Predictors of ertapenem therapeutic efficacy in the treatment of urinary tract infections (UTIs) in hospitalized adults: the importance of renal insufficiency and urinary pH

  title={Predictors of ertapenem therapeutic efficacy in the treatment of urinary tract infections (UTIs) in hospitalized adults: the importance of renal insufficiency and urinary pH},
  author={Burke A. Cunha and J. Giuga and Steve Gerson},
  journal={European Journal of Clinical Microbiology \& Infectious Diseases},
In hospitalized adults acute uncomplicated cystitis (AUC) and catheter associated bacteriuria (CAB) may be treated with oral antibiotics. With AUC or CAB due to extended spectrum ß-lactamase (ESBL) + Gram negative bacilli (GNB) physicians often use intravenous therapy, e.g., ertapenem. We reviewed our recent experience in hospitalized adults with AUC and CAB treated with ertapenem. Therapeutic efficacy of ertapenem was assessed by decreased pyuria/bacteriuria, and elimination of the uropathogen… Expand
An infectious disease and pharmacokinetic perspective on oral antibiotic treatment of uncomplicated urinary tract infections due to multidrug-resistant Gram-negative uropathogens: the importance of urinary antibiotic concentrations and urinary pH
  • B. Cunha
  • Medicine
  • European Journal of Clinical Microbiology & Infectious Diseases
  • 2016
The importance of urinary antibiotic concentrations in determining the urinary spectrum of oral antibiotics and the effect of urinary pH are discussed as determinants of therapeutic efficacy. Expand


Ertapenem for the treatment of urinary tract infections caused by extended-spectrum β-lactamase-producing bacteria in children
The experience of ertapenem use in 50 patients with complicated UTIs, mainly pyelonephritis, caused by ESBL-producing organisms is reported, and ertapenem is promising for the culture-guided treatment of ESBL -producing Gram-negative complicatedUTIs. Expand
Clinical Efficacy of Ertapenem for Recurrent Cystitis Caused by Multidrug-Resistant Extended-Spectrum β-Lactamase-Producing Escherichia coli in Female Outpatients
Parenteral ertapenem treatment can be an effective and well-tolerated treatment option for intractable recurrent cystitis by multidrug-resistant ESBL-producing E. coli. Expand
Comparison of the effectiveness and antibiotic cost among ceftriaxone, ertapenem, and levofloxacin in treatment of community-acquired complicated urinary tract infections.
Among the three agents, ETP had better susceptibility than CRO and LVX, reached defervescence sooner, and was associated with shorter hospital stays, but using CRO in cUTIs was less expensive than the other two agents. Expand
In vitro susceptibility of recent antibiotic-resistant urinary pathogens to ertapenem and 12 other antibiotics.
In view of its significant antibiotic potency against antibiotic-resistant Enterobacteriaceae, ertapenem may constitute a good therapeutic alternative in urinary infections caused by these pathogens. Expand
Pharmacokinetics of ertapenem in outpatients with complicated urinary tract infections.
The authors' simulations suggested that a sufficiently high ertapenem concentration could be achieved in urine to overcome low to intermediate resistance. Expand
Impact of pH on Activity of Trimethoprim, Fosfomycin, Amikacin, Colistin and Ertapenem in Human Urine
The present in vitro findings indicate that acidification of urine during the treatment of UTIs should be carefully considered, and growth curves of one strain supports the concept of therapeutic or prophylactic acidification during UTIs. Expand
The outcome of treating ESBL infections with carbapenems vs. non carbapenem antimicrobials.
It is possible to successfully treat at least the less serious infections due to ESBL producing gram negative organisms with non-Carbapenem antimicrobials and will likely result in restricting the use of Carbapenems which may help preserve their efficacy against increasingly resistant organisms. Expand
The influence of urinary pH on antibiotic efficacy against bacterial uropathogens.
Clinicians should consider the urinary pH of patients when treating urinary tract infection, especially in complicated scenarios, and future clinical investigations examining urinary pH and antibiotic efficacy may result in the application of decreased antibiotic dosages and regimen durations. Expand
Ertapenem. A review of its microbiologic, pharmacokinetic and clinical aspects.
Ertapenem sodium (trade name Invanz, also designated as MK-0826, MK-826 and L-749345), manufactured by Merck & Co., Inc, is a structurally unique parenteral 1 beta-methyl carbapenem that demonstrates excellent activity against cephalosporin-resistant enteric organisms producing extended spectrum beta-lactamases (ESBLs) or AmpC beta- lactamased. Expand
Effects of Urine Matrix and pH on the Potency of Delafloxacin and Ciprofloxacin against Urogenic Escherichia coli and Klebsiella pneumoniae.
The potency of delafloxacin was further enhanced in the acidic environment commonly observed in the setting of urinary tract infection, and ciprofloxacIN showed a 1 doubling dilution increase for E. coli and no change for K. pneumoniae. Expand