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Invanz

Ertapenem is a carbapenem marketed by Merck as Invanz®. It is structurally very similar to meropenem in that it possess a 1-β-methyl group. more...

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Indications

Ertapenem is designed to be effective against Gram negative bacteria. It is not active against MRSA, ampicillin-resistant enterococci, Pseudomonas aeruginosa or Acinetobacter species. Ertapenem also has clinically useful active against anaerobic bactera.

Ertapenem is marketed by Merck as first line treatment for community acquired infections. It should not be used as empirical treatment for hospital-acquired infections because of its lack of activity against Pseudomonas aeruginosa. In practice, it is reserved primarily for use against ESBL-producing and high level AmpC-producing Gram negative bacteria.

Dosing

Ertapenem is dosed as 1g given by intravenous injection over 30 minutes, or 1g diluted with 3.2ml of 1% lignocaine given intramuscularly. There is no oral preparation of ertapenem available. Ertapenem cannot be mixed with glucose.

The marketing slogan for ertapenem is "The Power of One", because the dose is one gram, once a day.

Pharmacokinetics

Unlike imipenem and meropenem, ertapenem is highly protein blound, which explains its long half life (4 hours).

Renal and hepatic dosing

Ertapenem is excreted primarily (80%) by the kidneys. Metabolism by the liver is not clinically important and does not affect dosing.

Patients on haemodialysis should be given ertapenem at least 6 hours before dialysis. If it is given less than six hours before dialysis, then the patient should be given an additional dose of 150mg IV after dialysis. Ideally, patients on haemodialysis should be given ertapenem immediately following dialysis.

Adverse effects

There are few adverse effects of ertapenem. The only absolute contra-indication is a previous anaphylactic reaction to ertapenem or other β-lactam antibiotic. There are no studies done in pregnant women, so the manufacturers cannot comment on its safety in pregnancy. There are no studies in children, and therefore there is no license for use in children aged under 18 years of age.

Use of all antibiotics is associated with increased rates of resistance (although carbapenem resistance is currently rare). There is particular worry that although ertapenem has no clinically useful activity against Pseudomonas aeruginosa, widespread use of ertapenem could still lead to increased carbapenem resistance in Pseudomonas (Livermore 2005).

Like all antibiotics, C. difficile colitis has been associated with its use.

Read more at Wikipedia.org


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From Chicago Sun-Times, 11/29/01

LTV agrees to keep making steel for now

LTV Corp. agreed today to continue steel production until a bankruptcy court hearing next week on the long-term future of steelmaking operations. However, LTV attorney David Heiman reiterated that the company had not planned a shutdown that would have affected a possible restart of operations. "We are not stopping operations. We are not idling furnaces," Heiman told a federal bankruptcy judge in Cleveland today. "We are preparing the furnaces so they can be sold to a third party." The company announced Wednesday it plans to idle some production lines this week at Cleveland and East Chicago, Ind., and stop making steel by Tuesday, citing a lack of demand.

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An index measuring the volume of help-wanted advertising in major U.S. newspapers fell in October to the lowest in 37 years, the Conference Board said. The New York group's help-wanted index slumped to 46 last month from 52 in September. October's reading was the lowest since October 1964, when it was 45.

Merck injectable antibiotic wins OK

Merck & Co. won U.S. Food and Drug Administration approval for an injectable antibiotic called Invanz designed to work against infections resistant to the cephalosporin class of antibiotics, the company said. The drug, from the same class of antibiotics as Merck's Primaxin and AstraZeneca's Merrem, is designed to be given once daily, while the other drugs must be given three times every day.

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Copyright The Chicago Sun-Times, Inc.
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