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Meropenem vs Ertapenem
Introduction
For patients with severe bacterial infections, specific drugs known as antibiotics can aid in combatting the infection and managing symptoms. Meropenem and Ertapenem are two such drugs often prescribed during grave situations like these. Both belong to the carbapenem class of antibiotics that work by inhibiting bacterial cell wall synthesis, ultimately leading to the death of susceptible bacteria.
Meropenem is a broad-spectrum antibiotic frequently used in treating pneumonia, urinary tract infections (UTIs), and intra-abdominal infections. On the other hand, Ertapenem has a slightly narrower spectrum but still effective against many gram-positive and gram-negative bacteria including those causing community-acquired pneumonia, UTIs, skin structure infections among others.
It's important to note that although both are potent weapons against numerous types of bacteria, they should only be used under medical supervision due to potential side effects which may include headache, nausea or diarrhea.
Meropenem vs Ertapenem Side By Side
| Attribute | Merrem | Invanz |
|---|---|---|
| Brand Name | Merrem | Invanz |
| Contraindications | Allergy to meropenem or other carbapenems, kidney disorders, interaction with seizure medications like valproic acid/sodium valproate/divalproex sodium | Allergy to ertapenem or other carbapenems, kidney disorders, interaction with seizure medications like valproic acid/sodium valproate/divalproex sodium |
| Cost | $60-$70 per vial (Generic), $800–$850 for 10 vials (Brand Name) | $75-$90/vial (Generic), $110-$120 per vial (Brand Name) |
| Generic Name | Meropenem | Ertapenem |
| Most Serious Side Effect | Seizures or convulsions, allergic reactions, unusual bleeding or bruising, kidney problems | Severe allergic reactions, seizures, diarrhea that is watery or bloody |
| Severe Drug Interactions | Valproic acid/sodium valproate/divalproex sodium | Valproic acid/sodium valproate/divalproex sodium |
| Typical Dose | 500 mg to 1 g every 8 hours, up to 2g every eight hours for severe infections | 1g/day via intravenous or intramuscular injection |
What is Meropenem?
Meropenem (the generic name for Merrem) was the first drug of the carbapenem class of antibiotics, which marked a significant advancement from the earlier class of penicillin antibiotics. Meropenem was first approved by the FDA in 1996. It works by inhibiting bacterial cell wall synthesis, effectively "trapping" bacteria and leading to their death. It is prescribed for the treatment of various forms of severe infections caused by susceptible bacteria. Meropenem has a broad-spectrum activity against Gram-positive, Gram-negative and anaerobic bacteria with minor influence on normal human flora, resulting in it having fewer side effects than other antibiotics that have stronger effects on these beneficial microbes.
On the other hand, Ertapenem (Invanz) is another member of this antibiotic group but differs slightly in its spectrum and dosing frequency. While also effective against many types of bacteria, it doesn't cover as wide a range as meropenem does which makes it more targeted but less versatile.
What conditions is Meropenem approved to treat?
Meropenem is approved for the treatment of several severe bacterial infections:
- Intra-abdominal infections
- Bacterial meningitis
- Skin and skin structure infections,
- Complicated urinary tract infections, including pyelonephritis
On the other hand, ertapenem is used primarily to treat:
- Complicated intra-abdominal infections
- Complicated skin and skin structure infections
- Community-acquired pneumonia
- Complicated urinary tract infections, including acute pyelonephritis -The prophylaxis of surgical site infection following elective colorectal surgery.
How does Meropenem help with these illnesses?
Meropenem is an antibiotic that fights bacteria by inhibiting the synthesis of their cell walls, leading to bacterial cell death. It does this by binding to penicillin-binding proteins (PBPs) which are involved in the final stages of assembling the bacterial cell wall. Hence, Meropenem blocks these PBPs and halts the construction of the microbial cell wall structure. This forms an integral part in combating a variety of severe infections caused by gram-positive, gram-negative, and anaerobic bacteria.
Ertapenem works similarly as it also belongs to a group of antibiotics known as carbapenems. However, its spectrum is narrower than that of meropenem; while still highly effective against many types of bacteria including some resistant strains, ertapenem doesn't cover Pseudomonas aeruginosa or Acinetobacter species - two pathogens frequently encountered in hospital settings. Therefore, when choosing between these drugs for treatment purposes, one must consider both patient-specific factors and local epidemiology.
What is Ertapenem?
Ertapenem, sold under the brand name Invanz among others, is a carbapenem antibiotic used primarily for the treatment of infections caused by gram-positive and gram-negative bacteria. It works by inhibiting bacterial cell wall synthesis which subsequently leads to cell death. First approved by the FDA in 2001, Ertapenem has proven to be effective against many types of infections including intra-abdominal infections, skin and soft tissue infections, community-acquired pneumonia as well as urinary tract infections.
Unlike Meropenem that requires multiple doses per day due to its short half-life, Ertapenem only needs once-a-day dosing because of its longer half-life providing patients with more convenience. However, it may not cover all varieties of bacteria that Meropenem can combat - so choosing between these antibiotics should be based on infection type and patient's specific needs. As an antibiotic drug class member known as carbapenems (like Meropenem), it does carry risks such as serious allergic reactions or seizures but generally has less side effects compared to other classes of antibiotics.
What conditions is Ertapenem approved to treat?
Ertapenem, a broad-spectrum antibiotic, is FDA-approved to treat a variety of infections caused by bacteria. These may include:
- Complicated intra-abdominal infections
- Skin and skin structure infections, including diabetic foot infection
- Community acquired pneumonia
- Urinary tract infections complicated by other factors such as kidney stones or catheters
How does Ertapenem help with these illnesses?
Ertapenem is a powerful carbapenem antibiotic that serves crucial roles in the fight against bacterial infections by inhibiting cell wall synthesis, leading to cell death. Just like Meropenem, it has broad-spectrum activity against many gram-positive and gram-negative bacteria. However, Ertapenem differs from Meropenem in its pharmacokinetic profile with a longer half-life allowing for once-daily dosing which can be beneficial for patient compliance. While both antibiotics are potent options, the choice between them often hinges on individual patient needs and responses. For instance, Ertapenem does not cover Pseudomonas aeruginosa or Acinetobacter species as effectively as Meropenem does; therefore it might not be the preferred choice when these organisms are suspected or confirmed as part of an infection.
How effective are both Meropenem and Ertapenem?
Both meropenem and ertapenem are effective carbapenems, a class of broad-spectrum antibiotics capable of treating a wide variety of bacterial infections. They were approved by the FDA in 1996 and 2001 respectively, marking their safety profiles as proven over time. Their mechanisms operate on similar principles, targeting bacteria cell wall synthesis to inhibit growth.
In terms of efficacy, both drugs exhibit potent antibacterial activity. A double-blind clinical trial conducted in 2013 comparing meropenem with ertapenem for severe intra-abdominal infections found that both antibiotics had comparable success rates in managing infection symptoms. No significant differences were noted between the two groups regarding adverse events or patient recovery times.
A comprehensive review published in Clinical Microbiology Reviews praised meropenem for its ability to combat serious gram-negative (including Pseudomonas aeruginosa) and gram-positive bacterial infections. It has been well-received due to its strong pharmacokinetic profile, allowing it penetration into various body tissues including cerebral spinal fluid making it an excellent choice for meningitis treatment.
Ertapenem stands out due to its impressive once-daily dosing regimen which can aid compliance especially where intravenous administration is involved; however unlike Meropenam it doesn’t cover pseudomonas species or enterococcus species hence not recommended if these pathogens are suspected . This makes Ertapenem less suited for hospital-acquired infections but more convenient when used outside hospitals settings e.g., home IV therapy services. A meta-analysis from Therapeutic Advances in Drug Safety concluded that while there may be slight variations in side effect profiles--with gastrointestinal complications being slightly more common among those taking meropenem--both drug’s safety profiles remain generally favorable.
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At what dose is Meropenem typically prescribed?
Dosages of Meropenem typically range from 500 mg to 1 g, administered intravenously every 8 hours. However, for severe infections like meningitis or sepsis, the dosage can be increased up to a maximum of 2g every eight hours. On the other hand, Ertapenem is usually given as a single dose of 1 g per day either through intravenous infusion over at least half an hour or deep intramuscular injection. In any case, it's important to remember that these are antibiotics and their dosages should always be determined by a healthcare professional based on individual patient needs and response.
At what dose is Ertapenem typically prescribed?
Ertapenem treatment is typically initiated at a dosage of 1g/day, administered via intravenous or intramuscular injection. The dose can be given once daily, unlike many other antibiotics that require multiple doses per day. This single-dose regimen can continue for up to two weeks, depending on the type and severity of the infection. For severe infections or those caused by less susceptible bacteria, treatment duration may need to extend beyond two weeks. It's important to remember that like all antibiotics, Ertapenem should be taken for the full prescribed course even if symptoms have improved before completing therapy in order to prevent bacterial resistance.
What are the most common side effects for Meropenem?
Common side effects of meropenem can include:
- Headache
- Nausea, vomiting
- Diarrhea
- Skin rash or itching
- Injections site reactions (pain, redness, swelling)
While those using ertapenem may experience:
- Diarrhea
- Nausea, vomiting
- Headache
- Dizziness or drowsiness
- Pain or swelling at the injection site
It's important to remember that while these side effects could potentially occur, they are generally mild and manageable. However, it is always recommended that you seek medical advice if any unusual symptoms arise during the course of treatment with either medication.
Are there any potential serious side effects for Meropenem?
Meropenem and Ertapenem are both antibiotics, however they can occasionally cause potentially serious side effects that include:
- Signs of an allergic reaction such as difficulty breathing; swelling in your face or throat; hives; rash, peeling or blistering skin
- Seizures or convulsions
- Changes in mental status including confusion, hallucinations, agitation or decreased consciousness
- Unusual bleeding or bruising
- Kidney problems - little to no urination, painful urination, blood in the urine
- Diarrhea that is watery or bloody (which may occur months after you last dose)
If any of these severe adverse reactions happen while taking Meropenem and Ertapenem it's important to stop using the drug immediately and seek medical attention. Please note this list doesn't cover all possible side effects with these antibiotics. Always consult a healthcare professional for advice about potential risks associated with medication use.
What are the most common side effects for Ertapenem?
The administration of Ertapenem can potentially lead to:
- Headache or dizziness
- Nausea, vomiting, stomach pain, and constipation
- Sleep problems (insomnia)
- Rash or itching
- Swelling, pain or redness near the injection site
- Increased sweating and feeling anxious
- Changes in heart rate It's important to note that while these side effects may occur, they are not always a cause for concern. However, if they persist or worsen during treatment with Ertapenem, it is essential to consult your healthcare provider promptly.
Are there any potential serious side effects for Ertapenem?
Ertapenem, like all medications, can have potential side effects. It's important to monitor your health closely for these signs:
- Reactions of severe allergy: hives, itching or rash; fever with swollen glands; difficulty breathing or swallowing; swelling in the face or throat
- Hallucinations or changes in behavior and mood
- Seizures (convulsions)
- Development of a yeast infection in the mouth or vagina
- Diarrhea that is watery or bloody
- Sudden weakness accompanied by ill feeling, fever, chills, sore throat, mouth sores, swollen gums.
If you experience any of these symptoms while using Ertapenem stop taking it immediately and seek medical attention.
Contraindications for Meropenem and Ertapenem?
Both meropenem and ertapenem, like other antibiotics, may cause undesirable side effects in some people. If you notice any signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat seek immediate medical attention.
Neither meropenem nor ertapenem should be used if you have a history of allergy to either drug or other similar antibiotics (i.e., carbapenems). Always inform your physician about all the medications and supplements that you are taking.
Patients with kidney disorders need special caution while using these medications as they are excreted through kidneys and can accumulate if renal function is compromised. This could lead to an increase in the risk of seizures.
Antibiotics including meropenem and ertapenem can interact with certain other drugs such as valproic acid/sodium valproate/divalproex sodium used for controlling seizures thereby reducing their effectiveness. If you're on one of these seizure medicines while initiating therapy with either meropenem or ertapenem then alternative anti-seizure medication might be required.
Always provide a complete health history to your healthcare provider before starting new medication including details related to previous hypersensitivity reactions, underlying health conditions especially pertaining to liver or kidney diseases.
How much do Meropenem and Ertapenem cost?
For the brand name versions of these drugs:
- The price of 10 vials of Merrem (Meropenem, 1g each) averages around $800–$850. Typically administered every 8 hours, this works out to approximately $80–$85 per day depending on your dose.
- The price for a single vial of Invanz (Ertapenem, 1 g) is about $110-$120 and it is often used once daily which would equate to the same cost per day.
Thus, if you are prescribed the typical dosage for either drug (i.e., up to three times daily for Meropenem or once daily for Ertapenem), then brand-name Invanz might be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For generic versions:
- Generic meropenem costs between $60 and $70 per vial (1 g). If taken thrice daily as typically recommended by clinicians, this can amount to roughly $180 -210/day.
- Generic ertapenem prices range from about $75-$90/vial (1g). Given its usual prescription as one dose per day, your expenses will likely fall within this range.
Again remember: Cost isn't everything; effectiveness and side effects may vary between individuals. Always consult with your healthcare provider before making conclusions based solely on price comparisons.
Popularity of Meropenem and Ertapenem
Meropenem, in its generic form and under brand names such as Merrem, was estimated to have been prescribed to about 1.5 million people in the US in 2020. As a broad-spectrum antibiotic, meropenem is widely used for severe bacterial infections requiring hospitalization. It accounts for nearly 20% of carbapenem prescriptions, which are powerful antibiotics reserved for multidrug-resistant pathogens.
On the other hand, Ertapenem (also known as Invanz) is considered a more selective carbapenem antibiotic and was prescribed to approximately 500 thousand individuals within the same timeframe. This represents around 7% of total carbapenem prescriptions across the country. Although it's less commonly employed than meropenem due to its narrower spectrum of activity against bacteria types, it has maintained steady usage over recent years due to its once-daily dosing advantage compared with other drugs in this class that need multiple daily doses.
Conclusion
Both Meropenem and Ertapenem are broad-spectrum antibiotics belonging to the carbapenem group. They have been proven effective in treating severe bacterial infections, with a multitude of clinical studies backing their efficacy against various pathogenic strains. Both drugs can be used alone or combined with other antibiotics, depending on the severity and type of infection.
Meropenem has a broader range for gram-negative bacteria making it useful in conditions where the causative organism is uncertain. On the other hand, ertapenem tends to be reserved for specific infections due to its narrower spectrum but longer half-life which allows once-daily dosing.
Both antibiotics are available as generics providing potential cost savings for patients who must pay out-of-pocket. However, they require administration through intravenous infusion which could mean additional costs associated with hospital care.
Their side effect profiles show similarities including gastrointestinal disturbances like diarrhea or nausea among others. Allergic reactions such as rash may also occur with both drugs. Patients receiving these treatments should be closely monitored by healthcare professionals for signs of worsening condition or possible adverse drug reactions.
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Refrences
- Lowe, M. N., & Lamb, H. M. (2000, September). Meropenem. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200060030-00010
- Baldwin, C. M., Lyseng-Williamson, K. A., & Keam, S. J. (2008). Meropenem. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200868060-00006
- Mohr III, J. F. (2008, September 15). Update on the Efficacy and Tolerability of Meropenem in the Treatment of Serious Bacterial Infections. Clinical Infectious Diseases. Oxford University Press (OUP).http://doi.org/10.1086/590065
- Edwards, J. R. (1995, July 1). Meropenem: a microbiological overview. Journal of Antimicrobial Chemotherapy. Oxford University Press (OUP).http://doi.org/10.1093/jac/36.suppl_a.1
- Keating, G. M., & Perry, C. M. (2005). Ertapenem. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200565150-00013
- Teng, C. P., Chen, H. H., Chan, J., & Lye, D. C. B. (2007, October). Ertapenem for the treatment of extended-spectrum β-lactamase-producing Gram-negative bacterial infections. International Journal of Antimicrobial Agents. Elsevier BV.http://doi.org/10.1016/j.ijantimicag.2007.05.016
- Brink, A. J., Richards, G. A., Schillack, V., Kiem, S., & Schentag, J. (2009, May). Pharmacokinetics of once-daily dosing of ertapenem in critically ill patients with severe sepsis. International Journal of Antimicrobial Agents. Elsevier BV.http://doi.org/10.1016/j.ijantimicag.2008.10.005
- Sodhi, M., Axtell, S. S., Callahan, J., & Shekar, R. (2004, December 1). Is it safe to use carbapenems in patients with a history of allergy to penicillin?. Journal of Antimicrobial Chemotherapy. Oxford University Press (OUP).http://doi.org/10.1093/jac/dkh454