What is the recommended dose of Invanz (ertapenem) for a male patient with a urinary tract infection (UTI)?

Recommended Dosage of Ertapenem (Invanz) for Male UTI

The recommended dose of ertapenem (Invanz) for a male patient with urinary tract infection is 1 gram intravenously once daily. 1, 2

Dosing Regimen Details

• Standard adult dose: 1 gram IV once daily 1, 2, 3
• Duration of therapy:
  • Typically 7-14 days total 4
  • Can be administered parenterally for at least 3 days, then transition to appropriate oral therapy to complete the course 2, 3
  • Median duration in clinical studies: 4 days IV followed by oral therapy to complete approximately 13-14 days total treatment 2

Administration Considerations

• Ertapenem should be administered as an intravenous infusion over 30 minutes 5
• For patients with normal renal function, no dosage adjustment is required 1
• High urinary concentrations (>128 mg/L) can be maintained for approximately 40% of the dosing interval 5

Clinical Evidence Supporting Efficacy

Ertapenem has demonstrated excellent efficacy for complicated UTIs in multiple clinical trials:

• In a large randomized controlled trial, ertapenem achieved a 89.5% favorable microbiological response rate in complicated UTIs, which was equivalent to ceftriaxone (91.1%) 2
• Another study showed 87.9% favorable microbiological response for ertapenem in treating acute pyelonephritis and complicated UTIs 3
• Ertapenem has shown efficacy against extended-spectrum β-lactamase (ESBL)-producing bacteria in complicated UTIs 6

Transition to Oral Therapy

• After clinical improvement (typically ≥3 days of IV therapy), patients can be switched to appropriate oral therapy 2, 3, 7
• Common oral step-down options include fluoroquinolones (if local resistance <10%) or trimethoprim-sulfamethoxazole (if organism is susceptible) 4
• In clinical trials, approximately 95% of patients were successfully transitioned to oral therapy 7

Important Considerations

• Ertapenem provides broad-spectrum coverage appropriate for complicated UTIs in males, which often involve more resistant pathogens 8
• Males with UTIs are generally considered to have complicated infections due to anatomical and microbiological factors
• Urine cultures should be obtained before initiating therapy to guide definitive treatment
• Clinical response should be assessed within 48-72 hours of initiating therapy 4

Monitoring

• Monitor for adverse effects, which are generally mild and include rash, diarrhea, and nausea (occurring in approximately 1-5% of patients) 4
• No routine laboratory monitoring is required for short-course therapy in patients with normal renal function 4

Ertapenem 1 gram IV once daily is a highly effective option for treating complicated UTIs in male patients, with the convenience of once-daily dosing and a well-established safety profile.