For the treatment the following moderate to severe infections caused by susceptible isolates of the designated microorganisms: (1) complicated intra-abdominal infections due to <i>Escherichia coli</i>, <i>Clostridium clostridioforme</i>, <i>Eubacterium lentum</i>, <i>Peptostreptococcus</i> species, <i>Bacteroides fragilis</i>, <i>Bacteroides distasonis</i>, <i>Bacteroides ovatus</i>, <i>Bacteroides thetaiotaomicron</i>, or <i>Bacteroides uniformis</i>, (2) complicated skin and skin structure infections, including diabetic foot infections without osteomyelitis due to <i>Staphylococcus aureus</i> (methicillin susceptible isolates only), <i>Streptococcus agalactiae</i>, <i>Streptococcus pyogenes</i>, <i>Escherichia coli</i>, <i>Klebsiella pneumoniae</i>, <i>Proteus mirabilis</i>, <i>Bacteroides fragilis</i>, <i>Peptostreptococcus</i> species, <i>Porphyromonas asaccharolytica</i>, or <i>Prevotella bivia</i>, (3) community acquired pneumonia due to <i>Streptococcus pneumoniae</i> (penicillin susceptible isolates only) including cases with concurrent bacteremia, <i>Haemophilus influenzae</i> (beta-lactamase negative isolates only), or <i>Moraxella catarrhalis</i>, (4) complicated urinary tract infections including pyelonephritis due to <i>Escherichia coli</i>, including cases with concurrent bacteremia, or <i>Klebsiella pneumoniae</i>, (5) acute pelvic infections including postpartum endomyometritis, septic abortion and post surgical gynecologic infections due to <i>Streptococcus agalactiae</i>, <i>Escherichia coli</i>, <i>Bacteroides fragilis</i>, <i>Porphyromonas asaccharolytica</i>, <i>Peptostreptococcus</i> species, or <i>Prevotella bivia</i>.
The bactericidal activity of ertapenem results from the inhibition of cell wall synthesis and is mediated through ertapenem binding to penicillin binding proteins (PBPs). In <i>Escherichia coli</i>, it has strong affinity toward PBPs 1a, 1b, 2, 3, 4 and 5 with preference for PBPs 2 and 3. Ertapenem is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, and cephalosporinases and extended spectrum beta-lactamases. Ertapenem is hydrolyzed by metallo-beta-lactamases.
The mean bioavailability is approximately 90%.
The mean plasma half-life is approximately 4 hours.
Of the 80% recovered in urine, approximately 38% is excreted as unchanged drug and approximately 37% as the ring-opened metabolite.
* 0.12 liter/kg [adults] * 0.2 liter/kg [pediatric, 3 months to 12 years] * 0.16 liter/kg [pediatric patients 13 to 17 years]
* 1.8 L/h