Introduction
Perinem 500 is an antibiotic belonging to the carbapenem group that fights bacteria. It is used to treat severe infections of the skin, lungs, stomach, urinary tract, blood and brain (eg. meningitis). It works by killing the bacteria that cause these problems.
Perinem 500 is commonly used to treat seriously ill patients admitted to the hospital. This medicine is given by drip or by direct injection into a vein, under the supervision of a healthcare professional. The dose depends on what type of infection you have, where it is in the body and how serious it is. You should have your injections at the same time each day to get the most benefit and you should keep on taking this medicine for as long as you are prescribed it, even if your symptoms quickly improve. If you stop taking it too early the infection may return or worsen.
Some people may develop side effects like vomiting, headache, nausea, diarrhea, rash or local redness and swelling at the site of injection. These side effects are usually temporary and go away during treatment as your body adjusts to the medicine. Consult your doctor if these side effects bother you or will not go away.
Before starting treatment with this medicine, you should tell your doctor if you have epilepsy, liver or kidney problems or if you are allergic to any antibiotic. While using it, you may be advised blood tests to monitor your blood cell counts and kidney function. This medicine is generally regarded as safe to use in pregnancy and breastfeeding if prescribed by your doctor.
Uses of Perinem 500
- Severe bacterial infections
Side effects of Perinem 500
Common
- Vomiting
- Nausea
- Injection site reactions (pain, swelling, redness)
How to use Perinem 500
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Perinem 500 works
Perinem 500 is an antibiotic. It kills bacteria by preventing them from forming the bacterial protective covering (cell wall) which is needed for them to survive.
What if you forget to take Perinem 500?
If you miss a dose of Perinem 500, please consult your doctor.
Indication
Intra-abdominal infections, Bacterial infections, Septicemia, Nosocomial pneumonia, Urinary tract infections, Pyelonephritis
Administration
Reconstitution:
Reconstitute 500 mg vial w/ 10 mL of sterile water for inj or NaCl 0.9% inj to form a susp containing 50 mg/mL. Further dilute the reconstituted vial w/ 100 mL of NaCl 0.9% or dextrose 5% inj, gently shake until clear. For a 250 mg dose, contents of the reconstituted vial should be withdrawn and added to 100 mL NaCl 0.9% infusion bag or dextrose 5% inj. Remove and discard 55 mL from the infusion bag to leave the remaining soln.
IV Administration
Infuse over 1 hr
Adult Dose
Intravenous
Complicated intra-abdominal infections
Adult: 500 mg 8 hrly infused over 1 hr for 5-14 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement.
Complicated urinary tract infections; Pyelonephritis
Adult: 500 mg 8 hrly infused over 1 hr for 10 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement. Duration can be extended up to 14 days for patients w/ concurrent bacteraemia.
Child Dose
<18 years: Safety and efficacy not established
Renal Dose
Renal impairment:
CrCl (ml/min)
30-50 250 mg every 8 hr by IV infusion over 1 hr
11-29 250 mg every 12 hr by IV infusion over 1 hr
Contraindication
Hypersensitivity; anaphylactic reactions to beta-lactams.
Mode of Action
Doripenem is a broad-spectrum carbapenem with potent in vitro antibacterial activity against aerobic and anaerobic gram-positive and gram-negative bacteria including Pseudomonas aeruginosa. It inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins; which in turn inhibits the final transpeptidase step of peptidoglycan synthesis in bacterial cell walls.
Precaution
May decrease serum concentration of valproic acid to below therapeutic range thus increasing risk of breakthrough seizure; consider alternative antimicrobial agents or additional anti-seizure medications if concurrent usage is necessary. Prolonged use may result in Clostridium difficile-associated diarrhoea (CDAD). May cause development of drug-resistant bacteria when used in the absence of proven or strongly suspected bacterial infection. Renal impairment. Safety and efficacy have not been established in patients <18 yr old.
Lactation: unknown if excreted in breast milk; use caution
Side Effect
>10%
Headache (4-16%),Nausea (4-12%),Diarrhea (6-11%)
1-10%
Anemia (2-10%),Phlebitis (4-8%),Rash (1-5%),Pruritus (3%),Transaminases elevated (1-2%),Oral candidiasis (1%),Renal impairment/failure (1%)
Potentially Fatal: Anaphylaxis, toxic epidermal necrolysis, Stevens-Johnson Syndrome, interstitial pneumonia, seizure.
Pregnancy Category Note
Pregnancy Category: B
Lactation: unknown if excreted in breast milk; use caution
Interaction
Increased plasma concentration w/ probenecid. May decrease plasma levels of valproic acid thus, increasing the risk of seizures.