Ertapenem

Background

• Carbapenem antibiotic
• More susceptible to carbapenemases than other carbapenems
• Can be given IV or IM
• Concerns exist regarding its efficacy in critically ill patients with hypoalbuminemia, though not much clinical evidence[1]

Dosing

• ESBL Enterobacterales and AmpC Enterobacterales: 1 g IV q24h infused over 30 minutes

Renal Dosing

• CrCl >30 min/mL: usual dose
• CrCl <=30 min/mL: 500 mg IV q24h
• Hemodialysis: 500 mg IV q24h, given after dialysis on dialysis days; or 500 mg IV after each session of dialysis
• CAPD: 500 mg IV q24h
• CRRT: 500 to 1000 mg IV q24h
• SLED: 1 g IV q24h

Safety

Adverse Effects

• Nausea, vomiting, diarrhea
• Liver enzyme elevations
• Headache
• Neutropenia, eosinophilia
• Local phlebitis
• Neurotoxicity, including seizures, particularly in patients with renal impairment