antibioticsbooks

chapter 6 Beta-Lactams 89
and thus more convenient than the other carbapenems,
so it may be a better choice for home
infusion therapy for susceptible infections.
• Carbapenems may uncommonly elicit an allergic
reaction in patients with a history of penicillin
allergy. One study showed the incidence
of such reactions to be as high as 47% with a
proven penicillin allergy (keep in mind that
many penicillin allergies are unproven), but
more recent and better-performed studies in
patients with anaphylaxis to penicillin have
shown this number to be much lower (close to
1%). Nevertheless, take the possibility of crossreactivity
seriously. Keep in mind that even if
the cross-reactivity is very low between these
agents, patients with a history of allergy to any
drug are more likely to react to another one.
What They’re Good For
All: mixed aerobic/anaerobic infections, infections
caused by ESBL-producing organisms, intraabdominal
infections
Imipenem, doripenem, meropenem: nosocomial pneumonia,
febrile neutropenia, other nosocomial
infections
Don’t Forget!
Check your dosing in patients with renal dysfunction
to minimize the risk of imipenem-induced
seizures.