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*Read only for medical professionals Reference 4 carbapenem antibiotics, what is the difference between them? Carbapenems are extended-spectrum β-lactam antibiotics, which play an extremely important role in the antibacterial treatment of multidrug-resistant severe infections
.
Imipenem, meropenem, biapenem, and ertapenem are four carbapenem antibiotics commonly used in clinic.
What is the difference between them? 1 There are four carbapenem antibiotics included in the 2020 medical insurance list: imipenem, cilastatin, meropenem, biapenem, and ertapenem
.
Table 1 Multi-drug resistance refers to the simultaneous resistance of a bacterium to three or more classes of antibiotics (three antibiotics with different mechanisms of action)
.
Severe infection refers to patients with clinical manifestations such as hypotension, hypoxemia, and organ dysfunction due to infection
.
2 Differences in indications Because the antibacterial spectrum, pharmacokinetics and adverse reactions of imipenem, meropenem, biapenem and ertapenem are different, the indications are different
.
Table 2 Bacteremia and sepsis: Bacteremia refers to the presence of pathogenic microorganisms in the blood; while sepsis refers to the growth and reproduction of pathogenic bacteria in the blood, producing toxins, resulting in acute systemic infectious diseases
.
3 Antibacterial spectrum comparison 1.
Non-fermenting gram-negative bacilli Non-fermenting gram-negative bacilli refer to a group of gram-negative bacilli that cannot utilize glucose in the form of fermentation, including Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii et al
.
Figure 12.
Antibacterial spectrum distinguishing non-fermenting gram-negative bacilli are mostly opportunistic pathogens, and the isolation rate in sputum, urine, blood, and body fluid samples of hospitalized patients is increasing day by day, which has become a difficult point in clinical antibacterial treatment
.
Table 3 Ertapenem: It has poor effect on Pseudomonas aeruginosa and Acinetobacter baumannii, and is not suitable for the treatment of hospital-acquired pneumonia
.
4 Pharmacokinetics The biggest feature of Ertapenem is its longer elimination half-life (4 hours), and it can be administered once a day
.
Table 4 Subarpenem: higher concentration in bone tissue (2.
6 μg/g), approved for bone and joint infection
.
Meropenem: Effective in the cerebrospinal fluid of patients with bacterial meningitis, approved for meningitis
.
Imipenem, biapenem, ertapenem: can cause side effects in the central nervous system, such as headache, dizziness, mental disorders, seizures,
etc.
5Usage and dosage 1.
Selection of solvent Table 5 The drug instructions clearly state that: Ertapenem should not be used in diluents containing glucose; it should not be mixed with other drugs or infused with other drugs
.
2.
Usage and dosage (intravenous infusion) Table 6 Meropenem: Carbapenems are time-dependent antibiotics, and proper prolongation of infusion time can improve the curative effect
.
Meropenem is relatively stable, and the infusion time is extended to 3 hours, which can successfully treat meningitis caused by drug-resistant Gram-negative bacteria
.
3.
Meropenem and ertapenem can be used in pregnant patients in special populations, and imipenem and biapenem are not recommended
.
Biapenem is not recommended for pediatric patients
.
Special reminder: Carbapenems can reduce the serum concentration of valproic acid and cause seizures in patients
.
Source of this article: Drug Evaluation Center Author of this article: Gcplive Editor-in-charge: Dai Daizhangli Copyright Notice Content; 2.
Interesting diagnosis and treatment stories of respiratory physicians; 3.
Significant progress in respiratory medicine industry
;
Contributions are welcome to share! We will provide you with competitive royalties and a platform to showcase your talents
.
Submission email: daijiaxing@yxj.
org.
cn (reply to all manuscripts) *The medical community strives to be accurate and reliable when the published content is approved, but it does not care about the timeliness of the published content and the accuracy of the cited materials (if any).
It does not make any commitments and guarantees for the integrity and completeness of the content, and does not assume any responsibility for the outdated content, the possible inaccuracy or incompleteness of the cited materials,
etc.
Relevant parties are requested to check separately when adopting or using it as a basis for decision-making
.
.
Imipenem, meropenem, biapenem, and ertapenem are four carbapenem antibiotics commonly used in clinic.
What is the difference between them? 1 There are four carbapenem antibiotics included in the 2020 medical insurance list: imipenem, cilastatin, meropenem, biapenem, and ertapenem
.
Table 1 Multi-drug resistance refers to the simultaneous resistance of a bacterium to three or more classes of antibiotics (three antibiotics with different mechanisms of action)
.
Severe infection refers to patients with clinical manifestations such as hypotension, hypoxemia, and organ dysfunction due to infection
.
2 Differences in indications Because the antibacterial spectrum, pharmacokinetics and adverse reactions of imipenem, meropenem, biapenem and ertapenem are different, the indications are different
.
Table 2 Bacteremia and sepsis: Bacteremia refers to the presence of pathogenic microorganisms in the blood; while sepsis refers to the growth and reproduction of pathogenic bacteria in the blood, producing toxins, resulting in acute systemic infectious diseases
.
3 Antibacterial spectrum comparison 1.
Non-fermenting gram-negative bacilli Non-fermenting gram-negative bacilli refer to a group of gram-negative bacilli that cannot utilize glucose in the form of fermentation, including Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii et al
.
Figure 12.
Antibacterial spectrum distinguishing non-fermenting gram-negative bacilli are mostly opportunistic pathogens, and the isolation rate in sputum, urine, blood, and body fluid samples of hospitalized patients is increasing day by day, which has become a difficult point in clinical antibacterial treatment
.
Table 3 Ertapenem: It has poor effect on Pseudomonas aeruginosa and Acinetobacter baumannii, and is not suitable for the treatment of hospital-acquired pneumonia
.
4 Pharmacokinetics The biggest feature of Ertapenem is its longer elimination half-life (4 hours), and it can be administered once a day
.
Table 4 Subarpenem: higher concentration in bone tissue (2.
6 μg/g), approved for bone and joint infection
.
Meropenem: Effective in the cerebrospinal fluid of patients with bacterial meningitis, approved for meningitis
.
Imipenem, biapenem, ertapenem: can cause side effects in the central nervous system, such as headache, dizziness, mental disorders, seizures,
etc.
5Usage and dosage 1.
Selection of solvent Table 5 The drug instructions clearly state that: Ertapenem should not be used in diluents containing glucose; it should not be mixed with other drugs or infused with other drugs
.
2.
Usage and dosage (intravenous infusion) Table 6 Meropenem: Carbapenems are time-dependent antibiotics, and proper prolongation of infusion time can improve the curative effect
.
Meropenem is relatively stable, and the infusion time is extended to 3 hours, which can successfully treat meningitis caused by drug-resistant Gram-negative bacteria
.
3.
Meropenem and ertapenem can be used in pregnant patients in special populations, and imipenem and biapenem are not recommended
.
Biapenem is not recommended for pediatric patients
.
Special reminder: Carbapenems can reduce the serum concentration of valproic acid and cause seizures in patients
.
Source of this article: Drug Evaluation Center Author of this article: Gcplive Editor-in-charge: Dai Daizhangli Copyright Notice Content; 2.
Interesting diagnosis and treatment stories of respiratory physicians; 3.
Significant progress in respiratory medicine industry
;
Contributions are welcome to share! We will provide you with competitive royalties and a platform to showcase your talents
.
Submission email: daijiaxing@yxj.
org.
cn (reply to all manuscripts) *The medical community strives to be accurate and reliable when the published content is approved, but it does not care about the timeliness of the published content and the accuracy of the cited materials (if any).
It does not make any commitments and guarantees for the integrity and completeness of the content, and does not assume any responsibility for the outdated content, the possible inaccuracy or incompleteness of the cited materials,
etc.
Relevant parties are requested to check separately when adopting or using it as a basis for decision-making
.
