two weeks as part of multi-drug regimen
  • 1+ month old
    • 120 mg/kg/day IV divided q8h for at least two weeks as part of multi-drug regimen
      • Max: 1 g/dose

Special Populations

  • Pregnancy Rating: B
  • Lactation: May use while breastfeeding
  • Renal Dosing
    • Adult
      • CrCl 30-50: 250mg IV q8h
      • CrCl 10-30: 250mg IV q12h
      • CrCl <10: Not defined
      • HD: Not defined
    • Pediatric
      • May be required, but specifics not defined
  • Hepatic Dosing
    • Adult
      • No adjustment
    • Pediatric
      • May be required, but specifics not defined

Contraindications

  • Allergy to class/drug
  • Anaphylactic reaction to beta-lactams
  • Inhalational use
  • Ventilator-associated pneumonia
  • Caution:
    • Hypersensitivity to beta-lactams
    • Hypersensitivity to multiple allergens
    • Renal impairment
    • CNS disorder
    • Seizure history or risk
    • Recent abx-associated colitis

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 1h
  • Metabolism: Kidney minimally
  • Excretion: Urine 85% (70% unchanged), feces <1%
  • Mechanism of Action: Inhibits cell wall synthesis

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 I
Enterococcus faecium R
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis S
C. jeikeium X1
L. monocytogenes S
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. I
Pseudomonas aeruginosa S
Burkholderia cepacia I
Stenotrophomonas maltophilia R
Yersinia enterocolitica S
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 X1
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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