Ertapenem, a
carbapenem antibacterial, has in vitro activity against many Gram- negative (including Enterobacteriaceae) and Gram-positive aerobic and anaerobic bacteria that are commonly associated with various
infections.Once-daily parenteral (intravenous or intramuscular)
ertapenem 1g was as effective as comparator
antimicrobial agents (
piperacillin/tazobactam or
ceftriaxone +/-
metronidazole) in patients with
bacterial infections in randomised, double-blind, multicentre clinical trials. Response rates with
ertapenem were 84% and 87% (combined microbiological and clinical) in patients with complicated
intra-abdominal infections (CIAI), 82% (clinical) in patients with complicated skin and skin structure
infections (CSSSI), 86% and 92% (microbiological) in patients with complicated
urinary tract infections (CUTI), 92% (clinical) in patients with community-acquired
pneumonia (CAP) associated with typical pathogens and 94% (clinical) in patients with acute
pelvic infection. Respective response rates were statistically equivalent to those with comparators (81-94%). The efficacy of
ertapenem was equivalent to that of
piperacillin/tazobactam in patients infected with Enterobacteriaceae or anaerobes and to
ceftriaxone in patients infected with Enterobacteriaceae.
Ertapenem was generally well tolerated by patients with
bacterial infections, with most adverse events being mild to moderate in severity. The most common
ertapenem-associated adverse events were diarrhoea, infused vein complication,
nausea,
headache,
vaginitis in females,
phlebitis and/or
thrombophlebitis and
vomiting.
CONCLUSION:
Ertapenem is a broad-spectrum parenteral
antibiotic with activity against many Gram-negative (including Enterobacteriaceae) and Gram-positive aerobic and anaerobic bacteria and is suitable for once-daily administration.
Ertapenem has a role in the treatment of CAP associated with typical respiratory pathogens and is of particular value in the treatment of
polymicrobial infections (such as CIAI, CSSSI, CUTI and acute
pelvic infections), especially where Enterobacteriaceae and anaerobic bacteria are involved.