Ertapenem
Ertapenem is a broad-spectrum **carbapenem antibiotic** structurally similar to imipenem and meropenem, but with a narrower spectrum of activity. * **Key Difference:** Unlike other carbapenems, it is **not effective against *Pseudomonas aeruginosa* or *Acinetobacter***. * **Clinical Utility:** It is particularly useful for treating resistant gram-negative bacterial infections, especially when aminoglycosides are contraindicated (e.g., renal failure) or ineffective, and when meropenem is unavailable. * **Veterinary Use:** Currently, there is very limited information regarding its use in dogs and cats; it is considered **investigational** in veterinary medicine. * **Advantage:** It has a longer half-life in humans, potentially allowing for once-daily dosing, though twice-daily dosing is currently suggested for small animals.
Mecanismo: Ertapenem is a **beta-lactam antibiotic** that exerts its bactericidal effect by inhibiting bacterial cell wall synthesis. * **Mechanism:** It binds to **penicillin-binding proteins (PBPs)** → inhibits peptidoglycan cross-linking → weakens the bacterial cell wall → causes cell lysis and death. * **Enzyme Stability:** It is highly resistant to degradation by most beta-lactamases, including penicillinases and cephalosporinases. * **Renal Stability:** Unlike imipenem, ertapenem is stable against renal **dehydropeptidase I**, meaning it does *not* require co-administration with cilastatin.
Dosificación por especie
- Susceptible infections (Investigational) · 15 mg/kg IV or IM every 12 hours (not to exceed a daily dosage of 1 gram) · IV/IM · q12h · Monitor literature for additional data.
- Susceptible infections (Investigational) · 15 mg/kg IV or IM every 12 hours (not to exceed a daily dosage of 1 gram) · IV/IM · q12h · Monitor literature for additional data.
Las dosis son una referencia clínica para médicos veterinarios. Confirme siempre con la información vigente del producto y el paciente individual.
Vías de administración
Contraindicaciones
- Hypersensitivity to ertapenem or other carbapenems
- History of anaphylaxis to any beta-lactam antibiotic
- Hypersensitivity to lidocaine or amide-type local anesthetics (if using 1% lidocaine as an IM diluent)
Efectos adversos
- Injection site reactions (most common in humans)
- Gastrointestinal effects (nausea, vomiting, diarrhea)
- Headache
- Tachycardia
- Hypersensitivity reactions (rare)
- CNS effects (hallucinations, agitation, seizures - rare)
Interacciones farmacológicas
- Probenecid · Can increase ertapenem AUC by 25% and elimination half-life by about 20%. Not recommended to be used concurrently to extend half-life.
Monitoreo
- Clinical efficacy (WBC count, resolution of fever, etc.)
- Adverse effects (GI signs, neurotoxicity, hypersensitivity)
- Hepatic, hematopoietic, and renal function (suggested for periodic assessment during prolonged use)
Sobredosis
Inadvertent overdoses are unlikely. In humans, a 3-gram IV dose caused an increased incidence of nausea and diarrhea. If overdose occurs and adverse effects are noted, treat supportively.
La referencia de fármacos de VetSheet está destinada a médicos veterinarios como apoyo a la decisión clínica; no sustituye el juicio profesional ni la información vigente del fabricante.