title: Ertapenem: review of a new carbapenem.
abstract: The carbapenems are beta-lactam-type antibiotics with an exceptionally broad spectrum of activity. Ertapenem is a new carbapenem developed to address the pharmacokinetic shortcomings (short half-life) of imipenem and meropenem. Ertapenem shares similar structural features with meropenem, including its stability to dehydropeptidase-1, allowing it to be administered without a dehydropeptidase-1 inhibitor. Ertapenem, like imipenem and meropenem, demonstrates broad-spectrum antimicrobial activity against many Gram-positive and -negative aerobes and anaerobes and is resistant to nearly all beta-lactamases, including extended-spectrum beta-lactamases and AmpCs. However, it differs from both imipenem and meropenem in demonstrating limited activity against Enterococcusspp., Pseudomonasaeruginosa and other nonfermentative Gram-negative bacteria commonly associated with nosocomial infections. The extensive protein binding of ertapenem extends the half-life and allows for once-daily dosing. Prospective, multicenter, randomized, double-blind, comparative clinical studies demonstrate similar clinical efficacy of ertapenem compared with other agents. Clinical trials of complicated intra-abdominal infection, acute pelvic infection, complicated skin and soft-structure infection, community-acquired pneumonia and complicated urinary tract infections demonstrated that ertapenem has equivalent efficacy and safety compared with ceftriaxone and piperacillin/tazobactam. Ertapenem is a promising new carbapenem with excellent efficacy and safety for the treatment of a variety of community-acquired infections. It also appears to be of great value as an outpatient parenteral antimicrobial therapy.
authors.affiliation: Health Sciences Center, Clinical Microbiology, MS673-820, Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada. ggzhanel@pcs.mb.ca
authors.forename: George G
authors.initials: GG
authors.lastname: Zhanel
authors.forename: Christel
authors.initials: C
authors.lastname: Johanson
authors.forename: John M
authors.initials: JM
authors.lastname: Embil
authors.forename: Ayman
authors.initials: A
authors.lastname: Noreddin
authors.forename: Alfred
authors.initials: A
authors.lastname: Gin
authors.forename: Lavern
authors.initials: L
authors.lastname: Vercaigne
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: Hoban
mesh_terms: D000818:Animals; D015780:Carbapenems / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use*; D015507:Drugs, Investigational / Q000009:adverse effects / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use*; D000077727:Ertapenem; D006801:Humans; D007769:Lactams / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use*; D047090:beta-Lactams
chemical_list: D015780:Carbapenems; D015507:Drugs, Investigational; D007769:Lactams; D047090:beta-Lactams; D000077727:Ertapenem