Safety and efficacy of long-term outpatient ertapenem therapy

Ertapenem is increasingly utilized in outpatient parenteral antimicrobial therapy (OPAT), but data regarding the efficacy and safety of long-term ertapenem therapy have been limited. We conducted a retrospective cohort study of adult patients who received outpatient ertapenem therapy at our center between 2010 and 2013. Among 306 unique patients who were discharged on ertapenem therapy, the most common indications were intra-abdominal infections (38%), followed by pneumonia (12%), bone and joint infections (11%), bloodstream infections (10%), urinary tract infections (10%), surgical site infections (5%), and skin and soft-tissue infections (4%). Of these 306 patients, 68 received regular outpatient follow-up visits at our infectious disease clinic, where the majority of patients (91%) were successfully treated with ertapenem by the end of therapy. Of the 6 patients who experienced clinical failure, 2 had adverse events leading to discontinuation of therapy and 4 required additional source control for clinical success. In addition, 2 patients had recurrent infection at 6 months.