Available carbapenems: properties and differences

Carbapenems are beta-lactam antibiotics endowed with a broader spectrum, activity and resistance to beta-lactamases than other beta-lactams. Due to their qualities, these antibiotics are crucial in empirical therapy, in the monotherapy of several severe hospital-acquired infections -and even that of some community-acquired infections as well as in the directed therapy of infections due to multiresistant Gram-negative bacteria. All the available carbapenems have a similar spectrum, although there are significant differences in their antimicrobial activity, which in the long run determines the clinical indications of each carbapenem. The spectrum of ertapenem does not cover eminently nosocomial pathogens such as Pseudomonas aeruginosa and Acinetobacter spp., and hence this antibiotic is indicated in community-acquired infections requiring hospital treatment. In contrast, doripenem shows greater intrinsic activity than other carbapenems in extended spectrum beta-lactamase-producing enterobacteria and AmpC P. aeruginosa, Acinetobacter spp. and other non-fermentative and anaerobic microorganisms. Additionally, like the remaining carbapenems, doripenem has adequate pharmacokinetic characteristics and a favorable safety profile. (c) 2010 Elsevier Espana, S.L. All rights reserved.