From the Guidelines
Ertapenem is a broad-spectrum antibiotic used to treat various bacterial infections, particularly effective against many gram-positive and gram-negative bacteria, including some resistant strains, and is commonly used for complicated intra-abdominal infections, complicated skin and skin structure infections, community-acquired pneumonia, complicated urinary tract infections, and acute pelvic infections. It's typically administered as a 1 gram intravenous or intramuscular injection once daily for 3-14 days, depending on the type and severity of infection, as recommended by the 2017 WSES guidelines for management of intra-abdominal infections 1. The drug works by inhibiting cell wall synthesis in bacteria, leading to their death, and belongs to the carbapenem class of antibiotics, which are often reserved for more serious infections or when other antibiotics have failed, as noted in the 2010 guidelines by the Surgical Infection Society and the Infectious Diseases Society of America 1. Some key points to consider when using ertapenem include:
- It is effective against extended-spectrum beta-lactamase (ESBL)-producing pathogens, but not active against P. aeruginosa and Enterococcus species, as mentioned in the 2017 WSES guidelines 1.
- The use of carbapenems, including ertapenem, should be limited to preserve the activity of this class of antibiotics due to the concern of emerging carbapenem-resistance, as highlighted in the 2017 WSES guidelines 1.
- Side effects may include diarrhea, nausea, headache, and injection site reactions, and it's essential to complete the full course of treatment as prescribed to prevent antibiotic resistance, as generally recommended in antibiotic treatment 1. Patients should inform their healthcare provider of any allergies, especially to other beta-lactam antibiotics, before starting ertapenem treatment, as is standard practice in antibiotic therapy 1.
From the FDA Drug Label
Ertapenem for injection is a sterile, synthetic, parenteral, 1-β methyl-carbapenem that is structurally related to beta-lactam antibiotics. Ertapenem is a carbapenem antibiotic.
- It is a synthetic and parenteral antibiotic.
- It is structurally related to beta-lactam antibiotics. 2, 2, 2
From the Research
Definition and Mechanism of Ertapenem
- Ertapenem is a parenteral broad-spectrum 1-beta-methyl-carbapenem antibiotic 3
- It has in vitro activity against many common aerobic and anaerobic Gram-positive and -negative bacteria, including Enterobacteriaceae carrying plasmid- or chromosomal-mediated beta-lactamases 3
- Ertapenem is suitable for once-daily administration and has a role in the treatment of various infections, including complicated intra-abdominal infections, skin and skin structure infections, acute pelvic infections, complicated urinary tract infections, and pneumonia 4, 5
Efficacy of Ertapenem
- Ertapenem has been shown to be as effective as comparator antimicrobial agents, such as piperacillin/tazobactam and ceftriaxone, in patients with bacterial infections 6, 4, 5
- Clinical trials have demonstrated that ertapenem has a high clinical cure rate in patients with complicated infections, including intra-abdominal infections, skin and skin structure infections, and urinary tract infections 6, 7
- Ertapenem has also been shown to be effective in the treatment of pediatric patients with complicated community-acquired bacterial infections 5
Safety and Tolerability of Ertapenem
- Ertapenem is generally well tolerated, with most adverse events being mild to moderate in severity 4, 5
- Common adverse events associated with ertapenem include diarrhea, infused vein complication, nausea, headache, and vomiting 4
- A meta-analysis of randomized controlled trials found no difference in the incidence of drug-related adverse events between ertapenem and piperacillin/tazobactam groups 7