CHANGING-ROLE OF CARBAPENEMS IN THE TREATMENT OF LOWER RESPIRATORY-TRACT INFECTIONS

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 infection s (LRTI). Carbapenems like imipenem and meropenem offer interesting an tibacterial activities and beta-lactamase-stability, as well as adequa te pharmacokinetic characteristics, to cover most of the pathogens inv olved in moderate to severe community-acquired and nosocomial LRTI. In contrast to imipenem, meropenem is not nephrotoxic and offers the adv antage of greater stability against renal dehydropeptidase-I, so no co ncomitant application of an enzyme inhibitor is necessary. Meropenem c an also be given by intravenous infusion or injection without the naus ea and vomiting often associated with the administration of imipenem/c ilastatin. Preliminary results with meropenem in LRTI show excellent c ure rates and good tolerance for this new carbapenem.