Ertapenem. A review of its microbiologic, pharmacokinetic and clinical aspects

Ertapenem sodium (trade name Invanz, also designated as MK-0826, MK-826 and L-749345), manufactured by Merck & Co., Inc. is a structurally unique parenteral 1 beta-methyl carbapenem. It has a broad spectrum of antimicrobial activity, including common community-acquired Gram-positive and Gram-negative aerobic and anaerobic pathogens, and restricted activity against nosocomial pathogens such as Pseudomonas aeruginosa, Acinetobacter species, methicillin-resistant staphylococci and enterococci. Ertapenem demonstrates excellent activity against cephalosporin-resistant enteric organisms producing extended spectrum beta-lactamases (ESBLs) or AmpC beta-lactamases and excellent activity against penicillin-resistant Streptococcus pneumoniae. Its high level of protein binding and serum half-life of 4 h allows it to be dosed once daily. Ertapenem may be administered intravenously or intramuscularly and has an excellent adverse reaction and tolerability profile. Invanz was approved by the United States Food and Drug Administration in November 2001 for the treatment of adult patients with moderate to severe infections caused by designated strains of susceptible microorganisms. The infections include complicated intraabdominal infections, complicated skin and skin structure infections, community-acquired pneumonia, complicated urinary tract infections including pyelonephritis and acute pelvic infections including postpartum endomyometritis, septic abortion and post surgical gynecologic infections. Invanz has also been approved in Mexico, Brazil and New Zealand.