title: Carbapenem stewardship: does ertapenem affect Pseudomonas susceptibility to other carbapenems? A review of the evidence.
abstract: The group 2 carbapenems (imipenem, meropenem and, more recently, doripenem) have been a mainstay of treatment for patients with serious hospital infections caused by Pseudomonas aeruginosa, Enterobacteriaceae and other difficult-to-treat Gram-negative pathogens as well as mixed aerobic/anaerobic infections. When ertapenem, a group 1 carbapenem, was introduced, questions were raised about the potential for ertapenem to select for imipenem- and meropenem-resistant Pseudomonas. Results from ten clinical studies evaluating the effect of ertapenem use on the susceptibility of Pseudomonas to carbapenems have uniformly shown that ertapenem use does not result in decreased Pseudomonas susceptibility to these antipseudomonal carbapenems. Here we review these studies evaluating the evidence of how ertapenem use affects P. aeruginosa as well as provide considerations for ertapenem use in the context of institutional stewardship initiatives.
authors: Center for Anti-Infective Research & Development, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA. dnicola@harthosp.org
authors: David P
authors: DP
authors: Nicolau
authors: Yehuda
authors: Y
authors: Carmeli
authors: Christopher W
authors: CW
authors: Crank
authors: Debra A
authors: DA
authors: Goff
authors: Christopher J
authors: CJ
authors: Graber
authors: Ana Lucia L
authors: AL
authors: Lima
authors: Ellie J C
authors: EJ
authors: Goldstein
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015780:Carbapenems / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004347:Drug Interactions; D024881:Drug Resistance, Bacterial; D000077727:Ertapenem; D006801:Humans; D008826:Microbial Sensitivity Tests; D011549:Pseudomonas / Q000187:drug effects; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D047090:beta-Lactams / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D047090:beta-Lactams; D000077727:Ertapenem