All references to doripenem activity are expressed in terms of the active doripenem moiety. Doripenem is administered intravenously as an infusion over 1 hour. For nmr studies, meropenem and doripenem solutions 12. Safety of intravenous infusion of doripenem pdf paperity. During clinical investigations, the overall seizure rate in meropenemtreated patients was 0. Doripenem doribax, a new carbapenem antibacterial agent. Carbapenems, including imipenem and meropenem, remain the mainstay. Laboratory detection of imipenem or meropenem resistance. Older carbapenems, such as imipenem, were often susceptible to degradation by the enzyme dehydropeptidase1 dhp1 located in renal tubules and required coadministration with a dhp1 inhibitor such as cilastatin. 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.
Whereas doripenem had the highest mic 90 for the 1107 klebsiella. Doripenem is a powder that must be mixed with a liquid diluent. Doripenem clinical infectious diseases oxford academic. Single dose minibags can be infused over 1530 minutes. The efficacy and safety of doripenem in the treatment of. After more than a year in clinical use, there are no reports of doripenemrelated seizures. Doripenem has been developed to date for intravenous use.
Doribax doripenem dose, indications, adverse effects. Therefore, we conducted a prospective observational study in 169 patients who developed pseudomonas aeruginosa vap. 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. Characterization of kpc, ndm and vim type carbapenem. After more than a year in clinical use, there are no reports of doripenem related seizures. The enhanced potency of doripenem, compared with imipenem, against p. The demographic characteristics of patients are shown in table 1. Doripenem injection is used to treat serious infections of the urinary tract, kidney, and abdomen that are caused by bacteria. If possible, store supplies containing carbapenems at the coldest temperature. Thus, it has significant in vitro activity against streptococci, methicillinsusceptible staphylococci, enterobacteriaceae including extendedspectrum b. We use cookies to offer you a better experience, personalize content, tailor advertising, provide social media features, and better understand the use of our services. Doripenem is distributed into most body fluids and tissues, including bile, gallbladder, peritoneal exudate, retroperitoneal fluid, and urine.
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. Stability of meropenem and doripenem solutions for. Dec 01, 2018 doripenem for injection was noninferior to meropenem with regard to clinical cure rates in microbiologically evaluable me patients, i. Only limited data exist on pseudomonas aeruginosa ventilatorassociated pneumonia vap treated with imipenem, meropenem, or doripenem. The pooled odds ratio or with 95% credible interval cri was calculated by markov. Apr 26, 2020 doripenem is active against both haemophilus influenzae mic 90, 0.
The mic 90 value of doripenem was at least 1 doubling dilution lower than the other carbapenems against ceftazidime susceptible or resistant enterobacter aerogenes and enterobacter cloacae. Doripenem side effects, dosage, interactions drugs. Pdf comparative efficacy of doripenem versus meropenem for. Later additions to the class such as meropenem, ertapenem and. Doribax, doripenem monohydrate for injection vials contain 500 mg of doripenem on an anhydrous basis, a white to slightlyyellowish offwhite sterile crystalline powder. It is a betalactam antibiotic drug able to kill pseudomonas aeruginosa doripenem can be used for bacterial infections such as. Efficacy and tolerability of iv doripenem versus meropenem. Comparative efficacy of doripenem versus meropenem for hospital. Possible factors involved in oral inactivity of meropenem, a. Doripenem is a broadspectrum, carbapenem antibiotic with bactericidal and betalactamase resistant activities. Compared to the meropenem group, the doripenem group was younger and had a higher sequential organ.
No convulsions were observed in mice given doripenem or meropenem at doses as high as 100 mg per mouse. Monographs for commonly administered intravenous medications in home and community care 1 p a g e meropenem 1drug class antibiotic carbapenem spectrum1,2 refer to product monograph for complete spectrum staphylococcus aureus, group d strep, aerobic gram negative acinetobacter species, citrobacter species, enterobacter cloacae, haemophilus influenza, escherichia coli. Doripenems chemical structure is very similar to that of meropenem, except that at position 2 the dimethylcarbamoyl side chain of meropenem is replaced by. We included randomized controlled trials rcts comparing different carbapenems vs tgc for the treatment of ciais. 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. 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. The purpose of this study was to compare the efficacy of doripenem dori vs. Carbapenems vs tigecycline for the treatment of complicated. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. May reduce serum valproic acid conc to subtherapeutic level. A phase iii, prospective, multicenter, randomized, doubleblind, noninferiority study 7 hospitalized adult patients with complicated intraabdominal infections n 476 doripenem 500 mg iv q 8 hr meropenem 1 g iv q 8 hr primary outcome. In the second study, the doripenem rate was 81% and the meropenem rate was 82. Noninferiority was also observed among the microbiological modified intenttotreat patients, which included those with. 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.
Nov 09, 2018 doripenem is a powder that must be mixed with a liquid diluent. Imipenem, meropenem, or doripenem to treat patients with. Doripenem provides another treatment option for resistant bacteria, particularly gram negative organisms. Studies suggest meropenem may be more stable than imipenem. Later additions to the class such as meropenem, ertapenem and doripenem. However, for either antimicrobial agent, storage conditions of susceptibility panels, cards, and disks must be monitored carefully and quality control results checked frequently. Predicting doripenem susceptibility based on meropenem and. Hypersensitivity to doripenem, betalactams or similar drugs. Pubmed, embase, medline via ovid sp and cochrane library databases were systematically searched. You may be switched to an oral pill form antibiotic after the first few days of receiving doripenem by injection. Comparative efficacy of doripenem versus meropenem for.
Based on these findings, doripenem use in ciai may be comparable to the use of meropenem. Fiftyseven patients with doripenem and 252 patients with meropenem were analyzed. For determination of mic of doripenem and meropenem, etest strips biomerieux india pvt. To compare safety and efficacy of doripenem versus. Pdf comparative efficacy of doripenem versus meropenem. Doripenem s chemical structure is very similar to that of meropenem, except that at position 2 the dimethylcarbamoyl side chain of meropenem is replaced by the sulfamoylaminoethylpyrrolidinylthio. Doripenem fda prescribing information, side effects and uses. Imipenem, meropenem, or doripenem to treat patients with pseudomonas aeruginosa ventilatorassociated pneumonia charlesedouard luyt, a, d alexandra aubry, b, d qin lu, c, d maite micaelo, b, d nicolas brechot, a, d florence brossier, b, d helene brisson, c, d jeanjacques rouby, c, d jeanlouis trouillet, a, d alain combes, a, d. Compared with other carbapenems such as meropenem and imipenem, doripenem demonstrates similar broadspectrum microbiological antibiotic activity against most gramnegative rods. Sigmaaldrich, st louis, mo, usa supplemented with 0. Doripenem does not appear to have proconvulsive activity.
In this study, using meropenem as a model carbapenem, we addressed factors restricting. Possible factors involved in oral inactivity of meropenem. Its antimicrobial spectrum more closely resembles those of meropenem and imipenem than that of ertapenem. The pooled odds ratio or with 95% credible interval cri was calculated by. This specific strain was distributed as an educational.
Comparative efficacy of doripenem versus meropenem for hospitalacquired and ventilatorassociated pneumonia. During clinical investigations, the overall seizure rate in meropenem treated patients was 0. This medication is known as a carbapenemtype antibiotic. Risk of clostridium difficileassociated diarrhea on longterm use. The aim of this study was to compare the efficacy and safety between doripenem and meropenem for patients with hap or vap. Laboratory detection of imipenem or meropenem resistance in. Sep 17, 2012 meropenem merrem, meronem is a broadspectrum antibacterial agent of the carbapenem family, indicated as empirical therapy prior to the identification of causative organisms, or for disease caused by single or multiple susceptible bacteria in both adults and children with a broad range of serious infections. Peritoneal and retroperitoneal fluid concentrations either match or.
Doripenem vs meropenem against pseudomonas and acinetobacter. Results of the trial showed that clinical cure rates of microbiologicallyevaluable patients were 84. Meropenem is approved for use in complicated intraabdominal infection ciai. 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. You will need to place the doripenem and diluent mixture in an iv bag of infusion solution before using it. Doripenem, the latest member of the carbapenem class, was approved by the us food and drug administration fda in 2007. Microbiological cure eradication or presumed eradication was 78. Doribax, doripenem dosing, indications, interactions. Agents with antipseudomonal activity, including doripenem, imipenem, and meropenem are not recommended in this population. The carbapenem ertapenem is one of several firstline agents recommended by the infectious disease society of america for the empiric treatment of communityacquired intraabdominal infections of mildtomoderate severity. To compare safety and efficacy of doripenem versus imipenem.
Doripenem is used to treat a wide variety of bacterial infections. Whereas doripenem had the highest mic 90 for the 1107. Doripenem doribax, finibax is an antibiotic drug in the carbapenem class. 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. 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 from days 1 to 7 and imipenem placebo days 1 to 10, other group will receive blinded imipenem days 1 to 10 and. There were no differences in gender, underlying diseases of solid organ or hematologic malignancies, solid organ or bone barrow transplants, chronic obstructive pulmonary disease copd, coronary. Monographs for commonly administered intravenous medications. Jan 10, 2008 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 from days 1 to 7 and imipenem placebo days 1 to 10, other group will receive blinded imipenem days 1 to 10 and. Initial results suggested that combination therapy of vancomycin or teicoplanin with doripenem, panipenem, meropenem or imipenem would be effective for severe infections. Imipenem, meropenem, and doripenem mics for pseudomonas aeruginosa isolates were determined using etests and compared according to the. Other available agents in the same class include imipenem cilastatin primaxin, meropenem merem, and ertapenem invanz. Doripenem for injection was noninferior to meropenem with regard to clinical cure rates in microbiologically evaluable me patients, i. Comparative evaluation of invitro doripenem susceptibility with.
Pharmacology and pharmacokinetics 1,2,3 doripenem is a parenteral bactericidal antibiotic which has a chemi. Meropenem and doripenem are thought to be the more potent in vitro agents against gram negative organisms. Doripenem is usually given for 5 days to 2 weeks, depending on the condition being treated. The doripenem clinical cure rate in microbiologically evaluable patients was 74. Data on file, sentry antimicrobial surveillance program. Iv doripenem versus meropenem in adults with complicated intraabdominal infection. Doripenem and meropenem had the lowest mic 90 s against esbl producing escherichia coli and klebsiella isolates ge 2004. A general consensus appears to exist among clinicians that imipenem is the most epileptogenic among carbapenems, 4,5 despite inconsistencies in the literature to support this belief. 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. May 01, 2008 results of the trial showed that clinical cure rates of microbiologicallyevaluable patients were 84. Valproic acid doripenem reduced the serum concentrations of valproic acid to below the therapeutic concentration range in healthy subjects 7. However, doripenem and meropenem were effective against 6. Doripenem is a new parenteral antibiotic from the carbapenem class. Doripenem is active against both haemophilus influenzae mic 90, 0.