Carbapenemcontaining

Carbapenem-containing refers to antibiotics that include a carbapenem as the active component or to formulations that pair a carbapenem with another agent. Carbapenems are a subclass of beta-lactam antibiotics with broad-spectrum activity against many Gram-positive and Gram-negative bacteria, including several multidrug-resistant strains. They are commonly reserved for serious, hospital-acquired infections and for complicated cases where resistance limits other options.

Mechanism-wise, carbapenems inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins. They tend to be resistant to many common beta-lactamases, giving them a broad effective range. However, their utility can be compromised by specific carbapenemases produced by bacteria, by porin loss, or by efflux mechanisms. Some modern carbapenem-containing formulations include beta-lactamase inhibitors to extend activity against certain resistant organisms.

Representative single-agent carbapenems include imipenem, meropenem, ertapenem, and doripenem. In addition, several combination products pair a carbapenem with a beta-lactamase inhibitor, such as meropenem with vaborbactam or imipenem with relebactam, to broaden spectrum and overcome certain resistance mechanisms. These combinations are used in targeted indications for complicated infections where resistance is encountered.

Administration is typically intravenous and confined to hospital settings or controlled clinical environments. Pharmacokinetics are influenced by renal function, necessitating dose adjustments in renal impairment. Safety considerations include the risk of seizures at high doses, potential interactions, and the importance of antimicrobial stewardship to minimize the emergence of resistance.

See also: beta-lactam antibiotics, carbapenemases, antibiotic resistance, antimicrobial stewardship.