In this article, we will discuss Carbapenems (Dosage). So, let’s get started.
Carbapenems
They are structurally similar to penicillins but the sulfur atom in position 1 has been replaced with a carbon atom. They are effective against beta-lactamase producing enterobacteriaceae like Klebsiella pneumoniae, E. coli, Citrobacter sp, Acinobacter sp; Pseudomonas aeruginosa and Alcaligenes sp. They are not effective against MRSA (methicillin-resistant Staphylococcus aureus) and NDM-1 (New Delhi metallo-beta-lactamase 1) strains. They can be administered only intravenously.
Doripenem
Adult dose: 500 mg IV 8 hourly, safety and efficacy in children not studied.
(Carbador, doribax, dorikem, inarem in 500 mg vial).
Ertapenem
Indication: Same as meropenem, 3 months-13 yr: 15 mg/kg/dose IV b.d., adult dose 1 god. IV.
Side effect: DRESS, pruritus, diarrhea, vomiting, nausea.
(Forstal, invanz, mypenem, zivatar in 1 g vial).
Faropenem Oral formulation is available, but it is not yet approved for use in children.
Adult dose: 150-300 mg t.d.s.
SE: Nausea, vomiting, diarrhea, skin rash, sweating, headache, myalgias.
(Duonem, farobact, faronac, farozet, orpenem tabs 150 mg, 200 mg, 300 mg)
Imipenem/cilastatin 60-100 mg/kg/day of imipenem q6 hr IV. Broad spectrum beta-lactam antibiotic for aerobic and anaerobic Gram-positive and Gram-negative bacteria.
Caution: Use with caution in children with epilepsy.
Adult dose: 250 mg-1 g IV q 6-8 hr; maximum daily dose 2 g.
Indication: Drug of choice for extended spectrum beta-lactamase producing microorganisms (ESBL).
(Imicrit, carbinem, cilaxter, cilanem, imecila, zienam, 1-nem contains 250 mg or 500 mg each of imipenam and cilastatin).
Meropenem 60 mg/kg/day q 8 hr IV. For neonatal sepsis, 20 mg/kg/dose q 12 hr, meningitis 40 mg/kg/dose q 8 hr.
Adult dose: 500 mg-1 g q 8 hr slow IV infusion.
Indication: Drug of choice for extended spectrum beta-lactamase producing microorganisms (ESBL).
(Inj. merobact, mero, merocrit, penam, aeropen, meronem, esblanem, romen 250 mg, 500 mg, 1000 mg vials)
The complete list of beta-lactamase resistant antibiotics includes 3rd and 4th generation cephalosporins, carbapenems, aztreonam, beta-lactamase-resistant penicillins (methicillin, naficillin, oxacillin,
cloxacillin, dicloxacillin) and combo penicillins (containing clavulanic acid or sulbactam).