Carbapenems are a class of beta-lactam antibiotics.
The following drugs belong to the carbapenem class:
Imipenem (often given as part of Imipenem/cilastatin)
Meropenem
Ertapenem
Faropenem
Doripenem
External Links
Structure Activity Relationships "Antibacterial Agents; Structure Activity Relationships," André Bryskier MD; beginning at pp131
Carbapenems
* * * * *
Carbapenems
Imipenem/Cilastatin(Primaxin)
Mechanism of action
Inhibits bacterial cell wall synthesis. Cilastatin blocks metabolism of imipenem.
Spectrum of activity
Gram-negative (including P aeruginosa); Gram-positive (including some enterococci); not MRSA; Anaerobes including Bacteroides fragilis
Half-life
1 h
Metabolism
In kidney by dehydropeptidase. Blocked by cilastatin
Excretion
70% unchanged in urine
Clinical Side effects
GI, phlebitis, neurologic (seizures <>
Laboratory abnormalities
Increased LFTs, other rare events
Mechanism of drug interactions
No CYP-450 interactions. Probenecid increases levels
Other considerations
Significant dosage adjustment in renal insufficincy
Approved indications
Intra-abdominal infection, lower respiratory tract infection, UTI, gynecologic infection, bacterial septicemia, bone, joint, and skin infections, endocarditis, polymicrobic infections
Usual Dose
500 mg q6h, adjusted for renal function
----------
Meropenem(Merrem)
Mechanism of action
Inhibits bacterial cell wall synthesis
Spectrum of activity
Gram-negative (including P aeruginosa); Gram-positive (including some enterococci); not MRSA; Anaerobes including Bacteriodes fragilis
Half-life
1-1.5 h
Metabolism
Minor hepatic to inactive metabolite
Excretion
75% unchanged in urine
Clinical Side effects
Headache, rash, GI, phlebitis, hypotension
Laboratory abnormalities
Increased LFTs, other rare events
Mechanism of drug interactions
No CYP-450 interactions. Probenecid increases levels
Other considerations
Dose adjustment necessary in renal insufficiency
Approved indications
Intra-abdominal infection, bacterial meningitis
Usual Dose
1 g q8h, adjusted for renal function
----------------Ertapenem(Invanz)
Mechanism of action
Inhibits bacterial cell wall synthesis
Spectrum of activityGram-negative—not P aeruginosa;Gram-positive, not enterococci, not MRSA; Anaerobes including Bacteriodes fragilis
Half-life
4h
Metabolism
Minor hepatic to inactive metabolite
Excretion
38% unchanged in urine; 37% inactive metabolite; 10% feces
Clinical Side effects
Headache, rash, GI, phlebitis, hypotension
Laboratory abnormalities
Increased LFTs, other rare events
Mechanism of drug interactions
No CYP-450 interactions. Probenecid increases levels.
Other considerations
Minor dose adjustment necessary in renal insufficiency
Approved indications
Intra-abdominal infection, skin and skin structure, community-acquired pneumonia, UTI, pelvic infections
Usual Dose
