Ertapenem

Usual Dosing (Adults)

DOSAGE AND ADMINISTRATION
The dose of INVANZ in patients 13 years of age and older is 1 gram (g) given once a day. The dose of INVANZ in patients 3 months to 12 years of age is 15 mg/kg twice daily (not to exceed 1 g/day). INVANZ may be administered by intravenous infusion for up to 14 days or intramuscular injection for up to 7 days. When administered intravenously, INVANZ should be infused over a period of 30 minutes.

Intramuscular administration of INVANZ may be used as an alternative to intravenous administration in the treatment of those infections for which intramuscular therapy is appropriate.

DO NOT MIX OR CO-INFUSE INVANZ WITH OTHER MEDICATIONS. DO NOT USE DILUENTS CONTAINING DEXTROSE (α-D-GLUCOSE).

Treatment Guidelines for Adults and Pediatric Patients With Normal Renal Function (creatinine clearance >90 mL/min/1.73 m2) and Body Weight

Infection	Daily Dose (IV or IM) Adults and Pediatric Patients 13 years of age and older	Daily Dose (IV or IM) Pediatric Patients 3 months to 12 years of age	Recommended Duration of Total Antimicrobial Treatment
Complicated intra-abdominal infections	1 g	15 mg/kg twice daily (not to exceed 1 g/day)	5 to 14 days
Complicated skin and skin structure infections, including diabetic foot infections	1 g	15 mg/kg twice daily (not to exceed 1 g/day)	7 to 14 days (adult patients with diabetic foot infections received up to 28 days of treatment (parenteral or parenteral plus oral switch therapy))
Community acquired pneumonia	1 g	15 mg/kg twice daily (not to exceed 1 g/day)	10 to 14 days (duration includes a possible switch to an appropriate oral therapy, after at least 3 days of parenteral therapy, once clinical improvement has been demonstrated.)
Complicated urinary tract infections, including pyelonephritis	1 g	15 mg/kg twice daily (not to exceed 1 g/day)	10 to 14 days (duration includes a possible switch to an appropriate oral therapy, after at least 3 days of parenteral therapy, once clinical improvement has been demonstrated.)
Acute pelvic infections including postpartum endomyometritis, septic abortion and post surgical gynecologic infections	1 g	15 mg/kg twice daily (not to exceed 1 g/day)	3 to 10 days

Prophylaxis Guidelines for Adults

Indication	Daily Dose(IV) Adults	Recommended Duration of Total Antimicrobial Treatment
Prophylaxis of surgical site infection following elective colorectal surgery	1 g	Single intravenous dose given 1 hour prior to surgical incision

Renal Dosing

Patients with Renal Insufficiency:
INVANZ may be used for the treatment of infections in adult patients with renal insufficiency. In patients whose creatinine clearance is >30 mL/min/1.73 m2, no dosage adjustment is necessary. Adult patients with advanced renal insufficiency (creatinine clearance ≤30 mL/min/1.73 m2) and end-stage renal insufficiency (creatinine clearance ≤10 mL/min/1.73 m2) should receive 500 mg daily. There are no data in pediatric patients with renal insufficiency.

Hemodialysis

Patients on Hemodialysis: When adult patients on hemodialysis are given the recommended daily dose of 500 mg of INVANZ within 6 hours prior to hemodialysis, a supplementary dose of 150 mg is recommended following the hemodialysis session. If INVANZ is given at least 6 hours prior to hemodialysis, no supplementary dose is needed. There are no data in patients undergoing peritoneal dialysis or hemofiltration. There are no data in pediatric patients on hemodialysis.

When only the serum creatinine is available, the following formula2 may be used to estimate creatinine clearance. The serum creatinine should represent a steady state of renal function.

Males: (weight in kg) x (140-age in years) / [(72) x serum creatinine (mg/100 mL)]
Females: (0.85) x (value calculated for males)

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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