Uses of Doripen: - Severe bacterial infections Intra-abdominal infections, Bacterial infections, Septicemia, Nosocomial pneumonia, Urinary tract infections, Pyelonephritis Hypersensitivity; anaphylactic reactions to beta-lactams.

Other beta-lactam Antibiotics

Doripenem is a synthetic broad-spectrum carbapenem β-lactam antibiotic with potent in vitro antibacterial activity against aerobic and anaerobic gm+ve and gm-ve bacteria including Pseudomonas aeruginosa. It inhibits bacterial cell wall synthesis by binding to several penicillin-binding proteins, which in turn inhibits the final transpeptidase step of peptidoglycan synthesis in bacterial cell walls.

How to use Doripenem: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: Reconstitution: Reconstitute 500 mg vial w/ 10 mL of sterile water for inj or NaCl 0.9% inj to form a susp containing 50 mg/mL. Further dilute the reconstituted vial w/ 100 mL of NaCl 0.9% or dextrose 5% inj, gently shake until clear. For a 250 mg dose, contents of the reconstituted vial should be withdrawn and added to 100 mL NaCl 0.9% infusion bag or dextrose 5% inj. Remove and discard 55 mL from the infusion bag to leave the remaining soln. IV Administration Infuse over 1 hr Adult Dose: Intravenous Complicated intra-abdominal infections Adult: 500 mg 8 hrly infused over 1 hr for 5-14 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement. Complicated urinary tract infections; Pyelonephritis Adult: 500 mg 8 hrly infused over 1 hr for 10 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement. Duration can be extended up to 14 days for patients w/ concurrent bacteraemia. Child Dose: <18 years: Safety and efficacy not established Renal Dose: Renal impairment: CrCl (ml/min) 30-50 250 mg every 8 hr by IV infusion over 1 hr 11-29 250 mg every 12 hr by IV infusion over 1 hr

Increased plasma concentration w/ probenecid. May decrease plasma levels of valproic acid thus, increasing the risk of seizures.

Hypersensitivity; anaphylactic reactions to beta-lactams.

Common - Vomiting - Nausea - Injection site reactions (pain, swelling, redness) >10% Headache (4-16%),Nausea (4-12%),Diarrhea (6-11%) 1-10% Anemia (2-10%),Phlebitis (4-8%),Rash (1-5%),Pruritus (3%),Transaminases elevated (1-2%),Oral candidiasis (1%),Renal impairment/failure (1%) Potentially Fatal: Anaphylaxis, toxic epidermal necrolysis, Stevens-Johnson Syndrome, interstitial pneumonia, seizure.

Pregnancy Category B. Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Precaution: May decrease serum concentration of valproic acid to below therapeutic range thus increasing risk of breakthrough seizure; consider alternative antimicrobial agents or additional anti-seizure medications if concurrent usage is necessary. Prolonged use may result in Clostridium difficile-associated diarrhoea (CDAD). May cause development of drug-resistant bacteria when used in the absence of proven or strongly suspected bacterial infection. Renal impairment. Safety and efficacy have not been established in patients <18 yr old. Lactation: unknown if excreted in breast milk; use caution

Reconstituted suspension may be held for 1 hr prior to dilution in infusion bag. Following dilution of the suspension with NaCl 0.9%, stability is 8 hr at room temperature or 24 hr between 2-8°C. Stability of solution when diluted with dextrose 5% injection is 4 hr at room temperature or 24 hr between 2-8°C.

Other beta-lactam Antibiotics

Doripenem is a broad-spectrum carbapenem with potent in vitro antibacterial activity against aerobic and anaerobic gram-positive and gram-negative bacteria including Pseudomonas aeruginosa. It inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins; which in turn inhibits the final transpeptidase step of peptidoglycan synthesis in bacterial cell walls.

Pregnancy Category: B Lactation: unknown if excreted in breast milk; use caution