Ertapenem for Complicated Urinary Tract Infections

Rationale for Using Ertapenem

• Switching from ceftriaxone to ertapenem represents an escalation in the antimicrobial spectrum, which should be justified by the clinical situation, such as the development of pneumonia, and consideration should be given to de-escalation to a narrower spectrum agent if culture and sensitivity results later indicate this is possible 1

Alternative Options if Ertapenem Is Not Available

• For carbapenem-resistant E. coli UTIs, alternative options include ceftazidime-avibactam, meropenem-vaborbactam, or imipenem-cilastatin-relebactam 2, 3
• Single-dose aminoglycosides can be effective for simple cystitis due to E. coli, including resistant strains 2, 3
• For complicated UTIs with multidrug-resistant organisms, plazomicin 15 mg/kg IV q12h is another option 2