Use of Ertapenem at an Academic Medical Center

This is the authors' abstract. We don't add key points for this paper.

Background Ertapenem is a once-daily, broad-spectrum antibiotic convenient for outpatient parenteral antimicrobial therapy (OPAT). The primary focus of our study was to assess the efficacy and safety of ertapenem for OPAT. Methods Data were retrospectively collected from patients receiving ertapenem for a 24-month period. Patient characteristics, therapeutic indication, and microbiology were reviewed. Outcome measures included clinical and microbiologic success, improvement, or failure and the safety profile of ertapenem. Results Two hundred ninety-two consecutive patients received ertapenem, and 202 met inclusion criteria for ertapenem OPAT. Patients received a median of 29 days for a range of indications, most commonly intra-abdominal (32.2%), osteomyelitis (29.2%), and skin and soft tissue infection (14.4%). One hundred seventeen OPAT patients had a polymicrobial infection. One hundred eighty-six patients were evaluable for clinical outcomes. Clinical success occurred in 92% of patients: clinical improvement was achieved in 69%, and clinical cure was achieved in 23% of patients. Clinical failure occurred in 15 patients (8.1%). Ertapenem was well tolerated with only 25 (13.4%) of 186 patients experiencing an adverse event. The most common adverse drug events were altered mental status in 7 patients and 2 additional patients with seizures in patients with creatinine clearances of less than 50 mL/min, and increased liver function tests (n = 4). Conclusions Ertapenem is frequently used for OPAT because it is convenient, well tolerated, and clinically effective for abdominal, skin and soft tissue, and bone infections. It has an excellent safety profile, but central nervous system irritability in patients with diminished renal function may warrant closer attention.