General mechanism and properties for Carbapenems

and drug interactions

Broadest spectrum beta-lactams

G+/G- anaerobes

reserved for resistant infections

decreases level of valproic acid (anti-epilepsy drug) --> increased risk of seizures

w/ Cilastatin (Primaxin)

IV/IM

Can't reach critical levels in urinary tract so not good for UTIs

Releases nephrotoxic metabolite while being metabolized

Mechanism for Cilastatin: inhibits dihydropeptidase (enzyme that metabolizes Imipenem)

Side effects: naseua, vomitting, increased risk of C. Difficile. Seizures 1.5%

Not metabolized by dihydropeptidase

Few seizures (0.5%)

injection for complicated intra-abdominal infections and UTIs

General Use: UTI

lower RTI

bone, joint, skin infections

intra-abdominal & gynecological infections

bacterial septicemia