Tessa Quinn
Ertapenem is a carbapenem antibiotic used to treat bacterial infections. It is available in the form of an injection for intravenous or intramuscular use. The drug was initially approved for use in 2001. Since then, it has been added to the formulary of several hospitals. However, it is not clear how common this practice is. Some studies have investigated the impact of including ertapenem on a hospital's formulary, and while there are concerns about increased usage, the results suggest that it can be a cost-effective component of an antimicrobial stewardship program.
| Characteristics | Values |
|---|---|
| Ertapenem | A carbapenem antibiotic that treats some bacterial infections |
| Use | For intravenous or intramuscular injection |
| Adverse Reactions | Diarrhea, nausea, headache, and infused vein complication |
| Diarrhea, vomiting, and infusion site pain in pediatric patients | |
| Medicare prescription drug plans | Listed on Tier 4 of their formulary |
| Availability | Available in cartons of 10 vials of 1g |
| Use in Hospitals | Added to the formulary of a 344-bed community teaching hospital in 2002 |
| Added to the formulary of a hospital in July 2005 | |
| Used for healthcare- and hospital-associated pneumonia and diabetic foot infections |
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What You'll Learn
- Ertapenem is a carbapenem antibiotic used to treat bacterial infections
- It is available as an injection for intravenous or intramuscular use
- Common adverse reactions include diarrhea, nausea, headache, and infusion site complications
- Medicare prescription drug plans list ertapenem on Tier 4, which is typically more expensive
- Studies show ertapenem's addition to hospital formularies reduced the usage of other antibiotics
Ertapenem is a carbapenem antibiotic used to treat bacterial infections
Ertapenem works by inhibiting the synthesis of peptidoglycan, a vital component that provides stability to the bacterial cell wall. By blocking the production of peptidoglycan, ertapenem disrupts the cell wall and makes the bacteria vulnerable to osmotic disruption. Additionally, ertapenem is stable against many beta-lactamases, including penicillinases, cephalosporinases, and extended-spectrum beta-lactamases, making it a potent antibiotic.
The use of ertapenem is indicated for treating infections such as complicated intra-abdominal infections, complicated skin and skin structure infections, complicated urinary tract infections, community-acquired pneumonia, and acute pelvic infections. It has been found to be effective in treating diabetic foot infections, either as a single treatment or in combination with vancomycin. Ertapenem has also shown efficacy in preventing surgical site infections following elective colorectal surgery.
It is important to note that ertapenem should only be used when a bacterial infection is proven or strongly suspected. Prolonged use of ertapenem may lead to the development of drug-resistant bacteria and an increased risk of fungal or bacterial superinfections. Common adverse reactions in patients treated with ertapenem include diarrhea, nausea, headache, and infused vein complications.
Regarding hospital formularies, several studies have examined the introduction of ertapenem into hospital formularies and its impact on antimicrobial usage and susceptibility. These studies suggest that the addition of ertapenem did not adversely affect the activity of other antibiotics and provided effective treatment options for various bacterial infections.
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It is available as an injection for intravenous or intramuscular use
Ertapenem is a carbapenem antibiotic that treats some bacterial infections. It is not suitable for colds, the flu, or other viruses. It is available as an injection for intravenous or intramuscular use.
Ertapenem is administered through injection into a muscle or vein, usually once or twice daily. It is infused (injected slowly) intravenously over at least 30 minutes for up to 14 days. It can also be given intramuscularly for up to 7 days. The length of treatment depends on the type of infection being treated.
If you are using ertapenem injection at home, your healthcare provider will instruct you on how to use the medication. It is important to follow these directions carefully and ask any questions you may have. You should begin to feel better within the first few days of treatment. If your symptoms do not improve or worsen, contact your doctor. It is important to use ertapenem injection until you finish the prescription to ensure the bacteria are completely treated and to prevent antibiotic resistance.
The most common adverse reactions (≥5%) in patients treated with ertapenem injection are diarrhea, nausea, headache, and infused vein complications. In pediatric patients, the most common adverse reactions are diarrhea, vomiting, and infusion site pain.
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Common adverse reactions include diarrhea, nausea, headache, and infusion site complications
Ertapenem is a carbapenem antibiotic used to treat bacterial infections. It is administered through intravenous infusion or intramuscular injection. The drug is usually well-tolerated, but common adverse reactions have been observed in both adult and pediatric patients.
Diarrhea is one of the most frequently reported side effects, occurring in 5.5% to 6.5% of patients. It is important to monitor diarrhea and consult a doctor before taking any medication for it, as it may be a sign of a more serious reaction.
Nausea is another common adverse reaction, affecting 3.1% of patients. This can be managed with appropriate medical care and, in some cases, dietary adjustments. Headaches have also been reported in 2.2% of patients and can be addressed through pain management strategies and adequate hydration.
Infusion site complications, such as infused vein complications and infusion site pain, are also relatively common. These issues can often be mitigated through careful administration techniques and post-infusion monitoring. Additionally, in pediatric patients, vomiting was reported as a common adverse reaction, occurring in 2.1% of cases.
While ertapenem is generally well-tolerated, it is important for patients to be aware of these potential side effects and to seek appropriate medical advice if any adverse reactions occur.
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Medicare prescription drug plans list ertapenem on Tier 4, which is typically more expensive
Medicare prescription drug plans have different tiers for different drugs, with each tier having a different cost. Drugs in lower tiers generally cost less than drugs in higher tiers. Tier 4, which is a non-preferred drug tier, includes higher-cost generic drugs and brand-name drugs with lower-cost generic therapeutic equivalents.
The addition of ertapenem to a hospital formulary has been studied for its effect on antimicrobial utilization and in vitro susceptibility of various antimicrobial agents against Pseudomonas aeruginosa. These studies have shown that ertapenem does not adversely affect the in vitro activity of imipenem and/or meropenem against P. aeruginosa.
Ertapenem is also used for the treatment of chorioamnionitis after cesarean delivery. It has been found to be more costly but more effective than AGC-1, with an incremental cost-effectiveness ratio of $3738 per infection avoided.
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Studies show ertapenem's addition to hospital formularies reduced the usage of other antibiotics
Ertapenem is a carbapenem antibiotic that treats bacterial infections. It is typically listed on Tier 4 of the Medicare prescription drug formulary. It is not suitable for treating colds, the flu, or other viruses.
Studies have shown that the addition of ertapenem to hospital formularies has reduced the usage of other antibiotics. One study, conducted at the VA Greater Los Angeles Healthcare System, a teaching hospital, and tertiary referral center with about 300 acute-care beds, found that the introduction of ertapenem to the formulary in July 2005 resulted in decreased usage of other broad-spectrum antibiotics, such as piperacillin-tazobactam and ampicillin-sulbactam. The study also found that the susceptibility of nosocomial Enterobacteriaceae and Pseudomonas clinical isolates to these antibiotics increased or remained mostly unchanged, with the possible exception of ceftriaxone susceptibility in Enterobacteriaceae.
Another study, conducted at a 344-bed community teaching hospital, found that the addition of ertapenem to the formulary resulted in a decrease in ampicillin-sulbactam usage due to autosubstitution. Imipenem usage peaked 6 months after the introduction of ertapenem and then started to decline as the use of ertapenem increased.
A retrospective study conducted in three community hospitals in Iowa and Illinois from 2015 to 2018 also found a significant reduction in ertapenem use over time. This study included a daily review of ertapenem use, alternative alerts for providers through electronic health records, and educational meetings with high-use provider groups.
The addition of ertapenem to hospital formularies has been shown to be an important component of antimicrobial stewardship programs, helping to improve P. aeruginosa susceptibilities and reduce antibiotic pressure. However, there is some concern that widespread usage of ertapenem may promote cross-resistance to other carbapenems. To mitigate this risk, ertapenem should only be used to treat or prevent infections proven or strongly suspected to be caused by susceptible bacteria.
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Frequently asked questions
Ertapenem is a carbapenem antibiotic that treats some bacterial infections. It is ineffective against colds, the flu, or other viruses.
The most common adverse reactions (≥5%) in patients treated with ertapenem for injection were diarrhea, nausea, headaches, and infused vein complications. In pediatric patients, the most common adverse reactions were diarrhea, vomiting, and infusion site pain.
While I cannot say for certain if most hospitals have ertapenem on their formulary, I have found multiple sources that mention hospitals adding ertapenem to their formulary.
