厄他培南
Ertapenem
Ertapenem sodium
別名: Invanz · L-749345 · ML-0826 · ZD-4433 · ertapenemum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Susceptible infections (Investigational) | 15 mg/kg IV or IM every 12 hours (not to exceed a daily dosage of 1 gram) | IV/IM | q12h | — | 🌎 NA |
- Susceptible infections (Investigational): Monitor literature for additional data.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Susceptible infections (Investigational) | 15 mg/kg IV or IM every 12 hours (not to exceed a daily dosage of 1 gram) | IV/IM | q12h | — | 🌎 NA |
- Susceptible infections (Investigational): Monitor literature for additional data.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
厄他培南是一種廣效的碳青黴烯類抗生素，結構上類似於亞胺培南 (imipenem) 和美羅培南 (meropenem)，但抗菌譜較窄。
- 主要差異： 與其他碳青黴烯類不同，它對綠膿桿菌 (Pseudomonas aeruginosa) 或 不動桿菌 (Acinetobacter) 無效。
- 臨床應用： 特別適用於治療具抗藥性的革蘭氏陰性菌感染，尤其是當氨基醣苷類藥物有禁忌（如腎衰竭）或無效，且無法取得美羅培南時。
- 獸醫應用： 目前在犬貓使用的相關資訊非常有限；在獸醫學中被視為試驗性用藥。
作用機制
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.
安全性與警告
禁忌症
- 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)
不良反應
- Injection site reactions (most common in humans)
- Gastrointestinal effects (nausea, vomiting, diarrhea)
- Headache
- Tachycardia
- Hypersensitivity reactions (rare)
- CNS effects (hallucinations, agitation, seizures - rare)
注意事項
Investigational Use: Consider its use in dogs and cats as investigational due to limited published data.
- Diluent Warning: Do not use diluents containing dextrose.
- IM Administration: If given IM, it must be diluted with 1% lidocaine HCl (without epinephrine) to minimize pain, and must be used within one hour. Do not give this lidocaine mixture IV.
藥物相互作用
Can increase ertapenem AUC by 25% and elimination half-life by about 20%. Not recommended to be used concurrently to extend half-life.
監測
- 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)
藥物動力學
吸收
Not appreciably absorbed after oral administration. Intramuscular bioavailability is about 90% with peak plasma levels occurring in approximately 2.3 hours (in humans).
分佈
Exhibits concentration-dependent binding to plasma proteins (85% to 95% bound depending on concentration).
代謝
Biotransformation is not dependent on hepatic mechanisms; the major inactive metabolite is formed by hydrolysis of the beta-lactam ring.
排除
Approximately 80% of an IV dose is excreted in the urine (evenly split between inactive metabolites and unchanged drug). Approximately 10% is excreted in feces.
過量
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.
可用產品
劑型
- Lyophilized powder for injection
人用標示
- Ertapenem Sodium Lyophilized Powder for Injection: 1 g (as 1.045 g ertapenem) in single-dose vials; Invanz®
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store unmixed vials at or below 25°C (77°F). Reconstitute with water for injection or 0.9% NaCl, then immediately transfer to a 50 mL bag of 0.9% NaCl. Once diluted in normal saline for IV use, it is stable at room temperature for 6 hours, or refrigerated for 24 hours (use within 4 hours of removal). Do not freeze. If diluted with lidocaine for IM use, use within 1 hour.
飼主須知
重要提示： 此藥物在獸醫學中被視為試驗性用藥，通常僅保留用於高度抗藥性的感染。
- 給藥方式： 此藥物必須由獸醫專業人員透過注射給予。
- 監測： 密切觀察您的寵物是否有噁心、嘔吐、腹瀉或異常的神經行為（如焦躁或抽搐），若有發現請立即通知您的獸醫師。
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