Carbapenem

Carbapenems are broad-spectrum β-lactam antibiotics distinguished by a carbon atom replacing sulfur in the β-lactam ring’s fused five-membered ring. They treat many serious bacterial infections, including infections resistant to other antibiotics.

Penicillin-binding proteins: Bacterial enzymes that build and remodel peptidoglycan in the cell wall. Carbapenems bind these enzymes, disrupting bacterial cell-wall construction.
Meropenem: An injectable carbapenem antibiotic used for serious bacterial infections. It is a widely used member of the family with broad Gram-negative activity.
Penicillin: A β-lactam antibiotic family originally derived from Penicillium fungi. Carbapenems generally resist more β-lactamases than many penicillins.
Carbapenem-resistant Enterobacterales: Enterobacterales bacteria resistant to at least one carbapenem antibiotic. This resistance group includes pathogens for which carbapenems may fail.
β-lactam ring: A four-membered cyclic amide found in several major antibiotic families. This strained ring enables carbapenems to inhibit cell-wall enzymes.
Imipenem/cilastatin: A combination of the carbapenem imipenem and cilastatin, which inhibits renal breakdown of imipenem. Cilastatin protects this carbapenem from metabolism in the kidneys.
Cephalosporin: A β-lactam antibiotic family with a six-membered ring fused to the β-lactam ring. Cephalosporins differ structurally and in spectrum from carbapenems.
Klebsiella pneumoniae carbapenemase: A β-lactamase enzyme that can inactivate carbapenems and other β-lactam antibiotics. KPC is a widely recognized mechanism of carbapenem resistance.
Porin: A membrane-channel protein that permits small molecules to cross a cell membrane. Entry through outer-membrane porins affects carbapenem activity against Gram-negative bacteria.
Ertapenem: A long-acting injectable carbapenem with limited activity against Pseudomonas and Acinetobacter. Its narrower spectrum distinguishes it from several other commonly used carbapenems.

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