___________________________________________________________________________ Antibiotics Review
THE OTHER BETA-LACTAMS
Agent
Adult Dosing Range
Pediatric Dosing Range
Route
Common Side Effects
Comments
Carbapenems Doripenem
500 mg every 8 hours for 5 to 14 days
Not studied for pediatric use
IV
Headache, rash, nausea, vomiting, diarrhea, phlebitis
Dosage adjustment necessary for renal impairment. Cannot be used in patients with known serious hypersensitivity or history of anaphylaxis to any beta- lactam antibiotic. Seizure risk in patients with CNS disorders. Seizure risk in patients with CNS disorders. IV therapy may be administered for up to 14 days; IM for up to 7 days. Documentation of cross- allergy with penicillin allergy is limited. Seizure risk in patients with CNS disorders. Adults <70 kg may require decreased dosing. Documentation of cross- allergy with penicillin allergy is limited. Seizure risk in patients with CNS disorders. Can cause elevated LFTs. Seizure risk in patients with CNS disorders.
Ertapenem
1 g/day for 3 to 14 days
15 mg/kg every 12 hrs Max: 1 g/day for 3 to 14 days
IV, IM Diarrhea, nausea, phlebitis at infusion site
Imipenem/ cilastatin
500–1,000 mg every 6 to 8 hrs Max: 4 g/day
>3 mos: 15–25 mg/kg every 6 hrs Max: 4 g/day
IV
Phlebitis at infusion site, rash
Imipenem/ cilastatin/ relebactam
1.25 g every 6 hours for a 5-14 days
N/A
IV
Anemia
Meropenem
1.5–6 g/day in 3 divided doses
Infants <3 mos (IV): Gestational age <32 weeks AND postnatal age <14 days: 20 mg/ kg/dose every 12 hrs Postnatal age ≥14 days: 20 mg/kg/dose every 8 hrs Gestational age ≥32 weeks AND postnatal age <14 days: 20 mg/kg/dose every 8 hrs Postnatal age ≥14 days: 30 mg/kg/dose every 8 hrs >3 mos and <50 kg: 30–120 mg/kg/day in 3 divided doses Max: 6 g/day >50 kg: Same as adult dosing Not studied in pediatric patients
IV
Diarrhea, nausea, inflammation at the injection site, headache
Meropenem/ vaborbactam
4 g every 8 hrs for <14 days
IV
Headache, GI symptoms, phlebitis at infusion site
Dosage adjustment necessary for renal impairment.
Table 3 continues on next page.
THE OTHER BETA-LACTAMS (Continued)
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