Ertapenem

Oral Antibiotics

Drug class: Carbapenem; beta-lactam antibiotics class, a broad-spectrum antibiotic belonging to the carbapenem.

Ertapenem (INVANZ)（中文：厄他培南）

Common Strengths

The common strength of ertapenem is 1 g, typically provided as a powder for injection.

Drug Trade Names

The primary trade name for ertapenem is Invanz.

Drug Usage

Ertapenem is indicated for the treatment of:

• Intra-abdominal infections
• Community-acquired pneumonia
• Pelvic infections
• Diabetic foot infections
• Complicated urinary tract infections
• Surgical prophylaxis for colorectal surgery

Mechanism of Action

Ertapenem exerts its antibacterial effects by inhibiting the synthesis of bacterial peptidoglycan cell walls. It achieves this by binding to penicillin-binding proteins (PBPs), which are essential for cross-linking the peptidoglycan layer, ultimately leading to cell lysis and death.

Route of Administration

Ertapenem is administered via intravenous (IV) infusion or intramuscular (IM) injection.

Dosages

• Adults: 1 g IV or IM once daily.
• Children (3 months to 12 years): 15 mg/kg every 12 hours (maximum 1 g/dose).
• Renal Dosing: For patients with an estimated glomerular filtration rate (eGFR) <30 mL/min, the dose should be adjusted to 0.5 g once daily.

Side Effects

Frequency	Adverse reactions
Common Side Effects	Nausea
	Diarrhea
	Headache
	Injection site reactions	Serious Side Effects	Seizures (especially in patients with a history of seizures)
Severe allergic reactions (anaphylaxis)
Clostridium difficile-associated diarrhea

Pharmacokinetics

• Onset Time: The onset of action is typically within one hour after administration.
• Duration of Action: Ertapenem has a half-life of approximately 4 hours, allowing for once-daily dosing.

Drug Precautions

Pregnancy

Use during pregnancy should be avoided unless the benefits outweigh the risks.

Breastfeeding

It is excreted in breast milk; breastfeeding is not recommended during treatment.

Children and Elderly

Not approved for use in children under three months. Caution is advised in elderly patients due to potential renal impairment.

Monitoring Items

• Regular monitoring of renal function and signs of allergic reactions or seizures is recommended.
• Signs of Clostridium difficile infection, which can occur due to alterations in gut flora from antibiotic use. Symptoms include persistent diarrhea, abdominal pain, or blood/mucus in stools.

Drug Interactions

• Epilim [Valproic Acid]: Ertapenem can significantly reduce the serum levels of valproic acid, potentially leading to inadequate seizure control. Avoid concomitant use if possible.
• Estrogens: Various forms of estrogen, including conjugated estrogens and estradiol, may interact with ertapenem, potentially affecting their efficacy.
• Digoxin: There is a potential for altered serum levels of digoxin when used concurrently with ertapenem, necessitating monitoring.
• Cholera and Typhoid Vaccines: Live bacterial vaccines may not work effectively during treatment with ertapenem. Patients should inform healthcare providers about their ertapenem use before receiving vaccinations.

FAQ

How Should I Take the Meropenem Ertapenem?

Ertapenem is not available as a tablet; it is administered by injection only.

What Should I Avoid While Taking?

Avoid other medications that may interact, particularly Epilim [valproic acid], and consult your healthcare provider about all medications being taken.