Carbapenems

Question 1

list 3 carbapenems

Answer 1

1) Iimipenem (imipenem with cilastatin)
2) meropenem
3) ertapenem

Question 2

what is the spectrum of activity of carbapenems?

Answer 2

1) Beta-lactam broad-spectrum, G+ve + G-ve bacteria, and anaerobes
2) Imipenem and meropenem good for : Pseudomonas aeruginosa
3) Not active against MRSA

Question 3

what conditions are Imipenem and meropenem used to treat?

Answer 3

1) severe hospital-acquired infections, e.g. HAP
2) septicaemia
3) intra-abdominal infections, skin and soft-tissue infections
4) complicated UTIs

Question 4

Ertapenem is licensed for what conditions?

Answer 4

1) Abdominal and gynaecological infections
2) CAP
3) Foot infections of the skin and soft tissue in patients with diabetes.

Question 5

Imipenem is partially inactivated in the kidney by enzymatic activity unlike the other drugs in this group, how is this overcome?

Answer 5

administered in combination with cilastatin (imipenem with cilastatin), a specific enzyme inhibitor, which blocks its renal metabolism

Question 6

Why is meropenem useful for treating CNS infections?

Answer 6

less seizure-inducing potential

Question 7

what allergy should carbapenems be used in caution with?

Answer 7

Avoid if history of immediate hypersensitivity reaction to beta-lactum antibacterials

Question 8

who should carbapenems be used in caution with?

Answer 8

1) caution in patients with epilepsy
2) Neurological toxicity, including seizures, if used at high dose or to patients with renal impairment. So dose reduce in renal impairment

Question 9

how are carbapenems administered?

Answer 9

Carbapenems are only available for IV administration (e.g. meropenem 1–2 g IV 8-hrly).