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Ertapenem

The meaning of «ertapenem»

Ertapenem (trade name Invanz) is a carbapenem antibiotic medication for the treatment of infections of the abdomen, the lungs, the upper part of the female reproductive system, and diabetic foot, used in the form of infusions or injections.[6][7]

The most common side effects include diarrhoea, nausea (feeling sick), headache, and problems around the area where the medicine is infused. It can significantly reduce the concentrations of valproic acid, an anti-seizure medication, in the blood to the point where it loses its effectiveness.[5]

The drug has been available in the US since 2001 and in Europe since 2002. It is marketed by Merck.[5][8]

Ertapenem is indicated for the treatment of intra-abdominal infections, community-acquired pneumonia, pelvic infections, and diabetic foot infections, with bacteria that are susceptible to this drug, or expected to be so. It can also be used to prevent infections after colorectal surgery. In the United States it is also indicated for the treatment of complicated urinary tract infections including pyelonephritis.[4][6][9]

It is given as an intravenous infusion or intramuscular injection. The drug is not approved for children under three months of age.[4][6][9]

The drug is contraindicated in people with known hypersensitivity to ertapenem or other carbapenem type antibiotics, or with severe hypersensitivity reactions (such as anaphylaxis or severe skin reactions) to other beta-lactam antibiotics in the past.[4][6][9]

Common side effects are diarrhoea (in 5% of people receiving ertapenem), nausea (in 3%) and vomiting, reactions at the injection site (5%, including pain and inflammation of the vein), and headache. Uncommon but possibly serious side effects include candida infections, seizures, skin reactions such as rashes (including nappy rash in children), and anaphylaxis.[9][10] Hypersensitivity cross-reactions with penicillins are rare.[11]

Ertapenem also can have an effect on some blood tests such as liver enzymes and platelet count.[6][9]

Overdosing is unlikely. In adults receiving the threefold therapeutic dose over eight days, no significant toxicity was observed.[9]

Ertapenem can reduce the concentrations of valproic acid, an epilepsy medication, by 70% and perhaps up to 95% within 24 hours; this can result in inadequate control of seizures.[10][12] The effect is described for other carbapenem antibiotics as well, but seems to be most pronounced for ertapenem and meropenem.[12] This is likely caused by several mechanisms: carbapenems inhibit transport of valproic acid from the gut into the body; they may increase metabolization of valproic acid to its glucuronide; they may reduce enterohepatic circulation and recycling of valproic acid glucuronide by acting against gut bacteria; and they may block transporter proteins that pump valproic acid out of red blood cells into the blood plasma.[13][14] The effect is also seen in reverse: in cases where ertapenem has been withdrawn blood concentrations of valproate have been reported to rise.[15][16]

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