karbapenem
Carbapenems are a class of β-lactam antibiotics with a distinctive carbapenem nucleus that makes them among the broadest-spectrum agents available. They were developed to resist many β-lactamases that inactivate other penicillins and cephalosporins. Clinically used examples include imipenem, meropenem, ertapenem, and doripenem. Imipenem is co-formulated with cilastatin to inhibit renal dehydropeptidase I, which would otherwise degrade it in the kidney; other carbapenems do not require cilastatin.
Carbapenems act by binding to penicillin-binding proteins, inhibiting peptidoglycan synthesis and producing bactericidal effects. They cover
They are used for severe or high-risk infections, such as complicated intra-abdominal infections, complicated urinary tract
Resistance to carbapenems arises mainly through carbapenemase production (eg, KPC, NDM, VIM, IMP, OXA-48), porin loss,