Carbapenems in clinical practice: a guide to their use in serious infection

Meropenem and imipenem/cilastatin, currently the only available carbapenem agents in Europe and the United States, are characterised by a broad spectr um of antimicrobial activity and stability to P-lactamase-mediated resistan ce mechanisms. A guide to the use of carbapenems in clinical practice is pr esented; the role of carbapenems in the treatment of several types of serio us bacterial infection and an up-to-date account of their clinical efficacy and safety profiles are discussed. The good clinical efficacy and favourab le safety profiles of the carbapenems make them valuable as initial empiric al therapy in the treatment of ventilator-associated pneumonia, sepsis of u nknown origin, post-operative peritonitis, paediatric meningitis. and febri le neutropenia. However, to maintain superior efficacy, the carbapenems sho uld be used appropriately for definitive therapy. (C) 1999 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.