title: Changing role of carbapenems in the treatment of lower respiratory tract infections.
abstract: The acquisition of antibiotic-resistance genes by virtually all major bacterial pathogens is currently a world-wide phenomenon. This problem is especially evident in nosocomial lower respiratory tract infections (LRTI). Carbapenems like imipenem and meropenem offer interesting antibacterial activities and beta-lactamase-stability, as well as adequate pharmacokinetic characteristics, to cover most of the pathogens involved in moderate to severe community-acquired and nosocomial LRTI. In contrast to imipenem, meropenem is not nephrotoxic and offers the advantage of greater stability against renal dehydropeptidase-I, so no concomitant application of an enzyme inhibitor is necessary. Meropenem can also be given by intravenous infusion or injection without the nausea and vomiting often associated with the administration of imipenem/cilastatin. Preliminary results with meropenem in LRTI show excellent cure rates and good tolerance for this new carbapenem.
authors.affiliation: Department of Chest and Infectious Diseases, City Hospital Heckeshorn/Zehlendorf, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lode
authors.forename: J
authors.initials: J
authors.lastname: Hamacher
authors.forename: J
authors.initials: J
authors.lastname: Eller
authors.forename: T
authors.initials: T
authors.lastname: Schaberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002442:Ceftazidime / Q000627:therapeutic use; D015377:Cilastatin / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D017714:Community-Acquired Infections / Q000188:drug therapy; D003428:Cross Infection / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D013845:Thienamycins / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D013845:Thienamycins; D015377:Cilastatin; D015378:Imipenem; D002442:Ceftazidime; D000077731:Meropenem