From the Research
Ertapenem is a viable treatment option for osteomyelitis, particularly in outpatient settings, with a recommended dose of 1 gram intravenously or intramuscularly once daily for 4-6 weeks, as supported by the most recent study 1. The use of ertapenem in treating osteomyelitis is backed by its broad-spectrum activity against gram-negative and anaerobic organisms, as well as methicillin-susceptible Staphylococcus aureus, making it a valuable choice for polymicrobial infections, including those involving diabetic foot and traumatic wound infections 2, 3. Key considerations for the use of ertapenem include:
- Its inability to cover Pseudomonas aeruginosa or enterococci, which may be significant pathogens in some osteomyelitis cases, necessitating culture results and susceptibility testing to guide therapy 4.
- The convenience of once-daily dosing, which facilitates outpatient parenteral antibiotic therapy (OPAT), potentially reducing hospital stays and associated costs 5.
- The importance of monitoring clinical response and potential side effects throughout the treatment course, given the variability in patient response and the emergence of antibiotic-resistant bacteria 1. Given the most recent evidence from 2024 1, which highlights the successful use of ertapenem in treating diabetic foot osteomyelitis caused by extended-spectrum beta-lactamase-producing Escherichia coli, ertapenem can be considered an effective option for osteomyelitis treatment, especially in cases involving susceptible organisms, and its use should be guided by patient-specific factors, suspected or confirmed pathogens, and local resistance patterns.