Ertapenem: review of a new carbapenem.
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.
Zhanel
George G
GG
Health Sciences Center, Clinical Microbiology, MS673-820, Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada. ggzhanel@pcs.mb.ca
Johanson
Christel
C
Embil
John M
JM
Noreddin
Ayman
A
Gin
Alfred
A
Vercaigne
Lavern
L
Hoban
Daryl J
DJ
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
D015780:Carbapenems; D015507:Drugs, Investigational; D007769:Lactams; D047090:beta-Lactams; D000077727:Ertapenem