RESTRICTED - ID CONSULT/CRITICAL CARE CONSULT REQUIRED.  Inform prescriber that the first 24 hours of doses wil be provided; however, an infectious disease consult must be initiated by the prescribing physician at the time the drug is ordered to continue past the first 24 hours.

Renal dosing removed temporarily, refer to Renal Dosing Policy via Policy Finder on GHS Connect

Non-Pseudomonal ESBL Infections (Excluding UTIs – See Below)

• Automatically substitute meropenem to renally dose adjusted ertapenem (ID consult is not needed)

Non-Pseudomonal ESBL UTIs

• Uncomplicated non-Pseudomonal ESBL UTIs: Automatically substitute meropenem to nitrofurantoin monohydrate/macrocrystals (Macrobid) 100 mg PO BID. If isolate is resistant to nitrofurantoin or nitrofurantoin is contraindicated, automatically substitute to fosfomycin 3 gm PO x 1 (ID consult is not needed)
  • Be aware that fosfomycin has limited or variable activity against Acinetobacter baumannii, Stenotrophomonas maltophilia, Bacteroides fragilis, Morganella species, Pseudomonas species, and Fusobacterium species and is not advised for these organisms
• Complicated non-Pseudomonal ESBL UTIs: Automatically substitute meropenem to renally dose adjusted ertapenem (ID consult is not needed)

• Recent Citations via Medline (PubMed)
• FDA DRUG INFORMATION
• MICROMEDEX
• FDA Daily Med Package Inserts