Ertapenem Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Ertapenem Injection (generic name: ertapenem) is a carbapenem antibiotic given by injection into a vein or muscle. It is used to treat a range of serious bacterial infections, including abdominal, skin, lung, urinary tract, and pelvic infections, and to help prevent infection after certain colon or rectal surgeries. It does not treat colds, flu, or other viral infections. It is given only by a healthcare provider, and dosing depends on age and the infection being treated.

What is Ertapenem Injection

Ertapenem is an antibiotic given by injection into a vein or muscle. It belongs to a group of antibiotics called carbapenems, which are beta-lactam antibiotics. It kills a wide range of bacteria that cause infections in different parts of the body. It does not work against colds, flu, or other infections caused by viruses.

Ertapenem Injection uses

• Complicated infections in the abdomen
• Complicated skin and skin structure infections, including certain diabetic foot infections
• Community-acquired pneumonia (lung infection caught outside a hospital)
• Complicated urinary tract infections, including kidney infections (pyelonephritis)
• Acute pelvic infections, including infections after childbirth, after a septic abortion, or after gynecologic surgery
• Prevention of infection at the surgical site after elective colon or rectal surgery (adults only)

Benefits of Ertapenem Injection

• Treats infections caused by many types of susceptible bacteria, including some resistant to other antibiotics
• Can be given once daily for most treatment uses, which may simplify dosing
• Can be used in both adults and children as young as 3 months of age
• Helps prevent surgical site infections after colorectal surgery

How Ertapenem Injection works

Ertapenem works by stopping bacteria from building their cell walls. It attaches to certain proteins in the bacteria, which blocks wall formation and kills the bacteria.

Ertapenem Injection dosage

Ertapenem Injection is given only by a healthcare provider as an injection into a vein (intravenous) or into a muscle (intramuscular). When given into a vein, it is infused slowly over 30 minutes. It should not be mixed or given at the same time with other medications, and should not be mixed with diluents containing dextrose. If given into a muscle, it is mixed with a local anesthetic (lidocaine) to reduce discomfort, and should never be given into a vein in this form.

Treatment with intravenous ertapenem may continue for up to 14 days, or intramuscular injection for up to 7 days, depending on the infection. For surgery prevention, a single dose is given about 1 hour before the surgical cut is made.

It is important to keep taking/receiving this medication exactly as prescribed, even if you start to feel better, and not skip doses. Do not treat diarrhea with over-the-counter remedies while on this medication without checking with your care team first.

Available forms and strengths

• Powder for solution for injection or infusion (1 gram per vial)
• ADD-Vantage vial (1 gram) for intravenous use

Side effects of Ertapenem Injection

Common

• Diarrhea
• Nausea and vomiting
• Headache
• Problems at the injection/infusion site, such as pain, redness, swelling, or irritation of the vein
• Vaginal irritation or discharge in women
• Rash and itching
• Changes in certain liver blood tests
• Increase in platelet count

Serious

• Severe allergic (anaphylactic) reactions, including swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, and severe skin rash
• Seizures and other nervous system problems
• Severe diarrhea or colitis caused by Clostridium difficile bacteria, which can range from mild to life-threatening
• Serious skin reactions such as blistering, peeling skin, or widespread rash with fever (including rare conditions such as DRESS syndrome or AGEP)
• Changes in mental status, including confusion, agitation, hallucinations, or decreased consciousness
• Low neutrophil or platelet counts (blood cell changes)
• Kidney problems

Warnings and precautions

• Serious and sometimes fatal allergic reactions can occur with this type of antibiotic. Tell your doctor about any past allergic reactions to penicillins, cephalosporins, or other antibiotics before starting treatment.
• Seizures and other nervous system effects have happened with this medicine, especially in people with brain disorders, a history of seizures, or kidney problems.
• Taking this medicine together with valproic acid or divalproex sodium can lower the levels of those seizure medicines in the blood, increasing the risk of breakthrough seizures. This combination is generally not recommended.
• This medicine can cause a serious bowel infection and inflammation called Clostridium difficile-associated diarrhea, which can range from mild diarrhea to life-threatening colitis.
• Care must be taken when giving this medicine as a shot into a muscle to avoid accidentally injecting it into a blood vessel.
• Using this medicine when it is not needed, or using it incorrectly, can lead to bacteria becoming resistant to antibiotics, making future infections harder to treat.
• Severe skin reactions affecting large areas of the body, sometimes with organ involvement, have been reported with this type of antibiotic.
• There is not enough research in pregnant women to know if this medicine is fully safe during pregnancy. It should only be used during pregnancy if your doctor decides the benefit outweighs the possible risk to the baby.
• This medicine passes into breast milk. Because of possible effects on a nursing baby, you should not breastfeed while receiving this medicine unless your doctor says the benefits outweigh the risks.
• People with reduced kidney function may need a lower dose of this medicine. Tell your doctor if you have kidney disease or are on dialysis, since your dose may need to be adjusted and your kidney function monitored.
• There is limited information on how this medicine affects people with liver problems, so no specific dose change is currently recommended, but your doctor may want to monitor your liver function.
• This medicine can cause dizziness and sleepiness in some people, which may affect your ability to drive or operate machinery safely. Do not drive or use machinery until you know how this medicine affects you.

Storage

• Store the unopened (lyophilized) powder vials at room temperature, between 15°C and 25°C, with brief excursions up to 30°C allowed
• After mixing with a diluent and further diluting for infusion, the solution can be kept at room temperature (25°C) and used within 6 hours, or refrigerated (5°C) for up to 24 hours and then used within 4 hours after removal from the refrigerator
• Do not freeze reconstituted or diluted ertapenem solutions
• Keep this medicine out of the sight and reach of children
• Used needles and syringes should be placed in a special sharps container, not in regular trash

When to see a doctor

• Get medical help right away if you notice signs of a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, trouble breathing or swallowing, or a serious skin rash.
• Contact your doctor promptly if you develop diarrhea, especially watery or bloody diarrhea, even if it starts weeks after you finish treatment, since this could signal a serious bowel problem.
• Seek immediate medical attention if you experience a seizure or signs of a nervous system problem, such as confusion, hallucinations, unusual movements, or decreased alertness.
• Tell your healthcare professional right away if you notice raised or fluid-filled skin spots over a large area of your body, or any severe skin peeling or blistering.
• If you think too much medicine has been given, contact your doctor, hospital emergency department, or your local poison control center right away.

Alternatives

• Meropenem
• Imipenem/cilastatin
• Piperacillin/tazobactam