Doripenem is an active substance, which belongs to the group of carbapenems. Consequently, Doripenem is an antibiotic that is used, among other things, for the treatment of infectious diseases (e.g., pneumonia, urinary tract infections, or abdominal infections). It is administered in the European Union primarily by infusion.
What is doripenem?
Doripenem is an antibiotic belonging to the carbapenems group. This group also includes agents such as ertapenem, imipenem, doripenem, tebipenem, and meropenem. They all have a broad antimicrobial spectrum of activity. That is, they can be used against a wide range of bacteria. Doripenem is sold in Germany and Austria under the trade name Doribax. In chemistry or pharmacology, the molecular formula C 15 – H 24 – N 4 – O 6 – S 2 is used to describe the substance. The moral mass of doripenem is 420.50 g/mol. The drug is used to treat various infectious diseases. In medical practice, dorpipenem is sold as a white to slightly yellowish powder. This is processed into an infusion solution prior to administration, since administration within the European Union is parenterally (“past the intestine”). The active ingredient is generally considered to be well tolerated.
Pharmacologic effect
Doripenem achieves its antibacterial effect by making cell wall synthesis by the affected bacteria impossible. The active ingredient is resistant to beta-lactase and extended-beta-lactamase (ESBL). This is typical for antibiotics of the carbapenems group. Ertapenem, imipenem and doripenem act in a comparable manner. Due to its chemical structure, doripenem is similar to meropenem, another member of the carbapenems. Doripenem has a broad spectrum of activity. It can be used to kill both gram-positive and gram-negative bacteria. Gram-positive bacteria are all bacteria that turn blue during differential staining (Gram staining) under the light microscope. Similarly, bacteria that stain red are called gram-negative. In addition, doripenem is also effective against anerobes, which include many hospital germs that are resistant to other antibiotics. Nevertheless, like all other members of the carbapenems, doripenem is ineffective against methicillin-resistant staphylococci. Studies continue to report that there is good efficacy against Pseudomonas aeruginosa and enterobacteria. This is particularly important since other carbapenems (including ertapenem) are either ineffective or have significantly reduced efficacy against these bacteria. In the body, doripenem is primarily broken down via the kidneys (renal). The burden on this organ is correspondingly high. The extent to which the active substance affects an undisturbed pregnancy or embryonic or fetal development is not sufficiently known. Therefore, it must not be used during pregnancy. The same also applies to breastfeeding.
Medical application and use
Doripenem is administered to combat infectious diseases of various kinds. In adults, the most important indications for use include complicated (i.e., not merely insignificant) infection of the urinary tract, complicated intra-abdominal infection (acute infections within the abdominal cavity), and nosocomial pneumonia (acute or chronic infections of the lung tissue). In particular, doripenem is prescribed for infections caused by the use of a ventilator. This is due to the fact that a comparatively good effect against multi-resistant hospital germs has been demonstrated. Doripenem is supplied as a white to whitish-yellow powder and is processed into an infection solution. For administration is usually parenterally and takes about an hour. In severely ill patients suffering from pneumonia (lung infections), the infusion time is increased up to four hours. The standard dose for a healthy adult of average weight is 500 mg. It must be repeated every eight hours.
Risks and side effects
Doripenem may also cause adverse side effects. In studies, side effects occurred in an average of one-third of subjects, which is why the drug is considered to be generally well tolerated. Side effects known to date that may be caused by doripenem include the development of oral candidiasis or mycosis of the vulva.Occasionally (in less than one in 1,000 treated but in more than one in 100), thrombocytopenias and neutropenias also occurred. Hypersensitivity may also occur. In this case, there is a contraindication. This means that it should not be used at all. Doripenem should also not be used if there is hypersensitivity to other carbapenems. Diarrhea (diarrhea), nausea, and headache occurred frequently (in less than one in 100 but in more than one in 10 patients). Also to be considered is the possibility of developing a skin rash from doripenem. Doripenem is hardly processed through the cytochrome P450 enzyme system. Therefore, there is little interaction with other drugs. However, serum levels must be monitored because carbapenems can decrease serum levels of valproic acid. Since doripenem is predominantly metabolized by the kidney, increased caution is required in the event of existing dysfunction. Treatment should then be omitted altogether or only at low doses.
