Doribax, doripenem monohydrate for injection vials contain 500 mg of doripenem on an anhydrous basis, a white to slightlyyellowish offwhite sterile crystalline powder. Doripenem does not require the addition of cilastatin, and has a lower seizure potential compared to imipenem. Doripenem is used to treat a wide variety of bacterial infections. Meropenem and doripenem are thought to be the more potent in vitro agents against gram negative organisms. In the current study, we have determined apparent km and kcat values of 0. Meropenem, sold under the brandname merrem among others, is a broadspectrum antibiotic used to treat a variety of bacterial infections. Doripenem is a powder that must be mixed with a liquid diluent. A similar drug interaction involving other carbapenem antibacterials and valproic acid has been described in published case reports. Therefore, we conducted a prospective observational study in 169 patients who developed pseudomonas aeruginosa vap. Nov 06, 2019 doripenem is usually given for 5 days to 2 weeks, depending on the condition being treated. 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 fda for treatment of complicated intraabdominal and urinary tract infections. C verwaest on behalf of the belgiun multicentre study group. Pm calls for global action on antibiotic resistance.
Doripenem is a new parenteral antibiotic from the carbapenem class. Past, present, and future antimicrobial agents and. Stability of meropenem and doripenem solutions for. The mean apache ii score was slightly higher in the meropenem group than in the imipenemcilastatin group, as was the number of patients who had received previous antibacterial therapy. Doripenem and meropenem were the most active agents among all. Single use clear glass vials containing 500 mg on an anhydrous basis of sterile doripenem powder. Pdf efficacy of doripenem in the treatment of pseudomonas. Doripenem has a spectrum of activity similar to imipenem and ertapenem against grampositive cocci and. Thus, it has significant in vitro activity against streptococci, methicillinsusceptible staphylococci, enterobacteriaceae including extendedspectrum bdoripenem has been approved by fda in 2007 for the treatment of.
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. Sigmaaldrich, st louis, mo, usa supplemented with 0. Tdmmonograph meropenem october 2015, concept version page 4 of 5 meropenem 500 mg every 8 hours, or 1 gram every 6 hours in patients with normal renal function. The brazilian journal of infectious diseases original article a metaanalysis of ef. Meropenem and doripenem are thought to maintain more antipseudomonal activity than imipenemcilastatin because of the multiple mechanisms of resistance required to. As seen in clinical trials, doripenem is fairly similar to meropenem. Furthermore, carbapenem resistance emergence was the same for patients treated with imipenem, meropenem, or doripenem.
Doripenem doribax, a new carbapenem antibacterial agent. Doripenem oxford academic journals oxford university press. Intravenous doripenem at 500 milligrams versus levofloxacin at 250 milligrams, with an option to switch to oral therapy, for treatment of complicated lower urinary tract infection and. It should be noted that these studies employed noninferiority methods rather than testing for superiority. A rational drug design approach was used to combine the antimicrobial. It combines the in vitro activities of imipenem and ertapenem against gram positive bacteria with the in vitro activity of meropenem against gramnegative. 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. Doripenem may also be used for purposes not listed in this. Doripenem injection is not approved by the food and drug administration fda to treat pneumonia that developed in people who were on a ventilator in a hospital. In the second study, the doripenem rate was 81% and the meropenem rate was 82. Primary doses of meropenem and doripenem were 1 g every eight hours and 500 mg every eight hours before renal dose adjustment, respectively. Doripenem binds to penicillin binding proteins pbps located on the bacterial cell wall, particularly pbps 2 and 3, thereby inhibiting the final transpeptidation step in the synthesis of peptidoglycan, an essential component of the bacterial cell wall.
The genome of mycobacterium tuberculosis contains a gene, blac, which encodes a highly active. Doribax doripenem powder, for solution for intravenous use initial u. In some of these reports, increasing the dose of valproic acid or sodium valproate did not result. 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. Doribax doripenem dose, indications, adverse effects. To compare safety and efficacy of doripenem versus. Some of these include meningitis, intraabdominal infection, pneumonia, sepsis, and anthrax. We have shown that carbapenems such as meropenem, doripenem, and ertapenem react with the enzyme to form enzymedrug. Meropenem vs standard of care for treatment of late. Doripenem definition of doripenem by medical dictionary. It combines the in vitro activities of imipenem and ertapenem against grampositive bacteria with the in vitro activity.
Feb 24, 2010 comparison of the major carbapenems imipenemcilastatin versus meropenem slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. To compare safety and efficacy of doripenem versus imipenem. The carbapenem class was initiated by the development of imipenem in 1985 and expanded by the inclusion of meropenem in 1996 and most recently by the addition of ertapenem. Doripenem vs meropenem against pseudomonas and acinetobacter article in indian journal of medical microbiology 303.
We have shown that carbapenems such as meropenem, doripenem, and ertapenem react with the enzyme to form enzymedrug covalent complexes that are hydrolyzed extremely slowly. Thus, it has significant in vitro activity against streptococci, methicillinsusceptible staphylococci, enterobacteriaceae including extendedspectrum b. Of 263 patients with nosocomial pneumonia 10 had seizures. It is a betalactam antibiotic drug able to kill pseudomonas aeruginosa doripenem can be used for bacterial infections such as. Find patient medical information for doripenem intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Monographs for commonly administered intravenous medications. Carbapenem antibiotics are cell wall synthesis inhibitors and belong to the. Doripenem a new broadspectrum carabapenem antibiotic. Carbapenems have stood the test of time so far but resistance. Approximately 70% 50% to 75% of a meropenem dose administered intravenously is recovered unchanged in the urine over 12 hours 1. For nmr studies, meropenem and doripenem solutions 12. Tore midtvedt, in side effects of drugs annual, 2011. A total of 212 patients entered the study, 107 in the meropenem group and 105 in the imipenemcilastatin group. Doripenem displays the favourable characteristics of other carbapenems, and appears to offer certain.
All references to doripenem activity are expressed in terms of the active doripenem moiety. Doripenem is usually given for 5 days to 2 weeks, depending on the condition being treated. 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. Comparative efficacy of doripenem versus meropenem for. Imipenem, meropenem, and doripenem mics for pseudomonas aeruginosa isolates were determined using etests and compared according to the. Neomero1, an open label, randomised, comparator controlled, superiority trial aims to compare the. Single dose minibags can be infused over 1530 minutes. Michael scheld, in antibiotic and chemotherapy ninth edition, 2010. Doripenem doribax, finibax is an antibiotic drug in the carbapenem class. Doripenem vs meropenem against pseudomonas and acinetobacter.
Department of clinical microbiology, trinity college dublin, dublin, ireland. Carbapenems have stood the test of time so far but resistance is emerging. Isolates responsible for vap recurrence obtained from few carbapenemtreated patients remained meropenem or doripenem susceptible but were imipenem resistant. Carbapenems have stood the test of time so far but. Louis, mo, usa or were provided by their domestic manufacturers ertapenem and imipenem from merck. The mics of doripenem, meropenem, ertapenem, and noncarbapenems for. Doripenem, meropenem, and ertapenem all possess a 1betamethyl side chain that provides resistance to the renal enzyme dehydropeptidase i. This medication is known as a carbapenemtype antibiotic. Imipenem, meropenem, or doripenem to treat patients with. As for clinical cure rates among microbiologically evaluable patients, doripenem was determined to be noninferior to meropenem at 25 to 45 days at the end of treatment. Doripenem has now been on the market for about 5 years. 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.
Doripenem has a similar profile to meropenem but is more active against pseudomonas. Causative pathogens with carbapenem high level resistance with minimal inhibitory concentration of doripenem meropenem 8 mgl were excluded. Its antimicrobial spectrum more closely resembles those of meropenem and imipenem than that of ertapenem. Tebipenem, a new carbapenem antibiotic, is a slow substrate. Meropenem is a carbapenem with a broad spectrum of activity against betalactamaseproducing organisms.
We also highlight important features of the carbapenems that are presently in clinical use. Only limited data exist on pseudomonas aeruginosa ventilatorassociated pneumonia vap treated with imipenem, meropenem, or doripenem. Two hundred and seventy four patients will be randomly assigned to receive either doripenem or imipenem with placebo of the other medication given simultaneously to maintain the blind eg, 1 group will receive blinded. Doripenem is a broadspectrum, carbapenem antibiotic with bactericidal and betalactamase resistant activities. Marketed under the brand name doribax in europe and the us, it is an. Valproic acid is widely used in the treatment of generalized tonicclonic and partial seizures. 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. Meropenem versus imipenemcilastatin in the treatment of serious bacterial infections in icu. You may be switched to an oral pill form antibiotic after the first few days of receiving doripenem by injection. The demographic and baseline clinical characteristics of the two groups were similar.
The pharmaceutical journal 21 jun 2014 by jenny bryan. 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. 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 nursing visit. Efficacy of doripenem in the treatment of pseudomonas aeruginosa experimental pneumonia versus imipenem and meropenem article pdf available in journal of antimicrobial chemotherapy 6511. In general, imipenem, panipenem, and doripenem are potent antibiotics against grampositive bacteria 11, 72, 190, 194. Comparison of the major carbapenems imipenemcilastatin versus meropenem slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 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. Doribax, doripenem dosing, indications, interactions.
Apr 16, 2020 22,23 doripenem is twofold more active than meropenem and twofold to eightfold more active than ertapenem against oxacillinsusceptible s. Doripenem is used to treat severe infections of the stomach, bladder, or kidneys. A multicenter, openlabel, randomized, parallelgroup trial was conducted in belgium, evaluating empirical monotherapy with meropenem or imipenemcilastatin both 1 g8 h intravenously in icu patients with one or more of the following infections caused by sensitive pathogens. Doripenem is an intravenously administered carbapenem with a broad spectrum of activity against many multidrugresistant pathogens, including aerobic or anaerobic gramnegative and grampositive microorganisms. To compare safety and efficacy of doripenem versus imipenemcilastatin in patients with ventilatorassociated pneumonia. Doripenem injection is used to treat serious infections of the urinary tract, kidney, and abdomen that are caused by bacteria. Meropenem versus imipenemcilastatin as empirical monotherapy.
Its safety is similar to that of other carbapenems. We have previously shown that blac has an extremely broad spectrum of activity against penicillins and cephalosporins but weak activity against newer carbapenems. The use of doripenem in uti, including pyelonephritis, with or without anatomical or functional abnormalities was evaluated in a multicenter trial. Doribax is contraindicated in patients with known serious hypersensitivity to doripenem or to other drugs in the same class or in patients who have demonstrated anaphylactic reactions to betalactams. Meropenem is an antibiotic with wide antibacterial coverage. Mechanisms such as drug inactivation by carbapenemhydrolyzing enzymes, mutant or acquired volume 23, issue 4 january 2008 doripenem. We have shown that carbapenems such as meropenem, doripenem, and ertapenem react with the enzyme to form. Doripenem is an injectable carbapenem antibiotic with a spectrum of activity comparable to that of imipenem and meropenem. If you continue browsing the site, you agree to the use of cookies on this website. In vitro antibacterial interaction of doripenem and amikacin against. Higher synergy can be achieved by combining 2 or 3 antibiotics of aminoglycosides, aztreonam, carbapenem, colistin, rifampin, tigecycline. The advantage of it over standard of care could be its wider antibacterial coverage and thus the use of monoinstead of combination therapy. Doripenem side effects, dosage, interactions drugs.
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