From the Research
Ertapenem does not have an oral formulation available, so a direct IV to PO conversion is not possible. When transitioning from IV ertapenem to oral therapy, clinicians should select an appropriate oral antibiotic based on the infection being treated, culture results, and antimicrobial susceptibility testing, as suggested by the most recent study 1.
Key Considerations
- Common oral alternatives include amoxicillin-clavulanate, fluoroquinolones (such as ciprofloxacin or levofloxacin), trimethoprim-sulfamethoxazole, or doxycycline, depending on the specific infection and pathogen sensitivity.
- The selection should provide adequate coverage for the identified or suspected pathogens.
- This transition from IV to oral therapy is typically considered when the patient shows clinical improvement, can tolerate oral medications, has a functioning gastrointestinal tract, and the infection is responding to treatment.
- The oral antibiotic should be started immediately after discontinuing ertapenem to maintain continuous antimicrobial coverage, as indicated by studies such as 2 and 3.
Rationale
Ertapenem is a carbapenem antibiotic with broad-spectrum activity against gram-positive, gram-negative, and anaerobic bacteria, so the oral alternative should provide similar coverage for the specific infection being treated, as noted in 4 and 5.
Clinical Implications
- Clinicians should prioritize selecting an oral antibiotic that matches the spectrum of activity of ertapenem for the specific infection.
- The choice of oral antibiotic should be guided by culture results and antimicrobial susceptibility testing to ensure adequate coverage.
- The transition to oral therapy should be made when the patient is clinically improving and can tolerate oral medications, to minimize the risk of treatment failure or complications.