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Carbapenems belong to a group of β-lactam antibiotics. Comparing with penicillins and cephalosporins, carbapenems are more resistant to hydrolyzing action of β-lactamases, including extended spectrum beta lactamases and possess a wider spectrum of antibacterial activity. Carbapenems were originally developed from thienamycin, a naturally-derived product of Streptomyces cattleya.
Carbapenems are generally used in severe infections of different localizations. In life-threatening infections carbapenems are indicated as preparations of first line treatment.
The following drugs belong to the carbapenem class:
Faropenem is closely related, but it is a penem, not a carbapenem
Carbapenems exert bactericidal action associated with interfering with the formation of bacterial cell wall. They suppress certain enzymes responsible for synthesis of murein. Murein (peptidoglycan) forms mesh-like layer outside the plasma membrane of bacteria. Spectrum of activity include gram-positive, gram-negative and anaerobic microorganisms.
Carbapenems are used to treat severe nosocomial infections caused polyresistant and mixed microflora:
Currently the use carbapemens is limited. They are primary administered in the form of intravenous injections in hospital settings in order to avoid developing of bacterial resistance.
Medications are contraindicated for use in known hypersensitivity or allergy to carbapenems. It is not recommended to use carbapenems during pregnancy and breastfeeding (only in case when benefit for mothers overweights the potential risk for fetus).
The most common side effects typical for carbapenems include:
Solution for injections should not be mixed with other preparations in one infusion system. Carbapenems should not be combined with other β-lactam antibiotic (penicillins, cephalosporins, aztreonam). Concomitant application with cyclosporine and theophylline increases the risk of seizures, especially in elderly patients and patients with significant renal failure.