Carbapenems

Question 1

Properties of Imipenem

Answer 1

Imipenem is naturally resistant to β-lactamase, but giving it with a β-lactamase inhibitor can amplify its effect.

Question 2

RoA of Imipenem

Answer 2

IV, slow infusion

Question 3

Spectrum of Imipenem

Answer 3

Narrow: gram +ve anaerobic (e.g., C. perfringens), gram -ve resistant to most antibiotics, and P. aeruginosa

Question 4

ADME of Imipenem

Answer 4

M: Imipenem is metabolized in kidneys by the enzyme Dehydropeptidase

Question 5

Drug-Drug Interactions of Imipenem

Answer 5

Cilastatin inhibits Dehydropeptidase, protecting Imipenem. Relebactam is the paired β-lactamase inhibitor.

Question 6

Indications of Imipenem

Answer 6

Anaerobic bacteria (e.g., C. perfringens) - Imipenem as empirical therapy.

Question 7

Adverse Effects of Imipenem

Answer 7

Cilastatin is a Category C agent and should be avoided during pregnancy.

Question 8

Properties of Meropenem

Answer 8

Meropenem is naturally resistant to Dehydropeptidase, so no need for Cilastatin.

Question 9

Drug-Drug Interactions of Meropenem

Answer 9

Vaborbactam is the paired β-lactamase inhibitor with Meropenem.

Question 10

Indications of Meropenem

Answer 10

Pyelonephritis (complicated UTI) - Carbapenem-resistant Enterobacteriaceae (CRE).