JMM Profile: Carbapenems: a broad-spectrum antibiotic

Carbapenems are potent members of the beta-lactam family that inhibit bacterial cell-wall biosynthesis inhibitors. They are highly effective against Gram-negative and Gram-positive drug-resistant infections. As such, carbapenems are typically reserved as an antibiotic of last resort. The WHO lists meropenem as an essential medicine. Nausea and vomiting are reported in <= 20% of carbapenem recipients, with 1.5% suffering seizures. Enzymatic hydrolysis of the beta-lactam ring is the main driver of clinical resistance. These enzymes can be classified as Class A, B and D. Classes A and D are serine beta-lactamases, whereas Class B rely on metal-mediated hydrolysis, typically through zinc.