Adult Dosing
Complicated intra-abdominal infections
- 500 mg IV (infused over 1 hr) q8 hrs for 5-14 days
- May shift to PO agents after at least 3 days of parenteral therapy if there is demonstrated clinical improvement
Complicated UTIs
- 500 mg IV (infused over 1 hour) q8 hrs x 10 days; can be extended till 14 days if concurrent bacteremia present
Pediatric Dosing
- Safety and effectiveness in patients <18 years have not been established
Renal Dose Adjustment (Based on CrCl)
- >50 mL/min: No dose adjustments
- 30-50 mL/min: 250 mg IV q8 hrs
- >10-< 30 mL/min: 250 mg IV q12 hrs
- Hemodialysis: Not defined
Hepatic Dose Adjustment
- Hepatic impairment: No dose adjustments
- Increased mortality was reported in patients with ventilator associated bacterial pneumonia. Doripenem is not indicated for ventilator associated bacterial pneumonia
- Serious and occasionally fatal hypersensitivity (anaphylactic) reactions and serious skin reactions have been reported in patients receiving beta-lactam antibiotics. These reactions require emergency treatment with epinephrine and other emergency measures, including oxygen, IV fluids, IV antihistamines, corticosteroids, pressor amines and airway management, as clinically indicated
- Patients with seizure disorders receiving valproic acid or sodium valproate will be at an increased risk for breakthrough seizures when treated with doripenem concomittantly
- Monitor serum creatinine and creatinine clearance at baseline and periodically if renal impairment present
- Clostridium difficile associated diarrhea which may vary in severity from mild to fatal colitis, has been reported with use of doripenem
- Probenecid interferes with the active tubular secretion of doripenem and increases plasma concentration of doripenem; avoid administration with probenecid
- The risk of the development of drug-resistant bacteria increases if administered in the absence of a proven or strongly suspected bacterial infection
- When used investigationally via inhalation, pneumonitis has occurred. Doribax should not be administered by this route
- In clinical trial seizures have been reported in patients with CNS disorders, compromised renal function and in those receiving doses greater than 500 mg every 8 hours
Cautions: Use with caution in
- Renal impairment (refer dose adjustment section)
- Hypersensitivity to penicillins or beta-lactams
- History of seizure disorder
- Geriatric population
- Lactation
Pregnancy Category:B
Breastfeeding: Safety unknown; manufacturer advises caution.
