antibioticsbooks

Carbapenems
Agents: imipenem/cilastatin, meropenem,
ertapenem, doripenem
Carbapenems are our most broad-spectrum antibacterial
drugs, particularly imipenem, doripenem,
and meropenem. They possess a beta-lactam
ring and share the same mechanism of action of
beta-lactams, but they are structurally unique and
differ from both penicillins and cephalosporins.
Their broad spectrum makes them both appealing
and unappealing for empiric therapy, depending
on the infection being treated and the risk factors
of the patient for a resistant organism. Imipenem,
doripenem, and meropenem have similar spectra of
activity; ertapenem has important deficiencies in
its spectrum that must be learned.
Mechanism of Action
All beta-lactams inhibit cross-linking of peptidoglycan
in the cell wall, leading to autolysis and cell
death.
Spectrum
Good: MSSA, streptococci, anaerobes, enteric GNRs,
Pseudomonas (not ertapenem), Acinetobacter
(not ertapenem), ESBL-producing GNRs
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