Clinical Microbiology and Antimicrobial Chemotherapy. 2006; 8(4):325-349
Carpabenems (imipenem, meropenem, ertapenem) are currently one of the antibiotic classes that exhibit the broadest spectrum of activity and characterized by the low resistance rates of clinically significant pathogens. This article is an attempt to identify the role of carbapenems in clinical practice and to analyze differences between individual antimicrobials of this class by their primary characteristics. We have reviewed microbiological and clinical data on carbapenems published over the past 20 years and performed their critical analysis using the specified algorithm. Based on the data from randomized controlled trials and available meta-analyses we compared carbapenems in terms of their clinical efficacy (outpatient vs nosocomial infections, severe vs non-severe infections, monotherapy vs combination therapy). A focus was made on evaluation of data on resistance to carbapenems in clinically significant pathogens compared to other antibiotic classes. Expert opinions and consensus papers concerning the issues, such as choice of individual carbapenem and indications for use, are also presented.