Home Drug Guide Ertapenem Sodium

Drug Guide

Generic Name

Ertapenem Sodium

Brand Names Invanz

Classification

Therapeutic: Antibiotic, Carbapenem

Pharmacological: Beta-lactam antibiotic, Carbapenem

FDA Approved Indications

Treatment of complicated intra-abdominal infections, including post-surgical peritonitis; complicated skin and skin structure infections; community-acquired pneumonia; acute pelvic infections; Diabetic foot infections.
Note: Use according to susceptibility data and clinical judgment.

Mechanism of Action

Ertapenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to cell death. It has broad-spectrum activity against many gram-positive, gram-negative, and anaerobic bacteria.

Dosage and Administration

Adult: 1 g IV once daily; dosage may be adjusted based on infection site and severity.

Pediatric: Not officially approved for pediatric use; off-label use should be guided by clinical judgment and weight-based dosing.

Geriatric: No specific dosage adjustment needed; monitor renal function as in other populations.

Renal Impairment: Adjusted dosing in patients with creatinine clearance <30 mL/min: 1 g every 48 hours.

Hepatic Impairment: No dosage adjustment required.

Pharmacokinetics

Absorption: Not absorbed orally; administered IV or IM.

Distribution: Widely distributed in body tissues and fluids, including pleural, pericardial, and cerebrospinal fluids (CSF).

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged.

Excretion: Primarily through renal excretion (glomerular filtration and tubular secretion).

Half Life: Approximately 4 hours.

Contraindications

Hypersensitivity to ertapenem, other carbapenems, or beta-lactam antibiotics.

Precautions

Use with caution in patients with history of allergies to penicillins or cephalosporins.
Caution in patients with renal impairment; monitor renal function closely.

Adverse Reactions - Common

Gastrointestinal disturbances (nausea, vomiting, diarrhea) (Common)
Headache (Less common)

Adverse Reactions - Serious

Seizures (Rare, mostly in patients with CNS disorders or renal impairment)
Allergic reactions (anaphylaxis, Stevens-Johnson syndrome) (Rare)

Drug-Drug Interactions

Probenecid may decrease renal clearance, increasing ertapenem levels.
Valproic acid/sevreric acid: may decrease serum levels of valproic acid, increasing risk of seizures.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of allergic reactions, superinfection, and changes in renal function.

Diagnoses:

Risk for allergic reaction
Risk for superinfection
Impaired renal function

Implementation: Administer as directed, monitor renal function, and observe for adverse reactions.

Evaluation: Assess effectiveness of therapy and discontinue if adverse effects occur.

Patient/Family Teaching

Report any signs of allergic reactions or severe diarrhea.
Complete the full course of therapy.
Maintain adequate hydration.

Special Considerations

Black Box Warnings:

Serious and sometimes fatal hypersensitivity reactions may occur in individuals allergic to penicillins or other beta-lactams.

Genetic Factors: N/A

Lab Test Interference: May cause false-positive results for urinary glucose with dipstick testing, especially when using p-dihydroxybenzene (false-positive with certain test strips).

Overdose Management

Signs/Symptoms: Nephrotoxicity, neurotoxicity, including seizures, especially in patients with impaired renal function or CNS disorders.

Treatment: Supportive care, maintain hydration, monitor renal function, consider hemodialysis if severe overdose occurs.

Storage and Handling

Storage: Store at room temperature (20°C to 25°C), protected from light and moisture.

Stability: Stable for up to 24 months when stored properly.