Carbapenems are a beta-lactam “cousin” to penicillins and cephalosporins.
Mechanism of Action: Carbapenems are typically bactericidal and work by inhibiting the synthesis of the bacterial cell wall.
Indications: 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 patients who are immunocompromised.
Nursing Considerations: Carbapenems are similar to cephalosporins. Cross-sensitivity may occur in patients allergic to penicillin or cephalosporins.
Side Effects/Adverse Effects: Common side effects of cephalosporin medications include gastrointestinal upset including nausea, vomiting, epigastric distress, and diarrhea. Additional adverse effects include injection site reactions, skin rash, and pruritis.
Patient Teaching & Education: Patients should monitor for signs of superinfection and report any occurrence to the provider. If a patient experiences fever and bloody diarrhea, they should contact the provider immediately. The patient 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 grid for imipenem in Table 3.7.[3]
Table 3.7 Carbapenem Medication Grid
Class/Subclass |
Prototype/Generic |
Administration Considerations |
Therapeutic Effects |
Side/Adverse Effects |
|---|---|---|---|---|
| Carbapenems | imipenem | Route: IV
Check for allergies, including penicillin and cephalosporins Dosage adjustment if renal impairment Use with caution with seizure disorder or renal dysfunction |
Monitor for systemic signs of infection:
-WBCs -Fever Monitor actual site of infection Monitor culture results, if obtained |
Similar to cephalosporins |
Critical Thinking Activity 3.7
John Smith was admitted to the hospital with a serious abdominal infection. The nurse notices that this patient is allergic to penicillin as he prepares to administer the first dose of imipenem medication. What is the nurse’s next best action?
Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book.
- Papp-Wallace, K. M., Endimiani, A., Taracila, M. A., & Bonomo, R. A. (2011). Carbapenems: Past, present, and future. Antimicrobial Agents and Chemotherapy, 55(11), 4943–4960. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195018/ ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵
