Carbapenems
Carbapenems , originally known as thienamycins, are β-lactam antibiotics that are used as drugs because of their broad spectrum of antimicrobial activity . Representatives are Imipenem , Ertapenem , Meropenem , Doripenem , Faropenem and Tebipenem . Carbapenems are considered reserve antibiotics , but resistance is increasing across Europe .
Imipenem is highly nephrotoxic (harmful to the kidneys). To extend the half-life, the antibiotic is combined with the dehydropeptidase inhibitor cilastatin (commercially available as Zienam ). This delays the hydrolytic breakdown of the drug in the kidneys and reduces nephrotoxicity. This combination is not required for the other carbapenems.
Carbapenems are used to treat severe nosocomial infections that can be caused, for example, by the bacterium Pseudomonas aeruginosa . Clinically notable resistances exist in Stenotrophomonas maltophilia , Enterococcus faecium and MRSA . In addition, in recent years there have been increasing reports of carbapenemase- producing strains in nosocomial infections .
According to the "Morbidity and Mortality Weekly Report" of the Centers for Disease Control and Prevention (CDC) from March 2013, the rate of American clinics with carbapenem-resistant enterobacteria (especially Klebsiella ) occurring at least once a year has increased from 1% in 2001 to 4% increased in 2012. Effective antibiotics are often no longer available for infections with these enterobacteria ; the mortality rate for such infections is 40 to 50%. But not only enterobacteria, such as Klebsiella pneumoniae , but also other rod bacteria such as Pseudomonas aeruginosa and gammaproteobacteria , such as Acinetobacter baumannii , develop resistance to carbapenems more frequently through the formation of carbapenemases.
Individual evidence
- ↑ J. Schölmerich: Medical Therapy 2007/2008 , 3rd completely revised edition (August 2007), p. 53, ISBN 978-3540485537 .
- ^ Carbapenemase-producing bacteria in Europe .
- ↑ Bodmann, Grabein, Paul Ehrlich Society for Chemotherapy eV: Recommendations for calculated parenteral initial therapy for bacterial diseases - Update 2010, ISBN 978-3-00-031623-4 , p. 8
- ^ New CDC Vital Signs: Lethal, Drug-Resistant Bacteria Spreading in US Healthcare Facilities. ( Memento of the original from June 17, 2017 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ On the current situation with carbapenemase-producing gram-negative bacteria . Epidemiological Bulletin of the Robert Koch Institute, May 13, 2013.
