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Ertapenem Dosage

Medically reviewed by Drugs.com. Last updated on Jan 24, 2020.

Applies to the following strengths: 1 g

Usual Adult Dose for Intraabdominal Infection

1 g IV or IM once a day for 5 to 14 days

Use: For the treatment of complicated intraabdominal infections due to Escherichia coli, Clostridium clostridioforme, Eggerthella lenta (previously Eubacterium lentum), Peptostreptococcus species, Bacteroides fragilis, B distasonis, B ovatus, B thetaiotaomicron, or B uniformis

Usual Adult Dose for Pelvic Infections

1 g IV or IM once a day for 3 to 10 days

Use: For the treatment of acute pelvic infections (including postpartum endomyometritis, septic abortion, postsurgical gynecological infections) due to Streptococcus agalactiae, E coli, B fragilis, Porphyromonas asaccharolytica, Peptostreptococcus species, or Prevotella bivia

Usual Adult Dose for Pneumonia

1 g IV or IM once a day
Total duration of therapy: 10 to 14 days

Comments:
-Duration includes a possible conversion to appropriate oral therapy (after at least 3 days of parenteral therapy) once clinical improvement established.

Uses:
-For the treatment of community-acquired pneumonia due to S pneumoniae (penicillin-susceptible isolates only) including cases with concomitant bacteremia, Haemophilus influenzae (beta-lactamase negative isolates only), or Moraxella catarrhalis
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to E coli, including cases with concomitant bacteremia, or Klebsiella pneumoniae

Usual Adult Dose for Pyelonephritis

1 g IV or IM once a day
Total duration of therapy: 10 to 14 days

Comments:
-Duration includes a possible conversion to appropriate oral therapy (after at least 3 days of parenteral therapy) once clinical improvement established.

Uses:
-For the treatment of community-acquired pneumonia due to S pneumoniae (penicillin-susceptible isolates only) including cases with concomitant bacteremia, Haemophilus influenzae (beta-lactamase negative isolates only), or Moraxella catarrhalis
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to E coli, including cases with concomitant bacteremia, or Klebsiella pneumoniae

Usual Adult Dose for Urinary Tract Infection

1 g IV or IM once a day
Total duration of therapy: 10 to 14 days

Comments:
-Duration includes a possible conversion to appropriate oral therapy (after at least 3 days of parenteral therapy) once clinical improvement established.

Uses:
-For the treatment of community-acquired pneumonia due to S pneumoniae (penicillin-susceptible isolates only) including cases with concomitant bacteremia, Haemophilus influenzae (beta-lactamase negative isolates only), or Moraxella catarrhalis
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to E coli, including cases with concomitant bacteremia, or Klebsiella pneumoniae

Usual Adult Dose for Skin or Soft Tissue Infection

1 g IV or IM once a day for 7 to 14 days

Comments:
-Not studied in diabetic foot infections with concurrent osteomyelitis
-Patients with diabetic foot infections received up to 28 days of treatment (parenteral or parenteral plus oral conversion therapy).

Use: For the treatment of complicated skin and skin structure infections (including diabetic foot infections without osteomyelitis) due to Staphylococcus aureus (methicillin-susceptible isolates only), S agalactiae, S pyogenes, E coli, K pneumoniae, Proteus mirabilis, B fragilis, Peptostreptococcus species, P asaccharolytica, or P bivia

Usual Adult Dose for Infection Prophylaxis

1 g IV once as a single dose, 1 hour before surgical incision

Use: For the prevention of surgical site infection after elective colorectal surgery

Usual Pediatric Dose for Intraabdominal Infection

3 months to 12 years: 15 mg/kg IV or IM twice a day
-Maximum dose: 1 g/day
13 years or older: 1 g IV or IM once a day

Duration of therapy: 5 to 14 days

Use: For the treatment of complicated intraabdominal infections due to E coli, C clostridioforme, E lenta (previously E lentum), Peptostreptococcus species, B fragilis, B distasonis, B ovatus, B thetaiotaomicron, or B uniformis

Usual Pediatric Dose for Pelvic Infections

3 months to 12 years: 15 mg/kg IV or IM twice a day
-Maximum dose: 1 g/day
13 years or older: 1 g IV or IM once a day

Duration of therapy: 3 to 10 days

Use: For the treatment of acute pelvic infections (including postpartum endomyometritis, septic abortion, postsurgical gynecological infections) due to S agalactiae, E coli, B fragilis, P asaccharolytica, Peptostreptococcus species, or P bivia

Usual Pediatric Dose for Pneumonia

3 months to 12 years: 15 mg/kg IV or IM twice a day
-Maximum dose: 1 g/day
13 years or older: 1 g IV or IM once a day

Total duration of therapy: 10 to 14 days

Comments:
-Duration includes a possible conversion to appropriate oral therapy (after at least 3 days of parenteral therapy) once clinical improvement established.

Uses:
-For the treatment of community-acquired pneumonia due to S pneumoniae (penicillin-susceptible isolates only) including cases with concomitant bacteremia, H influenzae (beta-lactamase negative isolates only), or M catarrhalis
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to E coli, including cases with concomitant bacteremia, or K pneumoniae

Usual Pediatric Dose for Pyelonephritis

3 months to 12 years: 15 mg/kg IV or IM twice a day
-Maximum dose: 1 g/day
13 years or older: 1 g IV or IM once a day

Total duration of therapy: 10 to 14 days

Comments:
-Duration includes a possible conversion to appropriate oral therapy (after at least 3 days of parenteral therapy) once clinical improvement established.

Uses:
-For the treatment of community-acquired pneumonia due to S pneumoniae (penicillin-susceptible isolates only) including cases with concomitant bacteremia, H influenzae (beta-lactamase negative isolates only), or M catarrhalis
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to E coli, including cases with concomitant bacteremia, or K pneumoniae

Usual Pediatric Dose for Urinary Tract Infection

3 months to 12 years: 15 mg/kg IV or IM twice a day
-Maximum dose: 1 g/day
13 years or older: 1 g IV or IM once a day

Total duration of therapy: 10 to 14 days

Comments:
-Duration includes a possible conversion to appropriate oral therapy (after at least 3 days of parenteral therapy) once clinical improvement established.

Uses:
-For the treatment of community-acquired pneumonia due to S pneumoniae (penicillin-susceptible isolates only) including cases with concomitant bacteremia, H influenzae (beta-lactamase negative isolates only), or M catarrhalis
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to E coli, including cases with concomitant bacteremia, or K pneumoniae

Usual Pediatric Dose for Skin or Soft Tissue Infection

3 months to 12 years: 15 mg/kg IV or IM twice a day
-Maximum dose: 1 g/day
13 years or older: 1 g IV or IM once a day

Duration of therapy: 7 to 14 days

Comments:
-Not studied in diabetic foot infections with concurrent osteomyelitis
-Adult patients with diabetic foot infections received up to 28 days of treatment (parenteral or parenteral plus oral conversion therapy).

Use: For the treatment of complicated skin and skin structure infections (including diabetic foot infections without osteomyelitis) due to S aureus (methicillin-susceptible isolates only), S agalactiae, S pyogenes, E coli, K pneumoniae, P mirabilis, B fragilis, Peptostreptococcus species, P asaccharolytica, or P bivia

Renal Dose Adjustments

Adult patients:
-CrCl greater than 30 mL/min/1.73 m2: No adjustment recommended.
-Severe renal dysfunction (CrCl up to 30 mL/min/1.73 m2) and ESRD (CrCl up to 10 mL/min/1.73 m2): 500 mg IV or IM once a day

Pediatric patients:
-Renal dysfunction: Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:
-Known hypersensitivity to the active component, any of the ingredients, or other drugs in the same class
-Demonstrated anaphylactic reactions to beta-lactams
-IM: Known hypersensitivity to amide-type local anesthetics

Safety and efficacy have not been established in patients younger than 3 months; this drug is not recommended for use in these patients.

Consult WARNINGS section for additional precautions.

Dialysis

Adult patients:
-Hemodialysis: 500 mg IV or IM once a day
---If administered at least 6 hours before hemodialysis: No supplemental dose is needed.
---If administered within 6 hours before hemodialysis: A supplemental dose of 150 mg is recommended after the hemodialysis session.
-Peritoneal dialysis or hemofiltration: Data not available

Pediatric patients: Data not available

Other Comments

Administration advice:
-For IV or IM use
-IV: Infuse over 30 minutes; do not use with a needleless IV system.
-IV: Complete the infusion within 6 hours of reconstitution.
-IM: May use as an alternative to IV administration for infections where IM therapy is appropriate; administer by deep IM injection into a large muscle mass (e.g., gluteal muscles, lateral part of the thigh); use caution to avoid inadvertent injection into a blood vessel.
-IM: Use the IM solution within 1 hour after reconstitution.
-May administer by IV infusion for up to 14 days or by IM injection for up to 7 days
-Do not administer the reconstituted solution IV.
-Do not co-infuse with other drugs.

Storage requirements:
-Before reconstitution: Do not store above 25C (77F).
-Reconstituted and infusion solutions: Reconstituted solution (immediately diluted) may be stored at room temperature (25C) and used within 6 hours or stored for 24 hours refrigerated and used within 4 hours after removal from refrigerator; do not freeze solutions.

Reconstitution/preparation techniques:
-This drug must be reconstituted and then diluted before IV administration.
-This drug must be reconstituted with lidocaine (without epinephrine) before IM administration.
-Diluents containing dextrose (alfa-D-Glucose) should not be used.
-The manufacturer product information should be consulted.

IV compatibility:
-Compatible: Water for Injection, 0.9% Sodium Chloride Injection, Bacteriostatic Water for Injection
-Do not mix with other drugs.

General:
-This drug is for the specified moderate to severe infections due to susceptible isolates of the designated microorganisms.
-To reduce the development of drug-resistant organisms and maintain effective therapy, antibiotics should be used only to treat or prevent infections proven or strongly suspected to be caused by susceptible bacteria.
-Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.

Monitoring:
-General: Organ system functions, including renal, hepatic, and hematopoietic (periodically during prolonged therapy)
-Hematologic: Hematopoietic function (periodically during prolonged therapy)
-Hepatic: Hepatic function (periodically during prolonged therapy)
-Renal: Renal function (periodically during prolonged therapy)

Patient advice:
-Avoid missing doses and complete the entire course of therapy.
-Contact physician as soon as possible if watery and bloody stools (with or without stomach cramps and fever) develop.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.