- Many Gram-negative and Gram-positive bacteria and anaerobes
- Not active against MRSA
These antibiotics tend to be reserved for serious infections of unknown origin. Where possible, narrower spectrum agents are preferred.
Broadest spectrum β-lactams available. Bactericidal via potent inhibition of cell wall synthesis. Carbapenems are stable to most β-lactamases including extended-spectrum β-lactamases (ESBLs). There is an emergence of some resistant organisms with chromosomal genes coding for imipenem-hydrolysing β-lactamases.
For a diagram of action see Penicillin information.
- Similar to other β-lactam drugs, see Penicillin or Cephalosporins information for adverse drug reactions.
- Hypersensitivity rash is common
- Nausea and vomiting, diarrhoea and abdominal discomfort
- Can lower seizure threshold
Antibiotic associated colitis can also be caused by carbapenem use however it is rare and carbapenems are not included as one of the 4Cs (co-amoxiclav, cephalosporins, clindamycin and ciprofloxacin) commonly associated with antibiotic associated colitis.
Patients should be advised to comply with instructions from the medical practitioner and to complete the prescribed course of antibiotic therapy as instructed. The accompanying information pamphlet should be read.
Administration is intravenous, excretion is renal (<1% in the bile). Cilastatin is also excreted by the kidney.
Carbapenems but not cilastatin can be cleared by extra-renal mechanisms.
