Carbapenems

Information about Carbapenems

The carbapenems are beta lactam antibiotics which have a broad spectrum of activity against many gram-positive and gram-negative, aerobic and anaerobic organisms.

Mechanism of action of Carbapenems

The carbapenems, like other beta lactam antibiotics, bind to critical penicillin-binding proteins, disrupting the growth and structural integrity of bacterial cell walls. Carbapenems have a fused beta lactam ring that is resistant to most beta lactamases.

The carbapenems have excellent activity against [[streptococci, enterococci, staphylococcci, listeria, enterobacteriaceae, and many pseudomonas, bacteroides and acinetobacter species. However, most methicillin-resistant staphylococci are also resistant to carbapenems.

Side effects of Carbapenems

Carbapenems have a safety profile similar to that of other beta lactam antibiotics such as the cephalosporins and the penicillins. The most common adverse effects are injection site reactions, diarrhea, nausea, vomiting, skin rash and pruritus.

FDA approval information for Carbapenems

The carbapenems (kar" ba pen' ems) that are currently available in the United States (with pronunciation, year of approval and initial brand name) include imipenem (im" i pen' em: 1985, Primaxin), meropenem (mer" oh pen' em: 1996, Merrem), ertapenem (er" ta pen' em: 2001, Invanz) and doripenem (dor" i pen' em: 2008, Doribax). All four agents are poorly absorbed orally and require parenteral administration. Imipenem is given with cilastatin (sye" la stat' in), which inhibits the renal metabolism of imipenem and prolongs its half-life. Imipenem is noted for its dose dependent gastrointestinal side effects as compared to the other carbapenems.

Liver toxicity of Carbapenems

Most carbapenems have been reported to cause transient, mild-to-moderate, and asymptomatic increases in serum aminotransferase levels that rapidly resolve once therapy is stopped. In addition, there have been rare reports of cholestatic liver injury arising during or shortly after carbapenem therapy, often in patients with multiple other medical problems and other causes for liver disease (parenteral nutrition, sepsis). The carbapenems are excreted largely unchanged in the urine with minimal hepatic metabolism, which may be the reason why clinically significant hepatotoxicity with jaundice from the carbapenems is rare.

List of carbapenems

• Doripenem
• Ertapenem
• Imipenem
• Meropenem

• Dailymed label info on Carbapenems
• FDA Carbapenems

Carbapenems Resources
Latest articles Most recent articles Ongoing trials	Wikipedia