Ertapenem

Restricted
Restricted

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$$$$

Dosing

Adult

1 g IV q24h

Renal

CrCl >50 ml/min

  • 1g IV Q24h

CrCl <30 ml/min

  • 500 mg IV Q24h

Dialysis (HD or CRRT)

  • 500mg IV Q24h

Restricted Use

For Pediatric patients: restricted to use by Pediatric Infectious Diseases Service approval.

General Information

Acceptable Uses

  • Mild to moderate intra-abdominal infections (biliary tract infections, diverticulitis, secondary peritonitis/GI perforation)

  • Moderate diabetic foot infections

  • Moderate surgical-site infections following contaminated procedures

  • Urinary tract infections caused by ESBL-producing organisms

  • Pyelonephritis due to ESBL-producing organisms

  • Outpatient antibiotic therapy for patients requiring IV antibiotics for polymicrobial infections caused by susceptible organisms

Unacceptable Uses

  • Infections in which Pseudomonas spp. or Acinetobacter spp. are suspected

Common Usage

Targeted therapy of ESBL infections and other resistant gram negative infections

Empiric therapy when broad spectrum of carbapenems is desired without the need for antipseudomonal activity

Drug Monitoring

Laboratory

  • CBC, CMP weekly

Clinical

  • Hypersensitivity

  • GI effects

  • Seizures (rare)

Adverse Effects

  • Hypersensitivity

  • GI effects

  • C. difficile

  • Seizures (especially with high doses or doses not adjusted for renal function)

Pharmacology

Antimicrobial class: Carbapenem

Pregnancy category: B

Average serum half life: 4 hours

Biliary penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic