Keating Gillian M, Perry Caroline M
Adis International Limited, Auckland, New Zealand.
Drugs. 2005;65(15):2151-78. doi: 10.2165/00003495-200565150-00013.
The Group 1, 1 beta-methyl carbapenem ertapenem (Invanz) is approved for parenteral use in patients with complicated intra-abdominal infection (cIAI), community-acquired pneumonia (CAP) and acute pelvic infection caused by susceptible strains of certain designated organisms in both the US and the EU. Additional approved indications in the US include complicated skin and skin structure infection (cSSSI) and complicated urinary tract infection (cUTI). Ertapenem is approved for use in adults in both the US and the EU and in paediatric patients aged >or=3 months in the US. Ertapenem has a broad spectrum of in vitro activity against Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae, Gram-positive pathogens and anaerobic pathogens. It has similar efficacy to comparator antibacterials such as piperacillin/tazobactam in cSSSI (including diabetic foot infection), cIAI and acute pelvic infection and ceftriaxone with or without metronidazole in cIAI, cUTI and CAP. The drug has also shown efficacy in the treatment of paediatric patients with complicated community-acquired bacterial infections. Ertapenem has a convenient once-daily administration schedule and is generally well tolerated. Thus, ertapenem is an important option for the empirical treatment of complicated community-acquired bacterial infections in hospitalised patients.
第1组,1β-甲基碳青霉烯类药物厄他培南(怡万之)在美国和欧盟均被批准用于治疗由某些特定病原体的易感菌株引起的复杂性腹腔内感染(cIAI)、社区获得性肺炎(CAP)和急性盆腔感染的患者。在美国,额外批准的适应症包括复杂性皮肤和皮肤结构感染(cSSSI)以及复杂性尿路感染(cUTI)。在美国和欧盟,厄他培南均被批准用于成人,在美国还被批准用于年龄≥3个月的儿科患者。厄他培南对革兰氏阴性病原体具有广泛的体外活性,包括产超广谱β-内酰胺酶(ESBL)和AmpC的肠杆菌科细菌、革兰氏阳性病原体和厌氧病原体。在cSSSI(包括糖尿病足感染)、cIAI和急性盆腔感染方面,它与比较抗菌药物如哌拉西林/他唑巴坦的疗效相似;在cIAI、cUTI和CAP方面,它与头孢曲松联合或不联合甲硝唑的疗效相似。该药物在治疗患有复杂性社区获得性细菌感染的儿科患者中也显示出疗效。厄他培南给药方案方便,每日一次,且一般耐受性良好。因此,厄他培南是住院患者复杂性社区获得性细菌感染经验性治疗的重要选择。