Ertapenem

Carbapenem·Infectious Diseases - Other Antibiotics

Complicated intra-abdominal infections, complicated UTI/pyelonephritis caused by ESBL-producing organisms, diabetic foot infections

CARBAPENEMInvanzVials (1 g powder) for IV in…S4TGA

Max Dose

1 g/day

Half-life

4 h

Freq

ONCE DAILY

Pseudomonas

NO COVER

Rapid Summary

Overview

Highly convenient, once-daily IV carbapenem. Outstanding cover against ESBL-producing Gram-negative gut bugs and anaerobes. Crucially, it lacks coverage against Pseudomonas or Enterococcus.

Maximum Dose

Max 1 g/day.

Clinical Focus

The only carbapenem that does NOT cover Pseudomonas. Do not use for hospital-acquired pneumonia or severe neutropenic fever.

Bottom Line

Ertapenem is a once-daily carbapenem suitable for community-acquired complicated infections and outpatient IV therapy, but lacks Pseudomonas coverage unlike meropenem.

Formulation & Access

Brand Names

Invanz

Parenteral

Vials (1 g powder) for IV infusion or deep IM injection (mixed with 1% lidocaine).

Prescribing & PBS

Hospital supply. Restricted by Antimicrobial Stewardship.

Indications & Use

Primary

TGA

Complicated intra-abdominal infections, complicated UTI/pyelonephritis caused by ESBL-producing organisms, diabetic foot infections.

Clinical Place

The absolute gold-standard 'OPAT' (Outpatient Parenteral Antimicrobial Therapy) drug. Its once-daily dosing allows patients with severe ESBL UTIs to be discharged home and treated by a visiting nurse.

Quick reference

Class & Role

Carbapenem — Highly convenient, once-daily IV carbapenem.

Route / Formulation

Vials (1 g powder) for IV infusion or deep IM injection (mixed with 1% lidocaine). (Invanz)

Usual Dose & Max

IV / IM 1 g OD. Max 1 g/day.

Key Indication Doses

ESBL UTI / Intra-abdominal Sepsis: IV / IM 1 g OD. Renal Impairment: Halve the dose. If eGFR < 30, give 500 mg OD.

Best Uses

Ertapenem is a once-daily carbapenem suitable for community-acquired complicated infections and outpatient IV therapy, but lacks Pseudomonas coverage unlike meropenem.

Avoid / Cautions

Anaphylaxis to carbapenems/penicillins. Known Pseudomonas infection. Pregnancy Category B3.

Key Risks

Neurological: Seizures, encephalopathy (Risk is highest in unadjusted severe renal failure or pre-existing CNS lesions). Gastrointestinal: Diarrhea, C. difficile infection. Immunological: Beta-lactam hypersensitivity cross-reactivity.

Key Interactions

Sodium Valproate. Ertapenem rapidly destroys valproate blood levels, dropping them to sub-therapeutic levels within 24 hours, guaranteeing breakthrough seizures in epileptics. AVOID.

Monitoring

Check eGFR to ensure the 1g dose is safe. Track FBC if on prolonged OPAT courses. Observe for neurological changes/myoclonus in the elderly.

Clinical Pearl

If a patient is clinically stable but their urine grows an E. coli resistant to Ceftriaxone and Tazocin (an ESBL), they usually require IV Meropenem TDS, keeping them stuck in hospital. Ertapenem 1g OD allows them to go home immediately.

Access

Invanz

Brand: Invanz

Ertapenem

Carbapenem·Infectious Diseases - Other Antibiotics

Complicated intra-abdominal infections, complicated UTI/pyelonephritis caused by ESBL-producing organisms, diabetic foot infections

CARBAPENEMInvanzVials (1 g powder) for IV in…S4TGA

Max Dose

1 g/day

Half-life

4 h

Freq

ONCE DAILY

Pseudomonas

NO COVER

Rapid Summary

Overview

Highly convenient, once-daily IV carbapenem. Outstanding cover against ESBL-producing Gram-negative gut bugs and anaerobes. Crucially, it lacks coverage against Pseudomonas or Enterococcus.

Maximum Dose

Max 1 g/day.

Clinical Focus

The only carbapenem that does NOT cover Pseudomonas. Do not use for hospital-acquired pneumonia or severe neutropenic fever.

Bottom Line

Ertapenem is a once-daily carbapenem suitable for community-acquired complicated infections and outpatient IV therapy, but lacks Pseudomonas coverage unlike meropenem.

Formulation & Access

Brand Names

Invanz

Parenteral

Vials (1 g powder) for IV infusion or deep IM injection (mixed with 1% lidocaine).

Prescribing & PBS

Hospital supply. Restricted by Antimicrobial Stewardship.

Indications & Use

Primary

TGA

Complicated intra-abdominal infections, complicated UTI/pyelonephritis caused by ESBL-producing organisms, diabetic foot infections.

Clinical Place

Quick reference

Class & Role

Carbapenem — Highly convenient, once-daily IV carbapenem.

Route / Formulation

Vials (1 g powder) for IV infusion or deep IM injection (mixed with 1% lidocaine). (Invanz)

Usual Dose & Max

IV / IM 1 g OD. Max 1 g/day.

Key Indication Doses

ESBL UTI / Intra-abdominal Sepsis: IV / IM 1 g OD. Renal Impairment: Halve the dose. If eGFR < 30, give 500 mg OD.

Best Uses

Ertapenem is a once-daily carbapenem suitable for community-acquired complicated infections and outpatient IV therapy, but lacks Pseudomonas coverage unlike meropenem.

Avoid / Cautions

Anaphylaxis to carbapenems/penicillins. Known Pseudomonas infection. Pregnancy Category B3.

Key Risks

Key Interactions

Sodium Valproate. Ertapenem rapidly destroys valproate blood levels, dropping them to sub-therapeutic levels within 24 hours, guaranteeing breakthrough seizures in epileptics. AVOID.

Monitoring

Check eGFR to ensure the 1g dose is safe. Track FBC if on prolonged OPAT courses. Observe for neurological changes/myoclonus in the elderly.

Clinical Pearl

Access

Invanz

Brand: Invanz