At Ertapenem it is a medicinal substance belonging to the group of carbapenems. Preparations containing the drug are u. a. used for the treatment of intra-abdominal infections, acute gynecological infections, community-acquired pneumonia and for the therapy of a diabetic foot. Ertapenem is also used preventively to prevent infection of the abdominal area before an operation.
What is ertapenem?
Ertapenem is assigned to the active substance group of carbapenems. This term covers various antibiotics that are administered as drugs because of their broad antimicrobial effect. In addition to ertapenem, meropenem, imipenem, doripenem and tebipenem also belong to this group.
Within the European Union and Switzerland, Ertapenem is sold under the trade name Invanz®. In pharmacology and chemistry, the active ingredient is described with the empirical formula C22-H25-N3-O7-S, which corresponds to a moral mass of 475.516 g / mol.
Ertapenem is given to treat infectious diseases caused by anaerobes or gram-negative or gram-positive pathogens. A bacterium is gram-positive if it turns blue when differential staining is performed. Gram negative are those that turn red.
Ertapenem is usually administered as an infusion solution and thus parenterally.
Pharmacological effect
Ertapenem works - which is typical for early representatives of the carbapenems - extremely quickly. This means that bacteria are quickly killed by the active ingredient. However, a minimally effective amount of ertapenem in the body must be permanently exceeded in order to achieve success. Experts therefore speak of a time-dependent killing characteristic.
Ertapenem is stable to most beta lactasmas. Beta lactasmas are certain enzymes that are produced by bacteria to prevent outside attack. Beta-lactase masks are thus comparable to antibodies and prevent the effectiveness of antibiotics. Because ertapenem is stable to almost all beta-lactase masks, the drug can be used effectively against numerous bacteria.
In addition, ertapenem is not attacked by the extended spectrum beta lactamases (ESBL) of a bacteria. These can also significantly reduce the effectiveness of antibiotics. However, ertapenem is ineffective against enterococci and Pseudomonas aeruginosa.
The drug kills bacteria by attaching itself to penicillin-binding proteins. This prevents the bacterium from renewing its cell wall, which ultimately leads to its death.
10% of Ertapenem is excreted in the stool. The active substance is further eliminated renally, i.e. through the kidneys.
Medical studies have not found a causal relationship between treatment with ertapenem and direct or indirect damage to the embryo. However, it should only be taken after a careful risk-benefit analysis. Because ertapenem can pass into breast milk, breast-feeding should not be carried out during or shortly after treatment.
Medical application & use
Ertapenem is given to control infectious diseases in adults, adolescents and children aged 3 months and over. There is an indication for acute gynecological infections, community-acquired pneumonia, intra-abdominal infections and diabetic foot, if this leads to a skin infection.
Ertapenem can also be used preventively, i.e. H. can be used preventively. A prescription is therefore often given to prevent postoperative infections of the abdominal cavity. Such infections can occur after elective colorectal surgery.
Ertapenem is sold as a powder. This is usually supplied as a concentrate. It is used to make an infusion solution. The administration is therefore parenteral.
Risks & side effects
Ertapenem should not be given if there is a contraindication. The term contraindication describes a circumstance that leads to a medical contraindication. This means that, from a medical point of view, treatment must absolutely not be given due to actual circumstances. Such a contraindication exists if hypersensitivity or allergies to ertapenem or other drugs of the carbapenem group exist.
Hypersensitivity could also be found in people treated with beta-lactam antibiotics. In addition, there is also a contraindication for kidney dysfunction, since the breakdown of the active ingredient mainly takes place renally, i.e. via the kidneys.
Furthermore, undesirable side effects can occur in the course of treatment with ertapenem. So far it has been observed that fungal infections (especially candidiasis), hypoglycaemia (blood sugar drop below 60 mg / gl), runny nose, cough and pharyngitis (inflammation of the pharynx) occurred.
Other undesirable side effects include insomnia, general states of fatigue and weakness, dizziness, restlessness, depressive moods and states of panic.
Allergic skin reactions are also possible. This usually manifests itself as a rash, urticaria (wheals), dermatitis or itching. Anorexia and disorders of the gastrointestinal tract (diarrhea, vomiting, nausea, etc.) can also occur.
In some cases there was also cardiac arrhythmia. Pain (especially in the head, muscles, stomach, chest or shoulder area) is also one of the possible side effects. Hyper- or hypotension are also conceivable during and shortly after treatment.
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