Which medications in the drug class Carbapenems are used in the treatment of Bacterial Pneumonia?

Updated: Sep 30, 2020
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Carbapenems

Ertapenem (Invanz)

Ertapenem is indicated for community-acquired pneumonia due to S pneumoniae (penicillin-susceptible isolates only) including cases with concurrent bacteremia, H influenzae (beta-lactamase negative isolates only), or M catarrhalis.

This agent is a carbapenem antibiotic that has bactericidal activity resulting from inhibition of cell wall synthesis and is mediated through ertapenem binding to penicillin-binding proteins. Ertapenem is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, cephalosporinases, and extended-spectrum beta-lactamases. It is hydrolyzed by metallo-beta-lactamases.

Imipenem and cilastatin (Primaxin)

Imipenem and cilastatin is a carbapenem antibiotic used for treatment of multiple organism infections in which other agents do not have wide spectrum coverage or are contraindicated due to the potential for toxicity. Use this agent with caution in the presence of renal insufficiency (adjust the dose), a history of seizures, and hypersensitivity to penicillins, cephalosporins, or other beta-lactam antibiotics. Avoid administering to children younger than 12 years with CNS infections.

Meropenem (Merrem IV)

Meropenem is indicated for community-acquired pneumonia, including multi–drug-resistant S pneumoniae. This agent is a bactericidal broad-spectrum carbapenem antibiotic that inhibits the A subunits of DNA gyrase, resulting in inhibition of bacterial DNA replication and transcription, and inhibits cell wall synthesis.

Meropenem is effective against most gram-positive and gram-negative bacteria and has slightly increased activity against gram-negatives and slightly decreased activity against staphylococci and streptococci compared with imipenem.

Imipenem/cilastatin/relebactam (Recarbrio)

Imipenem is a carbapenem that inhibits bacterial cell-wall synthesis. Cilastatin prevents renal metabolism of imipenem by competing with dehydropeptidase in the renal tubules. Relebactam is a beta-lactamase inhibitor. The combination is indicated for treatment of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP) caused by the following susceptible Gram-negative microorganisms: Acinetobacter calcoaceticus-baumannii complex, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Klebsiella aerogenes, Klebsiella oxytoca, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Serratia marcescens.


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