| ERTAPENEM SODIUM
Classifications: beta-lactam antibiotic; Therapeutic: antibiotic
Pregnancy Category: B
1 g vial
Broad-spectrum carbapenem antibiotic that inhibits the cell wall synthesis of gram-positive and gram-negative bacteria by
its strong affinity for penicillin-binding proteins (PBPs) of the bacterial cell wall.
Effective against both gram-positive and gram-negative bacteria. Highly resistant to most bacterial beta-lactamases.
Complicated intraabdominal infections, complicated skin and skin structure infections, community-acquired pneumonia, complicated
UTI (including pyelonephritis), and acute pelvic infections due to susceptible bacteria.
Hypersensitivity to ertapenem; hypersensitivity to penicillins; hypersensitivity to amide-type local anesthetics such as lidocaine;
hypersensitivity to meropenem or imipenem; previous anaphylactic reaction to beta-lactams.
Renal impairment; history of CNS disorders; history of seizures; hypersensitivity to other beta-lactam antibiotics (penicillins,
cephalosporins); hypersensitivity to other allergens; meningitis; pregnancy (category B); lactation (bottle feed during and
for 5 d after therapy ends).
Route & Dosage
|Community-Acquired Pneumonia; Complicated UTI
Adult: IV/IM 1 g q.d. x 1014 d May switch to appropriate PO antibiotic after 3 d if responding
Child/Infant (>3 mo): IV/IM 15 mg/kg q12h x 1014 d
Adult: IV/IM 1 g q.d. x 514 d
Child/Infant (>3 mo): IV/IM 15 mg/kg b.i.d. x 514 d
Skin and Skin Structure Infections
Adult: IV/IM 1 g q.d. x 714 d
Child/Infant (>3 mo): IV/IM 15 mg/kg b.i.d. x 714 d
Acute Pelvic Infections
Adult: IV/IM 1 g q.d. x 310 d
Clcr <30 mL/min: reduce dose to 500 mg q.d.
- Reconstitute 1 g vial with 3.2 mL of 1.0% lidocaine HCl injection (without epinephrine). Shake vial thoroughly to form
solution. Use immediately.
- Inject deep IM into a large muscle mass (such as the gluteal muscles or lateral part of the thigh).
- The reconstituted IM solution should be used within 1 h after preparation. Note: DO NOT use this solution for IV administration.
PREPARE: Intermittent for Adult/Child: Reconstitute 1 g vial with 10 mL of sterile water for injection, NS, or bacteriostatic water for injection. Shake well to
dissolve. Intermittent for Adult/Child (≥13 y): Immediately transfer contents to 50 mL of NS injection solution. Intermittent for Child (3 mo12 y): Immediately transfer required dose to enough NS injection solution to yield a final concentration of 20 mg/mL or less.
ADMINISTER: Intermittent: Infuse over 30 min. Note: Infusion should be completed within 6 h of reconstitution.
INCOMPATIBILITIES Solution/additive: Dextrose. Y-site: Do not mix or infuse with any other drugs.
- Store lyophilized powder above 25° C (77° F). Must use reconstituted solution stored at room temperature (not greater
than 25° C/77° F) within 6 h. May store for 24 h under refrigeration. Use within 4 h of removal from refrigeration.
Do not freeze.
Adverse Effects (≥1%)Body as a Whole:
Phlebitis or thrombosis at injection site, asthenia, fatigue
, fever, leg pain. CNS:
Anxiety, altered mental status, dizziness, headache, insomnia
Chest pain, hypertension, hypotension, tachycardia, edema. GI:
Abdominal pain, diarrhea
, acid regurgitation, constipation
, dyspepsia, nausea, vomiting, increased AST and ALT. Respiratory:
Cough, dyspnea, pharyngitis, rales/rhonchi, and respiratory distress. Skin:
Erythema, pruritus, rash. Urogenital: Vaginitis
decreases renal excretion.
90% absorbed from IM site. Peak:
2.3 h. Distribution:
95% protein bound, distributes into breast milk, may cross placenta. Metabolism:
Hydrolysis of beta-lactam ring. Elimination:
80% in urine, 10% in feces. Half-Life:
Assessment & Drug Effects
- Lab tests: Perform C&S tests prior to therapy. Monitor periodically liver and kidney function.
- Determine history of hypersensitivity reactions to other beta-lactams, cephalosporins, penicillins, or other drugs.
- Discontinue drug and immediately report S&S of hypersensitivity (see Appendix F).
- Report S&S of superinfection or pseudomembranous colitis (see Appendix F).
- Monitor for seizures especially in older adults and those with renal insufficiency.
- Lab tests: Monitor AST, ALT, alkaline phosphatase, CBC, platelet count, and routine blood chemistry during prolonged therapy.
Patient & Family Education
- Learn S&S of hypersensitivity, superinfection, and pseudomembranous colitis (see Appendix F); report any of these to physician