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Carbapenem — ESBL / Complicated Intra-Abdominal / Community OPAT

Ertapenem

Brand names: Invanz

Ertapenem is a long-acting carbapenem antibiotic given parenterally, used for serious community-acquired infections including intra-abdominal infection, complicated urinary tract infection and pneumonia, and as surgical prophylaxis in colorectal surgery.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds penicillin-binding proteins to inhibit bacterial cell wall synthesis, and its stability against many beta-lactamases gives broad activity, though notably not against Pseudomonas aeruginosa or enterococci.

Prescribing in practice

  • It is contraindicated in patients with severe hypersensitivity to other carbapenems and used with caution where there is a history of beta-lactam allergy because of cross-reactivity.
  • Carbapenems can lower the seizure threshold, so caution is needed in patients with CNS disorders or epilepsy.
  • It markedly reduces serum valproate levels, risking loss of seizure control, so this combination should be avoided.

Monitoring

Monitor renal function for dose adjustment and observe clinical response, with the dose reduced in significant renal impairment.

Counselling the patient

  • This antibiotic is given by injection or infusion, usually once daily.
  • Report any rash, swelling or breathing difficulty straight away.
  • Tell the team if you take valproate for epilepsy, as it interacts.

Evidence & guidelines

Ertapenem is reserved for defined indications under UK antimicrobial stewardship to limit carbapenem resistance.

Reference: MERINO Trial 2018; PHE ESBL Management Guidelines; NICE OPAT Guidance; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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