Antimicrobials
Ertapenem

Ertapenem

Restricted

Medium
N/A

Spectrum of Activity

Dosing

General Information

Administration

  • IV infusion over 30 minutes
  • Can also do IV push over 5 minutes

Preparation

  • Reconstitute 1 gm vial with 10mL of SWFI, bacteriostatic water, or NS using a syringe with needle of less than or equal to 21-gauge
  • Shake well
  • Further dilute in 50mL NS bag

Compatibility

  • NS or LR
  • Incompatible in D5W

Targeted therapy of ESBL infections and other resistant gram negative infections.

  • Intra-abdominal infection
  • Pelvic infection
  • Complicated SSTI
  • Complicated UTI

Empiric therapy when broad spectrum of carbapenems is desired without the need for anti-pseudomonal activity.

Tier 4 Protected Antimicrobial

  • Last line option, uncommonly used based upon susceptibility data, may rarely be used for special scenarios

    • Strategies used: ASP Prior Authorization for Non-formulary, Prescriber-based restriction, Outpatient use
  • For use in the Short Stay Infusion Clinic only. Restricted from use in all hospitalized patients and in the Emergency Department, excluding a single dose prior to discharge

  • If patient on outpatient and admitted, pharmacy will therapeutic substitution to meropenem at dosing and frequency appropriate for indication and renal function.

  • Periodic renal, hepatic and hematopoietic assessments during prolonged therapy
  • Neurological assessments
  • Immediate and delayed-type allergy
  • GI disturbance: esp. diarrhea
  • Chest pain
  • Phlebitis and skin rash
  • Decreased or increased potassium levels
  • Hyperglycemia
  • Cytopenias, eosinophilia, positive Coombs
  • Liver enzyme abnormalities
  • Seizure risk lower than other carbapenems
  • Decreases concentration of Valproate products
  • Probenecid may increase Ertapenem concentration
  • Increases concentration of Tacrolimus

Antimicrobial class: Carbapenem

Pregnancy category: B

Average serum half life: 4 hours

Urine penetration: Therapeutic, excreted 80% into urine

Lung penetration: Therapeutic

Biliary penetration: Moderate

Unlike other carbapenems, Ertapenem does NOT cover Pseudomonas