10.carbapenems monobactams and beta lactamase inhibitors

Question 1

Monobactam

(“AZ-3M”)

Answer 1

• *Aztreonam**
• has activity against aerobic gram negative rods

-monobactams and carbapenems treat Pseudomonas infections

-monobactam treats serious systemic infection with gram negative pathogens
(meningitis, pneumonia, sepsis)

• monobactams can be used in patients with a H/O penicillin allergy
• monobactams are resistant to beta-lactamases, ring shape on gun to remind us that beta lactamases are encoded by plasmid genes. they cleave beta lactams

Question 2

Carbapenems

(“hover car”)

Answer 2

Doripenem
Imipenem
Meropenem
Ertapenem

monobactams and Carbapenems treat pseudomonas infections

-broad spectrum carbapenems

-carbapenems treat anaerobic infections
(aspiration pneumonia, intra-abdominal infections)

“when others fail we get the job done”:
use of carbapenems with bugs resistant to other available treatments

-monobactam treats serious systemic infection with gram negative pathogens
(meningitis, pneumonia, sepsis)

• imipenem inactivated by dehydropeptidase in renal tubules
• cilastin inhibits dehydropeptidase in the renal tubules preventing degradation of imipenem
• GI side effects of carbapenems
• carbapenem may cause skin rash
• imipenem lowers the seizure threshold
• monobactams are resistant to extended spectrum beta-lactamases

Question 3

B-Lactamase inhibitors

Answer 3

Tazobactam
Sulbactam
Calvulanic acid