Ertapenem
| Evidence Level: L5 | Predicted Indications: 1 |
Table of Contents
Ertapenem: Bacterial arthritis
One-Sentence Summary
Ertapenem is a broad-spectrum carbapenem antibiotic that blocks bacterial cell wall synthesis. The TxGNN model predicts it may be effective for bacterial arthritis. There are no registered clinical trials directly studying this use, and the 10 publications compiled are mostly case reports, cohort studies and indirect literature.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Bacterial arthritis |
| TxGNN Prediction Score | 0.9972 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (at least 20) – CDSCO approval status is not included in this data |
| Number of Listed Products | at least 20 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Ertapenem is a carbapenem; carbapenems act by binding penicillin-binding proteins and so inhibiting bacterial cell wall synthesis. It is active against many Enterobacterales (including ESBL producers) and anaerobes.
These organisms are plausible causes of septic arthritis and other bone and joint infections. Case reports describe ertapenem used in joint infections with Klebsiella pneumoniae and Citrobacter koseri. This makes the prediction biologically plausible.
The link is not indication-specific, however. The high score (0.9972) is a computational output only. Because the drug is already an antibacterial, this is largely an extension within its own class rather than a true change of therapeutic area.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
None of the publications below is a controlled study of ertapenem in bacterial arthritis. They are case reports, a cohort, in vitro work, or indirect studies.
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 24709258 | 2014 | Retrospective cohort | Antimicrob Agents Chemother | 306 patients on long-term outpatient ertapenem; common indications were intra-abdominal infections, pneumonia and bone and joint infections |
| 22233826 | 2011 | Case report | J Chemother | Klebsiella pneumoniae septic wrist arthritis treated successfully with ertapenem and levofloxacin |
| 31352398 | 2019 | Case report | BMJ Case Rep | Citrobacter koseri septic arthritis with osteomyelitis in a diabetic foot, treated with ertapenem |
| 31585203 | 2020 | Case report with review | Anaerobe | Clostridium paraputrificum septic arthritis and osteomyelitis of the shoulder |
| 37578166 | 2023 | Case report with review | J Investig Med High Impact Case Rep | Prevotella bivia septic arthritis in an immunocompetent adult |
| 31220276 | 2019 | Cohort | J Antimicrob Chemother | Subcutaneous suppressive antibiotic therapy in 10 patients with bone and joint infections; not specific to ertapenem |
| 39193962 | 2024 | Epidemiological analysis | Clin Lab | Pathogen distribution and resistance in bone and joint infections in young children |
| 38924836 | 2024 | In vitro | Diagn Microbiol Infect Dis | Auranofin restored ertapenem susceptibility in carbapenem-resistant E. coli |
| 41878879 | 2026 | Clinical study (other drug) | J Antimicrob Chemother | Temocillin as an alternative in bone and joint infections due to resistant Enterobacterales; indirect relevance |
| 29183082 | 2017 | Review | JAMA | Hidradenitis suppurativa diagnosis and treatment; indirect relevance |
India Market Information
Ertapenem is marketed in India. At least 20 valid single-ingredient licences are recorded, and the list may be partial. Main authorizations:
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 107783 | Invanz 1gm Injection (MSD Pharmaceuticals) | Vial of 1 Injection | Not available |
| 94727 | Gerta Injection (Zydus Cadila) | Vial of 1 ml Injection | Not available |
| 75416 | Ertacrit 1gm Injection (Cipla) | Vial of 1 Injection | Not available |
| 73653 | Eczas 1gm Injection (Glenmark) | Vial of 1 Injection | Not available |
| 74371 | Ertamac 1gm Injection (Macleods) | Vial of 1 Injection | Not available |
Safety Considerations
- Drug Interactions: 38 interactions were recorded. The most notable is bupropion (Major). Picosulfuric acid, polyethylene glycol (3350 with electrolytes) and sodium sulfate are rated Moderate. Other recorded interactions (e.g. vancomycin, metronidazole, metformin, omeprazole) have no severity rating.
Package insert warnings and contraindications are not available in the data compiled for this report. Please refer to the package insert for further safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The mechanism is plausible and case reports describe ertapenem in septic arthritis. However, there are no clinical trials and no controlled study directly addressing bacterial arthritis, so the evidence level is L5 and the score alone is not enough.
To proceed, the following is needed:
- Controlled or comparative clinical data in bacterial arthritis or bone and joint infection
- Package insert warnings, contraindications and approved indication text from the Indian licences
- Detailed mechanism of action data
- Dosing, treatment duration and renal function considerations for joint infection
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.