Karbapeneemit

Karbapeneemit are a class of broad-spectrum beta-lactam antibiotics used primarily to treat severe bacterial infections. They are derived from the natural compound carbapenem and are structurally similar to penicillins and cephalosporins, though they exhibit greater resistance to beta-lactamase enzymes produced by many bacteria. This makes them highly effective against a wide range of gram-positive and gram-negative pathogens, including multidrug-resistant organisms such as *Pseudomonas aeruginosa*, *Acinetobacter baumannii*, and certain strains of *Enterobacteriaceae*.

The most commonly prescribed carbapenems include imipenem, meropenem, ertapenem, and doripenem. Imipenem was the first carbapenem introduced clinically in the 1980s, often administered in combination with cilastatin to inhibit its metabolism in the kidneys. Meropenem and doripenem are newer alternatives with improved pharmacokinetic profiles, while ertapenem is typically reserved for less complex infections due to its narrower spectrum of activity. These antibiotics work by inhibiting bacterial cell wall synthesis, leading to cell lysis and bacterial death.

Due to their potent activity and broad coverage, carbapenems are reserved for treating serious infections such as sepsis, hospital-acquired pneumonia, intra-abdominal infections, and complicated urinary tract infections. However, their use is closely monitored to mitigate the risk of antibiotic resistance. Overuse or misuse of carbapenems can contribute to the emergence of carbapenem-resistant bacteria, such as those producing carbapenemases like KPC (Klebsiella pneumoniae carbapenemase) or NDM (New Delhi metallo-beta-lactamase). This has led to increased efforts in infection control, stewardship programs, and the development of alternative treatments for resistant strains.

Side effects of carbapenems may include gastrointestinal disturbances, allergic reactions, and, in rare cases, neurotoxicity or seizures, particularly at higher doses. They are generally administered intravenously or intramuscularly, though some formulations allow for oral use in specific cases. Given their critical role in treating life-threatening infections, carbapenems remain an essential component of modern antimicrobial therapy.