Ertapenem is a medicinal agent of the carbapenems group. Preparations containing the drug are used, among other things, for the treatment of intra-abdominal infections, acute gynecological infections, community-acquired pneumonia, and diabetic foot therapy. In addition, ertapenem is used preventively to prevent abdominal infection before surgery.
What is ertapenem?
Ertapenem is classified as belonging to the carbapenems group of active ingredients. This term covers various antibiotics that are administered as medications because of their broad antimicrobial activity. In addition to ertapenem, meropenem, imipenem, doripenem and tebipenem also belong to this group. Within the European Union and Switzerland, ertapenem is marketed under the trade name Invanz. In pharmacology and chemistry, the active ingredient is described by the molecular formula C22-H25-N3-O7-S, which corresponds to a moral mass of 475.516 g/mol. Ertapenem is administered to treat infectious diseases caused by anaerobes or Gram-negative or Gram-positive pathogens. Gram-positive is a bacterium if it turns blue when a differential stain is performed. Gram-negative are those that turn red. Ertapenem is usually administered as an infusion solution and thus parenterally.
Pharmacologic action
Ertapenem has a markedly rapid effect, which is typical of early representatives of the carbapenems. That is, bacteria are rapidly killed by the drug. However, a minimally effective amount of ertapenem must be permanently exceeded in the body to achieve success. Experts therefore speak of time-dependent killing kinetics. Ertapenem is stable to most beta-lactase masmas. Betalactasmas are certain enzymes produced by bacteria to prevent external attacks. Betalactase masmas are thus comparable to antibodies and prevent the effectiveness of antibiotics. Because ertapenem is stable against almost all betalactase masmas, the drug can be used effectively against numerous bacteria. In addition, ertapenem is not attacked by a bacteria’s extended-spectrum beta-lactamases (ESBLs). These can also significantly impair the efficacy of antibiotics. However, ertapenem is ineffective against enterococci and Pseudomonas aeruginosa. The drug kills bacteria by binding to penicillin-binding proteins. This permanently prevents the bacteria from renewing their cell wall, which ultimately leads to their death. Ertapenem is excreted in 10 % via the stool. Further elimination of the active ingredient occurs renally, i.e. through the kidney. Medical studies have not established a causal relationship between treatment with ertapenem and direct or indirect damage to the embryo. Nevertheless, it should be taken only after a careful risk-benefit analysis has been performed. Because ertapenem may pass into breast milk, do not breastfeed during and shortly after treatment.
Medicinal use and application
Ertapenem is administered to control infectious diseases in adults, adolescents, and children 3 months of age and older. There is an indication for acute gynecologic infections, community-acquired pneumonia (pneumonia), intra-abdominal infections, and diabetic foot if it leads to skin infection. In addition, ertapenem can also be used preventively, i.e. as a prophylactic. It is therefore frequently prescribed to prevent postoperative infections of the abdominal cavity. Such infections can occur after elective colorectal surgery. Ertapenem is marketed as a powder. This is usually supplied as a concentrate. It is used to prepare an infusion solution. Thus, it is administered parenterally.
Risks and side effects
Ertapenem should not be administered if there is a contraindication. The term contraindication is used to describe a circumstance that results in a medical contraindication. This means that, due to actual circumstances, a treatment must necessarily be omitted from a medical point of view. Such a contraindication exists if there is hypersensitivity or allergy to ertapenem or other drugs of the carbapenem group.Hypersensitivity has also been observed in patients treated with beta-lactam antibiotics. In addition, renal dysfunction is also a contraindication, since the active substance is predominantly broken down renally, i.e. via the kidneys. Furthermore, undesirable side effects may occur in the course of treatment with ertapenem. So far, it has been observed that fungal infections (especially candidiasis), hypoglycemia (lowering of blood glucose below 60 mg/gl), rhinitis, cough, and pharyngitis (inflammation of the pharyngeal mucosa) occurred. Other undesirable side effects include insomnia, general fatigue and weakness, dizziness, restlessness, depressive moods, and panic states. Allergic skin reactions are also possible. These are usually manifested by rashes, urticaria (wheals), dermatitis or itching. Furthermore, anorexia and disorders of the gastrointestinal tract (diarrhea, vomiting, nausea, etc.) may occur. In some cases, cardiac arrhythmias also occurred. In addition, pain (especially in the head, muscle, abdomen, chest or shoulder area) is among the possible side effects. Hypertension or hypotension are also conceivable during and shortly after treatment.
