Doripenem: The Newest Addition to Carbapenem Antibiotics

Abstract

Objective: To review the pharmacology, pharmacokinetics, microbiology, and clinical efficacy and safety data of doripenem for the management of complicated and nosocomial infections. Data Sources: Literature searches were conducted using MEDLINE (1996-September 2009, week 2) and EMBASE (1996–2009, week 38) with the term doripenem. References from articles obtained from the search were evaluated for other relevant citations. Study Selection and Data Extraction: All articles in English evaluating the efficacy, adverse effects, pharmacology, microbiologic spectrum of activity, and pharmacokinetic profile of doripenem were selected. Data Synthesis: Doripenem is the newest addition to the carbapenem class of antibiotics and has been studied for a variety of indications. It is approved by the FDA for the treatment of complicated urinary tract infections and complicated intraabdominal infections. The manufacturer is also seeking an indication for the treatment of nosocomial pneumonia. Efficacy studies evaluating doripenem's use for these indications were conducted as noninferiority studies comparing doripenem with standard treatment options. Results showed that doripenem is noninferior to levofloxacin in the treatment of complicated urinary tract infections, noninferior to meropenem in the treatment of complicated intraabdominal infections, and noninferior to both piperacillin/tazobactam and imipenem/cilastatin for the treatment of nosocomial pneumonia. The adverse effect profile for doripenem is similar to that of other carbapenems, with the most commonly reported effects being headache, nausea, diarrhea, rash, and phlebitis. Conclusions: Doripenem has been shown to be an effective and well-tolerated carbapenem antibiotic for the treatment of complicated urinary tract infections and complicated intraabdominal infections. It has also exhibited promising results in studies evaluating its use in patients with nosocomial pneumonia.