Wednesday December 19, 2007
4 Carbapenems


Doripenem is the new agent added to the list of Carbapenems, making the list to grow to 4.

1. Primaxin (imipenem/cilastatin),
2. Meropenem (Merrem),
3. Invanz (ertapenem) and
4. Doripenem (Doribax)

Major points to remember about each carbapenem is

Primaxin is marked by associated neurotoxicity. It may decrease seizure threshold, particularly in renal patients.

Invanz is a very effective broad-spectrum choice against community acquired severe infections but does not cover pseudomonas and acinetobacter. It is now increasingly used as prophylaxis of surgical site infection following elective colorectal surgery, given as single 1-g dose given within 1 hour before surgical incision.

Meropenem is safest in terms of neuro-toxicity and also covers MDR pseudumonas and acinetobacter.

Newly introduced Doripenem is similar in clinical use as meropenem but is highly more effective with lower 50% inhibitory concentrations (MIC50) and 90% inhibitory concentrations (MIC90) for multidrug-resistant strains of mucoid Pseudomonas aeruginosa, nonmucoid P. aeruginosa and Burkholderia cepacia complex. This gives it advantage to be use in cases previously refractory to carbapenem therapy.



References : click to get abstract/article

1. In Vitro Activity of Doripenem (S-4661) against Multidrug-Resistant Gram-Negative Bacilli Isolated from Patients with Cystic Fibrosis - Antimicrobial Agents and Chemotherapy, June 2005, p. 2510-2511, Vol. 49, No. 6

2. Doripenem (S-4661), a novel carbapenem: comparative activity against contemporary pathogens including bactericidal action and preliminary in vitro methods evaluations - Journal of Antimicrobial Chemotherapy 2004 54(1):144-154;