Doripenem

[Doripenem photo]

KEY POINTS

Doripenem (Doribax) is an injectable carbapenem and beta-lactam antibiotic that interferes with bacterial cell wall synthesis in sensitive organisms
Use is commonly reserved for infections due to drug-resistant Gram negative bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and E. coli
- Doripenem is believed to have enhanced activity versus Pseudomonas aeruginosa, however promising in vitro data has not translated into better clinical outcomes as compared to other anti-pseudomonal carbpanems (i.e., meropenem and imipenem-cilastatin)
- DOES NOT cover MRSA or VRE
- Carbapenems like doripenem are generally considered the drugs of choice for ESBL-producing organisms (aka ESBL-positive organisms)
  - ESBL = extended-spectrum beta-lactmase
- Reserve this “big gun” antibiotic until you absolutely have to use it
Holds FDA-approval for:
- Complicated intra-abdominal infection
- Complicated urinary tract infections, including pyelonephritis
Typical dose is 500mg every 8 hours in adults
- Adjust doses when kidney function is below creatinine clearance of 50 mL/min
Patients who are allergic to penicillins or cephalosporins may also be allergic to carbapenems
- Generally speaking cross-reactivity is low, be more concerned in patients with a history of severe allergic reaction
Beware seizures and hypersensitivity
Beware drug interaction with valproic acid, as doripenem can reduce valproic acid concentrations
Hospital commonly carry meropenem or doripenem, but not both

RESOURCES