Doripenem

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications:

• Nosocomial pneumonia, excluding ventilator-associated pneumonia due to : Staphylococcus aureus (methicillin-susceptable strains only), Streptococcus pneumonia, Acinetobacter baumannii, Enterobacter cloacae, Escherichia coli, Klebsiella pneumonia, Haemophilus influenza, Pseudomonas aeruginosa
• Complicated intra-abdominal infections, due to: Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Bacteroides caccae, Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatis, Enterococcus faecalis, Streptococcus intermedius, Streptococcus constellatus, Peptostreptococcus micros
• Complicated urinary tract infections, including pyelonephritis, due to: Escherichia coli (including levofloxin-resistant strains) with or without co current bacteremia, Klebsiella pneumonia, Proteus mirabilis, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterococcus faecalis

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to beta-lactam antibiotics

Cautions

• Breastfeeding
• Moderate to severe renal impairment
• Hepatic Impairment
• Ventilator associated pneumonia
• Central nervous system disorders

Forms avail. in SA and covered in this monograph: inj

Infections caused by: Gram positive cocci (excluding Enterococci spp.), Gram negative bacilli (including E. coli, Klebsiella pneumonia, Pseudomonas aeruginosa), Some anaerobic cover (including Bacteroides spp., Peptostreptococcus micros) 

General dosing range

• IV: 500mg, 8hrly; Treatment duration: 5-14 days

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Nosocomial infection

• IV: 500mg, 8hrly, infused over 1-4hrs; Treatment duration: 7-14 days

Complicated intra-abdominal infection

• IV: 500mg, 8hrly, infused over 1hr; Treatment duration: 5-14 days

Complicated urinary tract infection
Pyelonephritis

• IV: 500mg, 8hrly, infused over 1hr; Treatment duration: 10 days

Infuse in 0.9% sodium chloride or 5% dextrose

No information available

Pregnancy

• Caution; no evidence of risk in studies
• Animal reproduction studies reveals no adverse events, including teratogenicity
• There are no human pregnancy data available

Breastfeeding

• Caution
• It is unknown if doripenem is excreted into breast milk
• A decision must be made whether to discontinue breastfeeding or discontinue doripenem taking into account the benefit of breastfeeding for the child and the benefit of therapy for the mother

Renal Impairment

• Moderate to severe: Caution; dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended 

Elderly

• No dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warning

Central Nervous System Disorders

• Headache

Cardiovascular Disorders

• Phlebitis

Gastrointestinal Disorders

• Nausea 
• Diarrhoea

Hepatobiliary Disorders

• Elevated hepatic enzymes

Skin and Subcutaneous Tissue Disorders

• Pruritis 
• Rash

Immune, Blood and Lymphatic System Disorders

• Oral candidiasis 
• Vulvomycotic infection

• Probenecid
• Valproic acid
• Sodium picosulfate
• Typhoid vaccine
• Cholera vaccine
• Bacillus Calmette–Guérin vaccine (intravesical)

None routine. Specific cases may require

• Renal function

Doripenem is a broad-spectrum carbapenem with in vitro antibacterial activity against aerobic and anaerobic gram-positive and gram-negative bacteria.

Spectrum of activity: Gram positive cocci (excluding Enterococci spp.) ; Gram negative bacilli (including E. coli, Klebsiella pneumonia, Pseudomonas aeruginosa); Some anaerobic cover (including Bacteroides spp., Peptostreptococcus micros) 

Injection (per vial) 500mg

• Doribax ( Acino Pharma) originator