Clinical Medicine Reviews in Therapeutics

Doripenem is a carbapenem bactericidal agent that demonstrates in vitro activity against a wide variety of Gram-negative and Gram-positive pathogens. In vitro data show that doripenem combines the intrinsic activity of meropenem against Gram-negative pathogens with the intrinsic activity of imipenem against Gram-positive pathogens. The availability of doripenem is particularly welcome in the current setting of increased resistance among Gram-negative pathogens including Pseudomonas aeruginosa, Acinetobacter species, and extended-spectrum β-lactamase-producing Enterobacteriaceae. Characteristic of doripenem is its potent activity against P. aeruginosa with a minimum inhibitory concentration (MIC) necessary for the inhibition of 90% of all isolates (MIC90) of 4 µg/mL, a value that is 2 to 4 times lower than the corresponding MIC90 values of meropenem and imipenem. Doripenem was shown to be noninferior to other commonly used antibiotics in phase 3 clinical trials and is currently approved for the treatment of complicated intra- abdominal infection and complicated urinary tract infection, and in some countries for the treatment of nosocomial pneumonia, including ventilator-associated pneumonia. Intravenous (IV) infusions of doripenem can be either 1 hour or for longer durations of 4 hours. Overall, IV doripenem is safe and well tolerated, with a limited propensity to induce seizures compared with other carbapenems. Doripenem may represent a valuable option when carbapenem therapy is warranted for the treatment of serious infection, particularly in cases in which the etiology is a drug-resistant, Gram-negative pathogen.