Doriprex

Doriprex (also known as doripenem) is an antibiotic from the carbapenem class. It is used to treat serious infections caused by various types of bacteria. Doriprex is commonly used in hospitals to treat infections of the gastrointestinal tract, urinary tract, skin, lungs, and other organs. This drug is often used when other antibiotics have not worked because the bacteria have become resistant to them. Like other antibiotics, the use of Doriprex must be prescribed and monitored by a doctor.

Indications Doriprexa

1. Complex gastrointestinal infections such as peritonitis (inflammation of the abdominal cavity).
2. Urinary tract infections, including pyelonephritis (inflammation of the kidneys), acute cystitis (inflammation of the bladder), and others.
3. Skin and soft tissue infections such as cellulitis (inflammation of the tissue under the skin) and infected wounds.
4. Complex lung infections such as pneumonia.
5. Other serious infections caused by microorganisms sensitive to Doriprex.

Release form

Doripenem, whose trade name is Doriprex, is usually available as a powder for the preparation of an injection solution. This powder is usually dissolved in a special solvent, provided in the kit, to make a solution, which is then injected into the patient's body intravenously.

Pharmacodynamics

1. Mechanism of action: Doripenem is a beta-lactam antibiotic, similar to penicillins and cephalosporins. It acts by inhibiting bacterial cell wall synthesis, resulting in bacterial death. It has a broad spectrum of activity against gram-positive, gram-negative and anaerobic bacteria.
2. Interaction with bacterial enzymes: Doripenem is resistant to beta-lactamases, which makes it more effective against many bacteria that are resistant to other antibiotics due to the production of this enzyme.
3. Pharmacokinetics: After intravenous administration, doripenem is rapidly and completely absorbed. Its maximum concentration in the blood is reached 0.5-1 hour after administration. It has a good distribution in tissues and body fluids.
4. Resistance mechanisms: Although doripenem has a broad spectrum of activity, some bacteria may develop resistance to it. This may be due to the production of beta-lactamases, changes in the structure of proteins that bind penicillin-binding proteins, etc.
5. Effect on microorganisms: Doripenem effectively destroys many bacteria, helping to eliminate infections caused by strains sensitive to it.

Doripenem has activity against a broad spectrum of bacteria, including many gram-positive, gram-negative and anaerobic organisms. Some of these include:

Gram-positive bacteria:

1. Streptococcus pneumoniae
2. Streptococcus pyogenes
3. Streptococcus agalactiae
4. Enterococcus faecalis (including penicillinase-producing strains)
5. Staphylococcus aureus (including methicillin-sensitive strains)

Gram-negative bacteria:

1. Escherichia coli
2. Klebsiella pneumoniae
3. Enterobacter species
4. Proteus mirabilis
5. Serratia marcescens
6. Haemophilus influenzae
7. Neisseria meningitidis
8. Pseudomonas aeruginosa

Anaerobic bacteria:

1. Bacteroides fragilis
2. Clostridium perfringens
3. Peptostreptococcus species

Pharmacokinetics

1. Absorption: Doripenem is usually administered intravenously because it is poorly absorbed from the gastrointestinal tract after oral administration.
2. Distribution: After intravenous administration, doripenem is rapidly and evenly distributed throughout the body tissues and fluids. It has a high penetration rate into many organs and tissues, including the lungs, skin, soft tissue, bile, bone tissue, and synovial fluid.
3. Metabolism: Doripenem is metabolized in the body mainly by dehydrogenases, forming inactive metabolites. The metabolism of doripenem does not play a significant role in its clinical activity.
4. Elimination: Doripenem is primarily eliminated from the body via the kidneys, both unchanged and as inactive metabolites. Its elimination half-life is approximately 1 hour.
5. Half life: The half-life of doripenem in the body is usually about 1 hour.
6. Dialysis: Doripenem can be removed from the blood by hemodialysis. Therefore, in case of long-term treatment of patients on hemodialysis, dosage adjustment may be required.

Dosing and administration

Doriprex (doripenem) is usually given as an intravenous injection. Dosage may depend on the patient's specific medical condition, the severity of the infection, and individual factors. The usual recommended dose is 500 mg to 1 g per day, divided into two or three injections.

However, the exact dosage and regimen of Doriprex should always be determined by a physician who takes into account all the specific features of the individual case and infection treatment protocols.

Use Doriprexa during pregnancy

Use of doripenem (Doriprex) during pregnancy is not recommended because there is limited information about its safety during pregnancy. Here are some data from studies:

1. Study of the safety and efficacy of doripenem in gynecologic infections: The study included women with gynecologic infections, including pregnant women. Doripenem was used as intravenous drops of 0.25 g twice daily for 3-8 days. The observed clinical efficacy was 91.7%, and the drug was well tolerated. However, the study was limited by the small number of pregnant patients, and therefore the data on the safety of its use during pregnancy are insufficient to draw final conclusions (Chimura et al., 2008).

Due to limited data on the safety of doripenem during pregnancy, it is important to take this medication only under strict indications and under the supervision of a doctor. Always consult a doctor before using any medication during pregnancy.

Contraindications

1. Allergy to carbapenem antibiotics: People with a known allergy to carbapenem antibiotics such as imipenem, meropenem, or others should avoid using Doriprex due to the risk of allergic reactions.
2. Allergy to drug components: Patients with a known allergy to any component of Doriprex, including doripenem itself or any additives, should also avoid its use.
3. Kidney problems: Patients with severe kidney problems, especially those undergoing hemodialysis, may require a dose adjustment of Doriprex or additional medical monitoring.
4. Pregnancy and breastfeeding: The safety of Doriprex during pregnancy or breastfeeding has not been established and its use in these cases should be carried out only if clearly needed and under the supervision of a physician.
5. GI problems: Some patients may have GI problems such as colitis or diarrhea, which may be contraindications to the use of Doriprex.
6. Epilepsy: Doripenem may cause seizures in some patients, so its use may require caution in people with a history of seizures.

Side effects Doriprexa

1. Elevated liver enzymes: Transient increases in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase may occur. This may indicate liver toxicity.
2. Diarrhea: One of the most common side effects of antibiotics, diarrhea can be mild or severe.
3. Candidiasis (fractured dermatitis): Overgrowth of Candida fungi, especially in the mouth, skin, or vagina.
4. Stomach and intestinal disorders: Including nausea, vomiting, abdominal pain.
5. Allergic reactions: Shortness of breath, skin rash, itching, angioedema (swelling of the skin and mucous membranes).
6. Systemic reactions: Angioedema, anaplaxia (severe allergic reaction), as well as anemia and other hematopoietic disorders are possible.
7. Possible kidney damage: Including deterioration of kidney function or occurrence of crystalluria (formation of crystals in the urine).
8. Neurological side effects: Including headache, dizziness, insomnia and others.

Overdose

Information on overdose with doripenem (trade name Doriprex) is generally limited, as overdose cases are rare due to the drug usually being administered under medical supervision. However, in case of overdose, unwanted side effects may occur.

If overdose with doripenem is suspected, seek immediate medical attention. Treatment of overdose usually consists of supportive care, including monitoring of organ and system functions, and symptomatic treatment.

Interactions with other drugs

1. Probenecid and other drugs that increase blood levels: Probenecid and other drugs that increase blood levels of antibiotics by decreasing their renal excretion may increase the concentration of doripenem in the body, which may increase its toxicity.
2. Antiepileptic drugs: Some antiepileptic drugs, such as carbamazepine and phenytoin, may accelerate the metabolism of doripenem and decrease its blood concentration, which may reduce its effectiveness.
3. Medicines that cause neutropenia: Medicines that can cause neutropenia (decreased levels of neutrophils in the blood), such as cytotoxic drugs and some antibiotics, may increase the risk of developing neutropenia when used concomitantly with doripenem.
4. Drugs that may adversely affect kidney function: Drugs that may adversely affect kidney function may increase the risk of doripenem toxicity since it is eliminated from the body primarily through the kidneys.
5. Drugs that reduce intestinal absorption: Drugs that may reduce the intestinal absorption of other drugs may reduce the effectiveness of doripenem when taken orally.
6. Drugs that have negative effects on the central nervous system: Some drugs that have negative effects on the central nervous system may increase some of the side effects of doripenem, such as dizziness or drowsiness.