3.8 Carbapenems

Carbapenems are a beta-lactam “cousin” to penicillins and cephalosporins.

Indications for Use: Carbapenems are useful for treating life-threatening, multidrug-resistant infections due to their broad spectrum of activity.^[1] These antibiotics are effective in treating gram-positive and gram-negative infections. Because of their broad spectrum of activity, these medications can be especially useful for treating complex hospital-acquired infections or for clients who are immunocompromised.

Mechanism of Action: Carbapenems are typically bactericidal and work by inhibiting the synthesis of the bacterial cell wall.

Nursing Considerations Across the Lifespan:  Some carbapenems (eg. meropenem) are considered safe for use in pediatrics. Dose adjustments are required based on renal dysfunction in older adults. Information related to carbapenems in pregnancy is limited.

Specific Administration Considerations: Carbapenems are similar to cephalosporins.  Cross sensitivity may occur in clients allergic to pencillin or cephalosporins.

Client Teaching & Education:  Clients should monitor for signs of superinfection and report any occurrence to the provider.  If a client experiences fever and bloody diarrhoea, they should contact the provider immediately.  The client should also be advised that side effects can occur even weeks after the medication is discontinued.^[2]

Now let’s take a closer look at the medication card for Carbapenems in Table 3.7.^[3][4] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.

Table 3.7 Carbapenem Medication Card

Class:  Carbapenems (prototypes: imipenem and meropenem)