Carbapenem

Carbapenems, originally called thienamycins, are β -lactam antibiotics, which are used because of their broad antimicrobial spectrum of activity than drugs. Representatives are imipenem, ertapenem, meropenem, doripenem and Tebipenem. Carbapenems are regarded as reserve antibiotics, however, occur in Europe, more and more resistance to.

Imipenem is highly nephrotoxic ( kidney damaging ). To prolong the half-life of the antibiotic with the dehydropeptidase inhibitor cilastatin combined (commercially about as Zienam ). Therefore, the hydrolytic degradation of the drug in the kidney is delayed and reduced nephrotoxicity. The other carbapenems this combination is not required.

Carbapenems are used to treat serious nosocomial infections that can be caused for example by the bacterium Pseudomonas aeruginosa. Clinically notable resistance exist in Stenotrophomonas maltophilia, Enterococcus faecium, and MRSA. In addition, it is reported in recent years in nosocomial infections increased over carbapenemase - producing strains.

According to the " Morbidity and Mortality Weekly Report," the Centers for Disease Control and Prevention (CDC ) in March 2013, the rate of American hospitals with at least once occurred annually carbapenem-resistant Enterobacteriaceae (especially Klebsiella ) by 1% in 2001 to 4% increased in 2012. Frequently for infections with these enteric bacteria are no longer available effective antibiotics, the mortality of such infections is 40 to 50%. But not only enterobacteria, such as Klebsiella pneumoniae, but other rod-shaped bacteria such as Pseudomonas aeruginosa and gamma proteobacteria, such as Acinetobacter baumanii, more likely to develop resistance to carbapenems through the formation of carbapenemases.