Carbapenems (Dosage)

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).

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