Akron Children's Hospital - Pediatric Infectious Diseases, One Perkins Square, Akron, OH 44333, USA.
Expert Opin Pharmacother. 2010 Mar;11(4):669-72. doi: 10.1517/14656561003631397.
Given their broad-spectrum and safety, carbapenems are a widely used class of antibiotics, especially in the treatment of hospital-acquired infections including infections due to multidrug-resistant organisms. Ertapenem is a unique member of this class, with a narrower spectrum that lacks reliable activity against Pseudomonas and Enterococcus. Given its spectrum and half-life of 4 h it is better suited to use in community-acquired infections and it is particularly well positioned for use in the outpatient setting.
Chemistry, mechanism of action, pharmacokinetics/pharmacodynamics, safety and indications for use will be covered in this review. Similar to other beta-lactams, the carbapenems inhibit cell wall synthesis by binding to and inhibiting penicillin-binding proteins. Their resistance to beta-lactamases including AmpC and extended-spectrum beta-lactamases enhances their usefulness. Similar to other beta-lactams, ertapenem exhibits time-dependent killing. Given this profile, ertapenem has been found to be useful in intra-abdominal infections, acute pelvic infections, complicated skin and skin structure infections, community-acquired pneumonia and complicated urinary tract infections.
This review will enable the reader to understand differences between the different carbapenems, especially with regard to ertapenem. Once an understanding is gained with regard to pharmacology and microbiology, the reader will be positioned to understand better those circumstances in which use of ertapenem should be considered.
Substantial differences between the carbapenems exist. Ertapenem has unique characteristics that may make it useful in specific clinical circumstances that are detailed in this review.
鉴于其广谱性和安全性，碳青霉烯类抗生素是一种广泛使用的抗生素类别，特别是在治疗医院获得性感染方面，包括多药耐药菌引起的感染。厄他培南是该类药物中的一个独特成员，其谱较窄，对铜绿假单胞菌和肠球菌缺乏可靠的活性。鉴于其谱和 4 小时的半衰期，它更适合用于社区获得性感染，特别适合在门诊环境中使用。
本综述将涵盖化学、作用机制、药代动力学/药效学、安全性和适应证。与其他β-内酰胺类药物一样，碳青霉烯类通过与青霉素结合蛋白结合并抑制其活性来抑制细胞壁合成。它们对包括 AmpC 和超广谱β-内酰胺酶在内的β-内酰胺酶的耐药性增强了它们的用途。与其他β-内酰胺类药物一样，厄他培南表现出时间依赖性杀菌作用。鉴于这种特性，厄他培南已被证明可用于治疗腹腔内感染、急性盆腔感染、复杂皮肤和皮肤结构感染、社区获得性肺炎和复杂尿路感染。
本综述将使读者能够理解不同碳青霉烯类药物之间的差异，特别是厄他培南。一旦对药理学和微生物学有了了解，读者将能够更好地理解在哪些情况下应考虑使用厄他培南。
碳青霉烯类药物之间存在显著差异。厄他培南具有独特的特性，使其在本综述中详细描述的某些特定临床情况下可能有用。
