Intravenous ertapenem improves hidradenitis suppurativa inflammation, patient satisfaction

Key takeaways:

• Patients were treated with intravenous ertapenem for an average of 13.1 weeks.
• During a 7-week, posttherapy follow-up, patients saw reductions from baseline in global assessment scores and pain.

The use of intravenous antibiotics, specifically ertapenem, was associated with improvement in inflammatory markers in patients with hidradenitis suppurativa, according to a study.

“Advanced [hidradenitis suppurativa (HS)] remains extremely challenging to treat,” Avigdor Nosrati, MD, of the division of dermatology in the department of medicine at Albert Einstein College of Medicine, and colleagues wrote. “Although oral antibiotics are generally accepted as a core therapeutic approach to HS, much less is known about the efficacy of [intravenous (IV)] antibiotics, especially ertapenem, a parenteral carbapenem possessing activity against many gram-positive bacteria, gram-negative bacteria, and anaerobic organisms.”

Previous studies have demonstrated the efficacy of ertapenem for recalcitrant HS, including one study conducted by these authors. However, in their study, the patients treated with daily IV ertapenem for 6 weeks experienced both a notable remediation of disease and a rapid loss of that remediation within 1 month of withdrawal.

In this study, Nosrati and colleagues sought to evaluate the efficacy of a longer duration of IV ertapenem for HS. Ninety-eight patients (mean age, 35.8 years; 62.2% female; 60.2% Black) with HS were treated with IV ertapenem for a mean of 13.1 weeks, give or take 4 weeks, with a posttherapy follow-up occurring at 7.8 weeks.

Results showed that these patients experienced significant reductions from baseline to posttherapy follow-up in their HS Physician Global Assessment scores (3.9 vs 2.7; P < .001) and their pain scores (4.2 vs. 1.8; P < .001).

Additionally, these patients saw reductions from baseline in their C-reactive protein counts (5.4 mg/dL vs. 2.4 mg/dL; P < .001), interleukin-6 (25.2 vs. 13.7; P < .001), and leukocytes (11.34 vs. 10; P < .001).

In a telephone survey performed at follow-up, 63 of the 76 patients that participated in the survey reported medium to high satisfaction in the therapy and 69 stated they would recommend IV ertapenem to other patients.

“The use of antibiotics continues to play a complementary role in the management of HS as new immunomodulator therapies are developed,” the authors concluded. “Larger, prospective, randomized clinical trials are needed to further optimize ertapenem dosing and duration, to evaluate the coadministration of other therapies, and to develop strategies for maintaining therapeutic outcomes.”