Indications
Ertapenem is a broad-spectrum carbapenem antibiotic used for moderate to severe bacterial infections, including complicated abdominal infections, complicated skin and soft tissue infections (including diabetic foot infections without bone infection), community-acquired pneumonia, complicated urinary tract and kidney infections (including those caused by ESBL-producing bacteria), and acute pelvic infections in women. It is also used to prevent infection after bowel (colorectal) surgery.
How It Works
Bacteria are protected by a strong cell wall. Ertapenem binds to the proteins that build this wall, so the wall becomes weak and the bacteria burst and die. It resists many of the enzymes that bacteria use to destroy other penicillin-type antibiotics. It does not work against Pseudomonas, Acinetobacter or MRSA.
Dosage and Administration
Ertapenem is given by a doctor or nurse, usually once a day as an infusion into a vein over about 30 minutes or as an injection into a muscle. The dose and length of treatment (often 3 to 14 days) are given as prescribed. Lower doses are needed in severe kidney disease, and doses for children are based on body weight.
Interactions
- Valproic Acid (Sodium Valproate): Ertapenem can sharply lower its blood level and lead to seizures; using them together is generally avoided.
- Probenecid can raise Ertapenem levels; not recommended together.
- It may affect the action of Warfarin; INR may need checking.
Contraindications
- Allergy to Ertapenem or other carbapenems.
- Previous severe allergic reaction (anaphylaxis) to penicillins, cephalosporins or other beta-lactam antibiotics.
- For muscle injection: allergy to local anaesthetics of the amide type such as Lidocaine, which may be used to dissolve the powder.
Side Effects
Common: diarrhoea, nausea, vomiting, headache, pain or swelling at the infusion site, and rash or itching. Raised liver enzymes may be found on blood tests. Less common: dizziness, sleepiness, confusion, and fungal infection of the mouth or vagina.
Get urgent medical help for swelling of the face or throat, difficulty breathing, seizures or fits, severe watery or bloody diarrhoea (even weeks after treatment), a widespread rash with blistering or peeling skin, or confusion and hallucinations.
Pregnancy and Lactation
There are limited data in pregnancy; it is used only if the doctor decides the benefit outweighs the risk. It passes into breast milk in small amounts; the doctor will advise on breastfeeding.
Precautions and Warnings
- Tell the doctor about any previous antibiotic allergy, epilepsy or other brain disorder, and kidney disease.
- Risk of seizures is higher in people with brain disorders or kidney problems.
- Long use can lead to resistant infections, including Clostridioides difficile diarrhoea.
- Use only for confirmed or strongly suspected bacterial infections and complete the full course.
Overdose
Overdose may cause nausea, diarrhoea, dizziness and, rarely, seizures. It is managed in hospital; Ertapenem can be removed by dialysis.
Therapeutic Class
Antibacterial, carbapenem (beta-lactam).
Storage
Hospital medicine: store the unopened vial below 25°C, as directed on the pack, and use the prepared solution promptly. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.