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Carbapenems are highly potent bactericidal beta-lactam antibiotics, which are beta-lactamases resistant.

Antimicrobial spectrum and indications[edit | edit source]

Carbapenems have an extremely broad spectrum of action. They are effective against both aerobic and anaerobic microorganisms, G + and G−, includingPseudomonas aeruginosa and strains of Streptococcus pneumoniae highly resistant to penicillins. In general, they have the broadest spectrum of all beta-lactams.

They are used in the treatment of 'life-threatening infections' and 'nosocomial infections' caused by multidrug-resistant strains (Acinetobacter spp., Klebsiella spp., Enterobacter spp. , Pseudomonas aeruginosa), severe pneumonia, complicated intra-abdominal infections, and severe skin and soft tissue infections. They are also used in the empirical treatment of febrile neutropenia.

Pharmacokinetics[edit | edit source]

Carbapenems are administered exclusively parenterally. They penetrate well into tissues and fluids, including the cerebrospinal fluid. They are excreted by the kidneys.

Side effects[edit | edit source]

They are quite rare and insignificant. The most common are allergic skin symptoms and GIT problems. Having an allergy to carbapenems does not signify an allergy to other beta-lactams. Overgrowth of yeast may occur after therapy.

Carbapenem resistance[edit | edit source]

Due to its low resistance, carbapenems are among the so-called backup antibiotics (last resort use), the use of which is limited to the most serious cases with the potential occurrence of resistant strains. Nevertheless, carbapenem-resistant bacterial strains appear. The most important mechanism of carbapenem resistance is the production of carbapenemases. Carbapenemases are enzymes produced by gram-negative microorganisms that are able to hydrolyze a carbapenem molecule. The emergence of carbapenem-resistant strains is associated with the use of broad-spectrum antibiotics. These organisms can cause both asymptomatic colonization and a range of infections such as bacteremia, ventilator-associated pneumonia, urinary tract infections, or catheter-associated sepsis. Carbapenemase-producing microorganisms include some strains of K. pneumoniae and E. coli. The treatment of infections caused by these microorganisms is very difficult and must involve a combination of carefully selected broad-spectrum antibiotics.

Examples[edit | edit source]


The combination with cilastatin is used (not an ATB, but prevents imipenem from being converted to inactive metabolites in the kidneys by dehydropeptidase I activity).

meropenem, ertapenem

These have good penetration into body fluids and tissues (lungs, bronchial secretions, bile, cerebrospinal fluids, gynecological tissues, skin, fascia, muscles, and peritoneal exudate). They penetrate into G + and G- bacteria.

References[edit | edit source]

Related Articles[edit | edit source]

External links[edit | edit source]

Source[edit | edit source]

Bibliography[edit | edit source]

  • HAVLÍK, Jiří, et al. Infektologie. 2. edition. Praha : Avicenum, 1990. pp. 393. ISBN 80-201-0062-8.
  • LOBOVSKÁ, Alena. Infekční nemoci. 1. edition. Karolinum, 2001. pp. 263. ISBN 80-246-0116-8.
  • LINCOVÁ, Dagmar – FARGHALI, Hassan, et al. Základní a aplikovaná farmakologie. 2. edition. Praha : Galén, 2007. ISBN 978-80-7262-373-0.
  • ŠVIHOVEC, Jan, et al. Farmakologie. 1. edition. Praha : Grada, 2018. ISBN 978-80-271-2150-2.