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doripenem (Doribax)
Tradename: Doribax
Indications:
- bacterial infections due to susceptible organisms
- complicated urinary tract infection
- pyelonephritis
- intra-abdominal infections
- appendicitis
- cholecystitis
- bacterial peritonitis
- abdominal abscess [3]
- FDA approval for hospital-acquired pneumonia sought
Contraindications:
Pregnancy category: B
Dosage:
- 500 mg IV every 8 hours, infused over 1 hour
- 500 mg vials for reconstitution
reconstitute in 20 mL of normal saline of sterile water
stable at room temperature for 8 hours & for 24 hours refrigerated
Dosage adjustment for renal insufficiency:
- 250 mg every 8 hours for creatinine clears 30-50 mL/min
- 250 mg every 12 hours for creatinine clears 11-30 mL/min
Antimicrobial activity:
- broad spectrum, especially gram negative organisms
- E coli
- K pneumoniae
- P mirabilis
- P aeruginosa
- B caccae
- B fragilis
- B thetaiotaomicron
- B uniformis
- B vulgatus
- S intermedius
- S contellatus
- Peptostreptococus micros
Adverse effects:
- headache (16%)
- nausea (12%)
- diarrhea (11%)
- rash (5%)
- phlebitis (8%)
- lower risk for seizures than other carbapenems [2]
- increased mortality compared with imipenem cilastatin when used to treat ventilator-associated pneumonia [4]
- doripenem similar in efficacy & adverse events to other carbapenems [5]
Drug interactions:
- doripenem lowers valproic acid levels
Mechanism of action:
- inhibits bacterial cell wall synthesis
- CNS penetration not well defined [2]
General
carbapenem (thienamycin)
References
- Prescriber's Letter 14(12): 2007
Comparison of Carbapenem antibiotics
New Drug: Doribax (doripenem)
Detail-Document#: 231205
(subscription needed) http://www.prescribersletter.com
- Medical Knowledge Self Assessment Program (MKSAP) 16,
American College of Physicians, Philadelphia 2012
- Deprecated Reference
- FDA MedWatch. March 6, 2014
Doribax (doripenem): Drug Safety Communication - Risk When
Used to Treat Pneumonia on Ventilated Patients.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm388328.htm
- Rapid Review Quiz: Hospital-Acquired Pneumonia
Medscape. Sept 15, 2022
https://reference.medscape.com/viewarticle/980567