Comparative review of imipenem/cilastatin versus meropenem

•We compiled pharmacological data and PK/PD parameters to improve the prescription of imipenem/cilastatin and meropenem. Table 5 presents such data for the main organs.•The main benefit is to help prescribers with daily situations requiring carbapenem prescription depending on the causative agent an...

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Bibliographic Details
Published in:Médecine et maladies infectieuses 2020-06, Vol.50 (4), p.316-322
Main Authors: Salmon-Rousseau, A., Martins, C., Blot, M., Buisson, M., Mahy, S., Chavanet, P., Piroth, L.
Format: Article
Language:English
Subjects:
Antibiotic stewardship
Antiinfectives and antibacterials
Bacilli
Carbapenem
Carbapenems
Central nervous system
Gram-negative bacilli
Gram-positive cocci
Health care
Imipenem
Imipenem/cilastatin
Life Sciences
Literature reviews
Meropenem
Pharmacodynamics
Pharmacokinetics
Pharmacology
Side effects
Stability
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Summary:•We compiled pharmacological data and PK/PD parameters to improve the prescription of imipenem/cilastatin and meropenem. Table 5 presents such data for the main organs.•The main benefit is to help prescribers with daily situations requiring carbapenem prescription depending on the causative agent and the infection site, and to maximize administration by explaining the stability of each antibiotic. Carbapenems are broad-spectrum antibacterial molecules. Imipenem-cilastatin and meropenem are the two main molecules used in French healthcare services. We aimed to evaluate the relative strengths and weaknesses of these two molecules by considering their pharmacokinetic, pharmacodynamic, microbiological, and clinical properties. We demonstrated that imipenem-cilastatin and meropenem are not alike. Review of the literature by querying the MEDLINE network. Imipenem-cilastatin is the first marketed molecule of the carbapenem class. It is more effective against Gram-positive cocci. Its stability does not allow for long infusions and its main adverse effect on the central nervous system limits its use. Meropenem is more effective against Gram-negative bacilli. Its stability and its milder adverse effects distinguish it from imipenem-cilastatin. Meropenem is preferred for daily use in healthcare services when carbapenems are to be used.
ISSN:0399-077X
1769-6690
DOI:10.1016/j.medmal.2020.01.001