Carbapenems are a subclass of antibiotics called beta-lactam antibiotics (antibiotics that have a chemical structure called a beta-lactam ring). Beta-lactam antibiotics also include cephalosporins, monobactams, and penicillins.
Carbapenems are broad-spectrum antibiotics. That is, they are effective against many types of bacteria, including bacteria that are resistant to many other antibiotics.
Carbapenems include the following:
Imipenem
Tebipenem
Carbapenems must be given by injection. They are often used with aminoglycosides to treat some infections because using them together enhances the effectiveness of both antibiotics.
Imipenem is always given in combination with the medication cilastatin and sometimes also relebactam. Cilastatin and relebactam are not antibiotics. They help prolong the effect of imipenem by protecting it from being broken down.
Some bacteria have an outer covering (cell wall) that protects them. Like other beta-lactam antibiotics, carbapenems work by preventing bacteria from forming this cell wall, resulting in death of the bacteria.
Rarely, because carbapenems are structurally similar to the penicillins, people who have an allergic reaction to penicillins have an allergic reaction to carbapenems.
Carbapenems
Medication | Common Uses | Some Potential Side Effects |
|---|---|---|
Tebipenem | Abdominal and urinary infections Infections due to susceptible bacteria resistant to other antibiotics | Uncommonly, seizures (risk is slightly higher with imipenem) Confusion Rarely, an allergic reaction in people who are allergic to penicillin |
(See also Overview of Antibiotics.)
Use of Carbapenems During Pregnancy and Breastfeeding
When certain carbapenems were given to certain pregnant animals, harmful effects on the fetus were observed, but this effect has not been seen with all carbapenems or in all pregnant animals tested. There are limited safety data in pregnant women and fetal risk cannot be ruled out. Carbapenems should only be used in pregnant patients when safer antibiotics are not an option. (See also Safety of Medications During Pregnancy.)
Small amounts of carbapenems are excreted in breast milk, but safety data are limited, so harmful effects on the infant cannot be completely ruled out.
It is possible that carbapenem use while breastfeeding may affect the balance of normal bacteria in the baby's digestive tract. (See also Medication and Substance Use During Breastfeeding.)
