How Do Carbapenems Work?

Carbopenems are a class of drugs used to treat a wide variety of bacterial infections (including Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloaca) of the skin, lungs, stomach, pelvis, urinary tract, and kidneys.

They are also used for the treatment of complicated intra-abdominal infections, complicated urinary tract infections including pyelonephritis (a bacterial infection causing inflammation of the kidneys), gynecological, bone and joint infections, skin and skin structure infections, and endocarditis (a life-threatening inflammation of the inner lining of the heart's chambers and valves).

Carbapenems are a subclass of antibiotics called beta-lactam antibiotics (that have a chemical structure called a beta-lactam ring). They are effective against many aerobic and anaerobic gram-positive and gram-negative organisms (classified depending on whether they get stained by a violet dye used in a laboratory test known as the gram stain test).

They bind to and block a type of enzyme called penicillin-binding proteins, which is responsible for peptidoglycan cross-linking during the synthesis of the bacterial cell wall. Whenever a bacterial cell tries to synthesize a new cell wall to grow and divide, they interfere with their ability to form cell walls, inhibit the bacterial cell wall synthesis, render the cell vulnerable to osmotic disruption, and eventually kill them.

Carbopenems are administered via intramuscular (into a muscle) and intravenous (into a vein) routes.

Carbopenems are used in conditions such as:

• Complicated intra-abdominal infections
• Bronchopulmonary infection
• Community-acquired pneumonia (pneumonia that is acquired outside the hospital)
• Complicated urinary tract infections including pyelonephritis
• Acute pelvic infections
• Complicated skin/skin structure infections
• Lower respiratory tract infections
• Gynecologic infections
• Pseudomonas infections
• Bacterial pneumonia (infection and inflammation of air sacs in one or both the lungs)
• Febrile neutropenia (a condition marked by fever and lower than normal number of neutrophils in the blood)
• Bacterial meningitis (an infection of the membranes [meninges] surrounding the brain and spinal cord)
• Diabetic foot

Side effects of carbopenems may include: 

• Nausea
• Vomiting
• Constipation
• Abdominal pain
• Headache
• Diarrhea
• Loss of appetite
• Tiredness/weakness
• Swelling/redness/pain/soreness at the injection site

Other rare side effects include:

• Dizziness 
• Fatigue 
• Rash/hives/itching
• Chest pain
• Anemia (low red blood cell count)
• Thrombocytopenia (low blood platelet count)
• Dyspnea (shortness of breath)
• Increased liver enzymes
• Insomnia (trouble falling and/or staying asleep)
• Tachycardia (fast heart rate)
• Pyrexia (fever)
• Elevated liver function tests 
• Phlebitis (inflammation of the walls of a vein)
• Thrombophlebitis (inflammation of a vein caused by a blood clot)
• Hypotension (low blood pressure)
• Oral candidiasis (a condition in which the fungus Candida albicans accumulates on the lining of the mouth)
• Palpitations 
• Hypersensitivity reaction (exaggerated or inappropriate immunologic responses occurring in response to an antigen or allergen)
• Hypokalemia (low blood potassium level)
• Increased creatinine 
• Tremor 

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of carbapenems include:

• Doribax
• Doripenem
• Ertapenem
• Imipenem/cilastatin
• Imipenem/cilastatin/relebactam
• Invanz
• Meropenem
• Meropenem/vaborbactam
• Merrem IV
• Primaxin
• Recarbrio
• Sulopenem (pending FDA approval)
• Sulopenem etzadroxil/probenecid (pending FDA approval)
• Vabomere