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Carbapenems

By Hans P. Schlecht, MD, MSc, Assistant Professor of Medicine, Department of Medicine, Division of Infectious Diseases & HIV Medicine, Drexel University College of Medicine ; Christopher Bruno, MD, Assistant Professor of Medicine, Division of infectious Diseases & HIV Medicine, Drexel University College of Medicine

Carbapenems are a subclass of antibiotics called beta-lactam antibiotics (antibiotics that have a chemical structure called a beta-lactam ring). Beta-lactam antibiotics also include cephalosporins, monobactams, and penicillins.

Carbapenems are broad-spectrum antibiotics. That is, they are effective against many types of bacteria, including bacteria that are resistant to many other antibiotics.

Carbapenems include the following:

  • Doripenem

  • Ertapenem

  • Imipenem (which is always given with cilastatin)

  • Meropenem

Carbapenems are used with aminoglycosides to treat some infections because using them together enhances the effectiveness of both antibiotics.

Imipenem is always given with cilastatin. Cilastatin is not an antibiotic. It helps prolong the effect of imipenem by protecting it from being broken down in the kidneys.

Some bacteria have an outer covering (cell wall) that protects them. Like other beta-lactam antibiotics, carbapenems work by preventing bacteria from forming this cell wall, resulting in death of the bacteria.

Rarely, because carbapenems are structurally similar to the penicillins, people who have an allergic reaction to penicillins have an allergic reaction to carbapenems.

Carbapenems

Drug

Common Uses

Some Side Effects

Doripenem

Ertapenem

Imipenem-cilastatin

Meropenem

Abdominal and urinary infections

Infections due to susceptible bacteria resistant to other antibiotics

Except for ertapenem, Pseudomonas infections

Uncommonly seizures (risk is slightly higher with imipenem)

Confusion

Rarely, an allergic reaction in people who are allergic to penicillin

Use of Carbapenems During Pregnancy and Breastfeeding

When carbapenems were given to pregnant animals, no harmful effects on the fetus have been observed. However, carbapenems have not been tested in pregnant women.

Carbapenems are excreted in breast milk and may affect the balance of normal bacteria in the baby's digestive tract.

Resources In This Article

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • INVANZ
  • DORIBAX
  • MERREM