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carbapenem (thienamycin)
Epidemiology:
1) New Delhi metallo-beta-lactamase 1 (NDM-1) encoded on a gene carried by both bacterial chromosomes & plasmids from E coli & Klebsiella pneumonia confers resistance to carbapenems [3] (isolated from patients in India & Pakistan in 2010)
2) carbapenem-resistant Klebsiella pneumoniae & other similarly resistant Enterobacteriaceae are resistant to most antimicrobial drugs, & are frequently fatal [2]
Indications:
- meropenem is the carbapenem of choice to treat Pseudomonas
Contraindications:
- penicillin allergy
- ertapenem does not cover Pseudomonas
Adverse effects:
1) carbapenem allergy occurs frequently in patients with penicillin allergy
Laboratory:
- carbapenemase resistance gene
- - carbapenem resistance gene
Interactions
drug interactions
Related
carbapenemase
Specific
doripenem (Doribax)
ertapenem (Invanz, Invance)
imipenem cilastatin (Primaxin)
meropenem (Merrem)
sulopenem etzadroxil
tebipenem
General
antibacterial agent
References
- Journal Watch 24(11):90, 2004
Prescott WA Jr, DePestel DD, Ellis JJ, Regal RE.
Incidence of carbapenem-associated allergic-type reactions
among patients with versus patients without a reported
penicillin allergy.
Clin Infect Dis. 2004 Apr 15;38(8):1102-7. Epub 2004 Mar 26.
PMID: 15095214
- Lledo W et al
Guidance for Control of Infections with Carbapenem-Resistant
or Carbapenemase-Producing Enterobacteriaceae in Acute Care
Facilities
MMWR 2009 58(10);256-260
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5810a4.htm
- Centers for disease Control and Prevention
Carbapenem-Resistant Enterobacteriaceae Containing New Delhi
Metallo-Beta-Lactamase in Two Patients - Rhode Island,
March 2012
MMWR June 22, 2012 / 61(24);446-448
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6124a3.htm
- Center for Disease Control and Prevention
Vital Signs: Carbapenem-Resistant Enterobacteriaceae
MMWR Early Release March 5, 2013 / 62;1-6
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm62e0305a1.htm