Carbapenem stewardship: does ertapenem affect Pseudomonas susceptibility to other carbapenems? A review of the evidence

• Published in: International journal of antimicrobial agents Vol. 39; no. 1; pp. 11 - 15
• Main Authors: Nicolau, David P, Carmeli, Yehuda, Crank, Christopher W, Goff, Debra A, Graber, Christopher J, Lima, Ana Lucia L, Goldstein, Ellie J.C
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01-01-2012; Elsevier
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; beta-Lactams - pharmacology; beta-Lactams - therapeutic use; Biological and medical sciences; Carbapenem; Carbapenems - pharmacology; Carbapenems - therapeutic use; clinical trials; Clinical Trials as Topic; Drug Interactions; Drug Resistance, Bacterial; Ecology; Enterobacteriaceae; Ertapenem; Humans; imipenem; Infectious Disease; Medical sciences; Microbial Sensitivity Tests; pathogens; patients; Pharmacology. Drug treatments; Pseudomonas; Pseudomonas - drug effects; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Pseudomonas Infections - drug therapy; Pseudomonas Infections - microbiology; Stewardship; Susceptibility; Stewardship; Carbapenem; Ecology; Pseudomonas; Susceptibility; Ertapenem; Pseudomonadales; β-Lactams; Review; Antibiotic; Carbapenem derivatives; Sensitivity; Bacteria; Pseudomonadaceae; Antibacterial agent; Bibliographic review
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2011.08.018

Abstract The group 2 carbapenems (imipenem, meropenem and, more recently, doripenem) have been a mainstay of treatment for patients with serious hospital infections caused by Pseudomonas aeruginosa , Enterobacteriaceae and other difficult-to-treat Gram-negative pathogens as well as mixed aerobic/anaerobic infections. When ertapenem, a group 1 carbapenem, was introduced, questions were raised about the potential for ertapenem to select for imipenem- and meropenem-resistant Pseudomonas. Results from ten clinical studies evaluating the effect of ertapenem use on the susceptibility of Pseudomonas to carbapenems have uniformly shown that ertapenem use does not result in decreased Pseudomonas susceptibility to these antipseudomonal carbapenems. Here we review these studies evaluating the evidence of how ertapenem use affects P. aeruginosa as well as provide considerations for ertapenem use in the context of institutional stewardship initiatives.