Overview:
Doripenem is a broad-spectrum antibiotic that can help treat various gram-positive and gram-negative bacteria. The drug gained FDA (Food and Drug Administration) approval in 2007 for treating complicated intra-abdominal infections and complicated urinary tract infections. It is administered intravenously in a clinical or hospital setting.
The FDA approval of the drug applies to specific indications and must be used under a healthcare professional's guidance. It is important to note that drug overuse can result in antibiotic resistance.
How Does Doripenem Work?
Dopirenem treats bacterial infections by killing the bacteria and preventing its growth. It is a broad-spectrum antibiotic belonging to the family of carbapenems. It is an antibiotic that helps inhibit the synthesis of the bacterial cell wall, which is required for the bacteria to multiply and survive.
The drug specifically attacks an enzyme called penicillin-binding protein (PBP) which is involved in the final stage of cell wall synthesis. It weakens and eventually leads to the destruction of the bacterial cell walls. Therefore, the bacteria become more vulnerable to osmotic pressure, which leads to the death of the bacteria.
Doripenem is effective against both gram-positive and gram-negative bacteria. However, overuse of antibiotics may result in antibiotic resistance. Therefore, it is important to use Doripenem as per the doctor’s prescription to avoid any complications in the future.
Uses:
Doripenem is used in the following medical conditions as it is highly effective in treating the following.
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In complicated urinary tract infections, Doperinem effectively eliminates the gram-negative bacteria from the urinary tract and minimizes the infection. It is highly effective against bacteria like Escherichia coli, pseudomonas, and Klebsiella pneumonia.
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In complicated intra-abdominal infections, the drug can effectively fight both gram-positive and gram-negative bacteria. This helps to treat abdominal infections and heal them effectively.
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The drug is also effective against bloodstream infections which could be caused by Staphylococcus aureus and Klebsiella pneumonia.
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In patients with ventilator-associated pneumonia, Doripenem is prescribed due to its broad-spectrum effects.
The drug is effective only in bacterial infections and cannot be used for viral infections like the common cold and flu. The drug can only be availed with a doctor’s prescription.
Dosage:
The most commonly available drug form of Doripenem is a powder for injection. The drug is administered by mixing with sterile water for injection and is administered intravenously. The dosage and duration of treatment depend on the type and severity of the infection. Other factors like age, weight, and overall patient health are detrimental to deciding the drug dosage. The drug is also available in the form of an injection solution. This is useful for health professionals to directly administer the medication without taking time to prepare the drug.
The drug can only be administered by trained health care professionals intravenously. The drug is slowly administered over one hour, and the patient is carefully monitored for adverse effects.
Warnings:
The drug should be used for patients with hepatic and renal impairment. Also, care should be taken in pregnant and lactating mothers. Since the drug is administered intravenously, it is important to watch for any side effects before proceeding with the treatment.
For Patients
What Are Urinary Tract Infections?
The urinary system helps eliminate waste products from the kidneys. An infection of the urinary tract may affect the urinary system, leading to inflammation. These infections are common in both men and women and are caused by a variety of factors, like hormonal changes and sexual activity. Symptoms of urinary tract infection include the following
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Persistent urge to urinate.
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Burning sensation during urination.
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Cloudy or strong-smelling urine.
What Are Complicated Intra-Abdominal Infections?
Complicated intra-abdominal infections occur in the abdominal cavity due to perforation or rupture of the gastrointestinal tract. These infections are considered complicated as they could cause abscesses or pus. The patient may experience frequent abdominal pain, fever, nausea, vomiting, and diarrhea. The condition is managed with antibiotics, but severe cases may require surgical intervention.
Learn More About Doripenem
When and How Often to Take Doripenem?
Doripenem is a prescription medication and can only be administered in a hospital set up under the supervision of a health professional. The doctor will decide the dosage depending on the weight of the patient and the severity of the condition. It is administered intravenously for an hour and may be given once in eight hours, which means thrice a day. The doctor may change the dosage accordingly as the disease starts showing regression.
Following the dosage, frequency, and treatment duration as per the doctor’s prescription is important for a healthy recovery.
How Effective Is Doripenem?
The drug has proven effective in clinical trials against gram-negative and gram-positive bacteria, especially in complicated intra-abdominal and urinary infections. It is the preferred last resort antibiotic when other antibiotics have failed to treat the condition efficiently. Just like other antibiotics, there are possibilities an individual may show resistance to the drug with overuse. Misuse could contribute to antibiotic resistance, which makes it difficult to treat. Hence, it is better to complete the full course of the drug to avoid drug resistance.
Things to Inform The Doctor Before They Prescribe Doripenem:
Before taking any medications, it is advisable to inform the doctor regarding the medical history and drug history, as it helps the doctor understand the medical conditions and prescribe medications accordingly.
Starting Doripenem:
How to Take Doripenem?
Since the drug is only available in the form of injection, it can only be administered in the hospital under the supervision of a healthcare professional. The drug is administered directly into the vein every eight hours, and the dosage is adjusted according to the need of the patient. The healthcare professional will perform necessary tests to assure the drug has no side effects on the patient. The patient may be closely observed for adverse effects.
What Are the Side Effects of Doripenem?
Some of the most common side effects observed in patients with Doripenem usage are
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Pain and tenderness of legs or feet.
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Unusual bleeding or bruising.
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Pale skin.
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Unusual tiredness or weakness.
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Difficult breathing.
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Abdominal cramps.
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Bloody urine.
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Less urine output.
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Increased blood pressure.
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Loss of appetite.
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Nausea or vomiting.
Dietary Alterations:
Unless the doctor specifies, following a regular diet is sufficient. No specific diet changes are required.
What Should Be Done When a Dose Is Missed?
While undergoing any treatment, it is crucial to avoid skipping any doses as it affects the recovery. In case of a dose, inform the health provider and reschedule the appointment at the earliest possible. Set reminders, as it prevents missing any doses.
What Should Be Done to Treat Doripenem Overdose?
It is very rare to overdose on Doripenem, as it is administered in the hospital under the supervision of a healthcare provider. In case of overdosing, the following steps must be followed
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Stop administering the drug.
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Monitor vital signs like blood pressure and heart rate.
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Depending on the dosage severity, supportive care like oxygen therapy and intravenous fluids may be administered to maintain the patient’s health.
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Activated charcoal helps to absorb the medication and prevents further absorption by the body.
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Hemodialysis may also be done in severe cases to remove medication from the bloodstream.
How to Store Doripenem?
The drug is stored in a cool, dry place and should avoid exposure to sunlight, as it may interfere with the drug's efficacy.
How to Handle Doripenem?
The drug should be handled safely by following the instructions provided by the doctor. Do not mix the drug with other medications, which may cause adverse effects. The drug is administered intravenously. When administering the drug at home, special training should be received from the health care provider. Do not use the drug if there are any color changes.
How to Dispose of Doripenem?
The drug is usually administered in the hospital, so it is properly disposed of according to biomedical waste management. In case of using the drug at home, inform the local setback program for proper disposal of the drug. Keep the drug out of reach of children and pets.
Avoid Self-Medication:
The drug must be used per the doctor’s instructions. Do not overdose, as it may cause side effects. Self-medication can be very harmful if the instructions are not followed properly. Hence follow the doctor’s supervision for better recovery.
For Doctors
Indication:
The drug is useful in treating bacterial infections in complicated intra-abdominal and urinary infections. Since it is an antibacterial drug, it helps fight gram-positive and gram-negative bacteria.
Mechanism of Action:
The drug inhibits bacterial cell wall synthesis, leading to bacterial death. It is also effective against a broad range of bacteria.
Ingredients:
The drug's active ingredient is Doripenem monohydrate, a broad-spectrum antibiotic. The chemical structure is similar to carbapenem antibiotics like Imipenem and Meropenem.
Absorption:
The drug can only be availed intravenously and is not available in oral formulations. The drug's half-life is about an hour, and it gets eliminated from the body after administration.
Distribution:
After administration, the drug is well-distributed throughout the body fluids, including the lungs and liver. Factors like the age and weight of the patient influence drug distribution. The drug is administered intravenously for rapid distribution. After distribution, the drug targets and kills a wide range of bacteria by inhibiting cell wall synthesis and ultimately leading to bacterial death.
Metabolism:
The drug is not extensively metabolized in the body; only a small fraction undergoes liver metabolism. The metabolic pathway is mediated by tissue enzymes called dehydropeptidases.
Elimination:
The drug is eliminated from the body via renal excretion. In renal-impaired patients, the elimination rate could be slower, and a higher drug concentration may enter the bloodstream and cause unnecessary side effects.
Warning and Precaution:
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Before prescribing the medication, check if the patient is allergic to any penicillin or cephalosporin drugs. Usage of Doripenem could aggravate allergic reactions.
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It could cause diarrhea in some patients. In such cases, inform the patient to contact the healthcare provider for help.
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Eliminating the drug from the body takes longer; hence, care should be given when prescribed in patients with kidney defects.
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Patients with a history of stroke or seizures could have exaggerated responses when administering Doripenem. Therefore, it must be carefully prescribed after ruling out any possible adverse effects.
Administration of the Drug:
The drug is administered intravenously in the hospital under the doctor’s guidance. No oral formulations of the drug are available.
Contraindications:
Some contraindications for the drug are listed below
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Hypersensitivity to the drug.
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Seizure disorders.
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Pregnancy and breastfeeding.
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Children.
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Impaired renal function.
Clinical Studies for Doripenem:
Numerous clinical studies have evaluated the safety and efficacy of the drug. Some examples include
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A randomized study published in 2005 compared the drug's safety in treating complicated intra-abdominal infections. It was found that the drug had a lower incidence of adverse effects.
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A study conducted in 2008 showed that the drug was associated with a lower incidence of nephrotoxicity.
Drug Interactions:
Avoiding certain drug combinations can help prevent adverse reactions. It is better to always take a thorough history of the patient’s medical and drug history before prescribing any drugs. The following medications must be avoided, as some studies have reported some adverse effects.
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Live cholera vaccine.
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Probenecid.
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Valproic acid.
Other Specifications:
Doripenem in Pregnant Women:
The drug should be used only during pregnancy if needed. If not, it is safer to avoid drug usage, as it may cause birth defects in children.
Doripenem in Lactating Women:
The drug is acceptable in breastfeeding mothers but should be prescribed only if required.
Doripenem in Pediatric Patients:
The exact use of the drug in pediatric patients is yet to be known. Hence it is not prescribed for young children.
Doripenem in Geriatric Patients:
The drug can be used in elderly patients if they do not have any associated medical conditions or compromised health. Care should be taken while prescribing the drug, as it could interact with other medications.
Doripenem in Renal Impairment Patients:
In patients with renal impairment, the drug should be administered in lower doses as it could aggravate the existing renal condition.
Doripenem in Hepatic Impairment Patients:
The exact effects of the drug in impaired hepatic patients are still being studied; hence it is safer to avoid using.
