For nmr studies, meropenem and doripenem solutions 12. Doribax doripenem dose, indications, adverse effects. Background anaerobic pathogens are normal flora of the oral cavity and the gastrointestinal tract. Doripenem doribax orthomcneil janssen, an intravenous iv carbapenem antibiotic with a spectrum of activity similar to that of imipenem and meropenem, has been approved by the. Ertapenem and doripenem appear to behave similarly to meropenem rather than to imipenem. All references to doripenem activity are expressed in terms of the active doripenem moiety. Doripenem is a recent antipseudomonal carbapenem that exhibits greater in vitro activity against pseudomonas aeruginosa isolates than other carbapenems and. Carbapenems meropenem, doripenem, imipenem, ertapenem gram. Costutility analysis comparing meropenem with imipenem. Doripenem vs meropenem against pseudomonas and acinetobacter. Piperacillintazobactam vs carbapenems for patients with. In some of these reports, increasing the dose of valproic acid or sodium valproate did not result.
Ris procite, reference manager, endnote, bibtex, medlars, refworks. Prescribing doripenem in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is. Because of the recent conversion to meropenem, the similar spectrum of activity of meropenem and doripenem, the lack of published data, the similarity in cure rates between doripenem and comparator agents according to published abstracts, and the increased cost of doripenem, meropenem will continue to be the carbapenem of choice at baylor. Efficacy of doripenem in the treatment of pseudomonas aeruginosa experimental pneumonia versus imipenem and meropenem article pdf available in journal of antimicrobial. To compare safety and efficacy of doripenem versus imipenemcilastatin in patients with ventilatorassociated pneumonia. Doripenem s4661 is a new parenteral antibiotic from the carbapenem class. Doribax, doripenem dosing, indications, interactions.
Therefore, we conducted a prospective observational study in 169 patients who developed pseudomonas aeruginosa vap. Doripenem, meropenem, and ertapenem all possess a 1betamethyl side chain that provides resistance to the renal enzyme dehydropeptidase i. Doripenem, like meropenem, has stability against renal dehydropeptidases, which unlike imipenem does not require the addition of cilastatin on administration, as a result of the. Imipenem, meropenem, or doripenem to treat patients with. Doripenem is an injectable carbapenem antibiotic with a spectrum of activity comparable to that of imipenem and meropenem. A similar drug interaction involving other carbapenem antibacterials and valproic acid has been described in published case reports.
Doripenem is used to treat severe infections of the stomach, bladder, or kidneys. Pdf efficacy of doripenem in the treatment of pseudomonas. Monographs for commonly administered intravenous medications in home and community care 2 p a g e meropenem administration2,4,5 can be dispensed as single doses and administered. Nov 06, 2019 doripenem is usually given for 5 days to 2 weeks, depending on the condition being treated. Pdf comparative efficacy of doripenem versus meropenem for. Monographs for commonly administered intravenous medications in home and community care 2 p a g e meropenem administration2,4,5 can be dispensed as single doses and administered by gravity or pole pump with each. Doripenem binds to penicillin binding proteins pbps located on the. However, since the pharmacokinetics of doripenem and meropenem are similar, it is not clear that the slight to moderate advantage in inhibitory activity of doripenem is clinically signi. Food and drug administration fda has concluded that doribax doripenem, an antibacterial drug that has been used to treat patients who develop pneumonia while on. Extended infusions of betalactams in pediatric patients.
A regimen of 500mg iv q6h is able to achieve a similar probability of target attainment with. Apr 26, 2020 22,23 doripenem is twofold more active than meropenem and twofold to eightfold more active than ertapenem against oxacillinsusceptible s. Causative pathogens with carbapenem high level resistance with minimal inhibitory concentration of doripenem meropenem 8 mgl were excluded. Monographs for commonly administered intravenous medications.
Its safety is similar to that of other carbapenems. Doripenem, a new addition to the intravenous carbape. Mechanisms such as drug inactivation by carbapenemhydrolyzing enzymes, mutant or acquired volume 23, issue 4 january 2008 doripenem. Costutility analysis comparing meropenem with imipenem plus cilastatin in the treatment of severe infections in intensive care article in the european journal of health economics 71. While oral anaerobic flora are mostly grampositive organisms such as peptococcus and peptostreptococcus spp. Recently, doripenem has been approved for the treatment of nosocomial pneumonia np, including ventilatorassociated pneumonia vap. Doripenem vs meropenem against pseudomonas and acinetobacter article in indian journal of medical microbiology 303. Doripenem is a new parenteral antibiotic from the carbapenem class. Meropenem and doripenem are thought to be the more potent in vitro agents against gram negative organisms. As seen in clinical trials, doripenem is fairly similar to meropenem. Imipenem, meropenem, and doripenem mics for pseudomonas aeruginosa isolates were determined using etests and compared according to the. Doripenem, like meropenem, has stability against renal dehydropeptidases, which unlike imipenem does not require the addition of cilastatin on administration, as a result of the protection afforded by the 1. Jan 10, 2008 to compare safety and efficacy of doripenem versus imipenemcilastatin in patients with ventilatorassociated pneumonia the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Doripenem fda prescribing information, side effects and uses.
It is a betalactam antibiotic drug able to kill pseudomonas aeruginosa doripenem can be used for bacterial infections such as. Primary doses of meropenem and doripenem were 1 g every eight hours and 500 mg every eight hours before renal dose adjustment, respectively. Doribax is not approved to treat any type of pneumonia. Prescribing doripenem in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drugresistant bacteria. Food and drug administration fda has concluded that doribax doripenem, an antibacterial drug that has been used to treat patients who develop pneumonia. A similar drug interaction involving other carbapenem antibacterials and valproic acid has been described in published case. After more than a year in clinical use, there are no reports of doripenem related seizures. You may be switched to an oral pill form antibiotic after the first few days of. The central nervous system safety of meropenem can be highlighted by the fact that it is approved for the treatment of meningitis, whereas for imipenem onethird of all patients with meningitis suffered from seizures. To compare safety and efficacy of doripenem versus imipenem. It should be noted that these studies employed noninferiority methods rather than testing for superiority. Doripenem doribax, a new carbapenem antibacterial agent. Sigmaaldrich, st louis, mo, usa supplemented with 0.
In march 2014, the fda issued a warning statement against doribax doripenem for ventilator associated pneumonia, saying. Doripenem is an intravenously administered carbapenem with a broad spectrum of activity against many multidrugresistant pathogens, including aerobic or anaerobic gram. Doribax, doripenem monohydrate for injection vials contain 500 mg of doripenem on an anhydrous basis, a white to slightlyyellowish offwhite sterile crystalline powder. Michael scheld, in antibiotic and chemotherapy ninth edition, 2010. Fda warns against doripenem doribax for ventilator. Doripenem showed similar or slightly better activity than meropenem and better activity than. You may be switched to an oral pill form antibiotic after the first few days of receiving doripenem by injection. Doribax carries an increased risk of death and lower clinical cure rates compared to use of imipenem and cilastatin. Tulkens, stability of meropenem and doripenem solutions for administration by continuous infusion, journal of antimicrobial chemotherapy, volume 65, issue 5.
Doripenem has now been on the market for about 5 years. Doripenem is a broadspectrum, carbapenem antibiotic with bactericidal and betalactamase resistant activities. In the second study, the doripenem rate was 81% and the meropenem rate was 82. Find patient medical information for doripenem intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. In vitro activity of doripenem and other carbapenems against. To compare safety and efficacy of doripenem versus. Valproic acid doripenem reduced the serum concentrations of valproic acid to below the therapeutic concentration range in healthy subjects 7. This is a pdf file of an unedited manuscript that has been accepted for publication. Doripenem does not appear to have proconvulsive activity. Predicting doripenem susceptibility based on meropenem and. Doripenem side effects, dosage, interactions drugs. This trial was designed to compare the effectiveness of colistin monotherapy versus colistinmeropenem combination therapy among patients with severe infections caused by carbapenemresistant gramnegative bacteria, targeting the patient population with carbapenemresistant gramnegative bacterial infections treated in clinical practice, in a.
Stability of meropenem and doripenem solutions for. May 01, 2008 doripenem is an intravenously administered carbapenem with a broad spectrum of activity against many multidrugresistant pathogens, including aerobic or anaerobic gramnegative and grampositive microorganisms. Doripenem, a new parenteral carbapenem, has been recognized as a. The purpose of this study was to compare the efficacy of doripenem dori vs. Pharmacotherapy of complicated urinary tract and intraabdominal. Doripenem has been developed to date for intravenous use. Doripenem, the latest member of the carbapenem class, was approved by the us food and drug administration fda in 2007. Doripenem is usually given for 5 days to 2 weeks, depending on the condition being treated. A retrospective study of causative agents and their resistance pro file. During clinical investigations, the overall seizure rate in meropenem treated patients was 0. Noninferiority was also observed among the microbiological modified intenttotreat patients, which included those with. Comparative efficacy of doripenem versus meropenem for hospitalacquired and ventilatorassociated pneumonia.
Doripenem injection is used to treat serious infections of the urinary tract, kidney, and abdomen that are caused by bacteria. The authors suggested that doripenem and meropenems enhanced pbp affinities in p. Carbapenems meropenem, imipenemcilastatin, ertapenem and doripenem have a spectrum of antimicrobial activity that exceeds most other antimicrobial classes, which includes organisms resistant to many other antimicrobials, including other. Efficacy of doripenem in the treatment of pseudomonas aeruginosa experimental pneumonia versus imipenem and meropenem article pdf available in journal of antimicrobial chemotherapy 6511. The etest was performed to determine the mics of doripenem and meropenem in 203 endotracheal aspirate isolates that consisted of 140 acinetobacter calcoaceticusacinetobacter baumannii complexes and 63 pseudomonas aeruginosa. Mic90 values for doripenem, meropenem, and imipenem, respectively. Doripenem injection is not approved by the food and drug. It is a betalactam antibiotic drug able to kill pseudomonas aeruginosa doripenem can be used for bacterial. Doripenem may also be used for purposes not listed in this. Doripenem doribax, finibax is an antibiotic drug in the carbapenem class.
Below are the links to the authors original submitted files for images. This trial was designed to compare the effectiveness of colistin monotherapy versus colistinmeropenem combination therapy among patients with severe infections caused by. The use of doripenem in uti, including pyelonephritis, with or without anatomical or functional abnormalities was evaluated in a multicenter trial. Dec 01, 2018 doripenem for injection was noninferior to meropenem with regard to clinical cure rates in microbiologically evaluable me patients, i. Comparative efficacy of doripenem versus meropenem for. Meropenem and doripenem are thought to maintain more antipseudomonal activity than imipenemcilastatin because of the multiple mechanisms of resistance required to. Only limited data exist on pseudomonas aeruginosa ventilatorassociated pneumonia vap treated with imipenem, meropenem, or doripenem. During clinical investigations, the overall seizure rate in meropenemtreated patients was 0. Colistin alone versus colistin plus meropenem for treatment. In one study, the doripenem clinical cure rate was 82. Comparative activity of carbapenem testing the compact study in. Doripenem is a powder that must be mixed with a liquid diluent.