厄他培南
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.
各物種劑量
- 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
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)
藥物相互作用
- Probenecid · 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)
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.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。