title: Appropriate use of the carbapenems.
abstract: The carbapenems are a group of broad-spectrum beta-lactam antibiotic agents of which there are three parenteral preparations currently available in South Africa, namely imimpenem/cilastatin, meropenem and ertapenem. Owing to the fact that imipenem/cilastatin and meropenem have a broad spectrum of activity that includes Pseudomonas and Acinetobacter species, they are ideal antibiotics for treatment of severe nosocomial infections. In contrast, ertapenem has limited in vitro activity against the latter non-fermentative gram-negative bacteria and is therefore more suitable for the treatment of certain severe community-acquired infections. This statement arises out of concerns about the general abuse of antibiotics such as the carbapenems, with the primary intention of highlighting the appropriate use of these agents.
authors.affiliation: Ampath, Johannesburg. brinka@ampath.co.za
authors.forename: A J
authors.initials: AJ
authors.lastname: Brink
authors.forename: C
authors.initials: C
authors.lastname: Feldman
authors.forename: D C
authors.initials: DC
authors.lastname: Grolman
authors.forename: D
authors.initials: D
authors.lastname: Muckart
authors.forename: J
authors.initials: J
authors.lastname: Pretorius
authors.forename: G A
authors.initials: GA
authors.lastname: Richards
authors.forename: M
authors.initials: M
authors.lastname: Senekal
authors.forename: W
authors.initials: W
authors.lastname: Sieling
mesh_terms: D000900:Anti-Bacterial Agents / Q000145:classification / Q000494:pharmacology / Q000600:supply & distribution / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D015780:Carbapenems / Q000145:classification / Q000494:pharmacology / Q000600:supply & distribution / Q000627:therapeutic use*; D015377:Cilastatin / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization; D000077727:Ertapenem; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007769:Lactams / Q000627:therapeutic use; D000077731:Meropenem; D018579:Patient Selection; D018410:Pneumonia, Bacterial / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011480:Protease Inhibitors / Q000627:therapeutic use; D013019:South Africa / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000188:drug therapy; D013845:Thienamycins / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000188:drug therapy; D047090:beta-Lactams
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D007769:Lactams; D011480:Protease Inhibitors; D013845:Thienamycins; D047090:beta-Lactams; D015377:Cilastatin; D015378:Imipenem; D000077731:Meropenem; D000077727:Ertapenem