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Carbapenem-resistant Enterobacteriaceae (CRE) have been defined as carbapenem-nonsusceptible and extended-spectrum cephalosporin-resistant Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae complex, Klebsiella pneumoniae, or Klebsiella oxytoca. Some exclude ertapenem resistance from the definition.
Common side effects include nausea, diarrhea, constipation, headache, rash, and pain at the site of injection. [3] Serious side effects include Clostridioides difficile infection, seizures, and allergic reactions including anaphylaxis. [3] Those who are allergic to other β-lactam antibiotics are more likely to be allergic to meropenem as well. [3]
[1] [2] Concern has arisen in recent years over increasing rates of resistance to carbapenems, as there are few therapeutic options for treating infections caused by carbapenem-resistant bacteria (such as Klebsiella pneumoniae and other carbapenem-resistant Enterobacteriaceae [3]). [4] [5] [6]
Other side effects may include Clostridioides difficile diarrhea and allergic reactions including anaphylaxis. [1] It is unclear if use during pregnancy is safe for the baby. [ 2 ] Imipenem is in the carbapenem family of medications and works by interfering with the bacteria's cell wall . [ 1 ]
The concern is that carbapenem is often used as a drug of last resort when battling resistant bacterial strains. New slight mutations could result in infections for which healthcare professionals can do very little, if anything, to treat patients with resistant organisms. A number of mechanisms cause carbapenem resistance in the Enterobacteriaceae.
A later publication indicated that Enterobacteriaceae that produce KPC were becoming common in the United States. [ 13 ] ) The resistance conferred by this gene ( bla NDM-1 ), therefore, aids the expansion of bacteria that carry it throughout a human host, since they will face less opposition/competition from populations of antibiotic-sensitive ...
The drug is not effective against Pseudomonas aeruginosa, Morganella morganii, or Providencia stuartii, nor against AmpC β-lactamase- and ESBL-producing Gram-negative bacteria or carbapenem-resistant Enterobacteriaceae (CRE). [15] It is not recommended in the empiric treatment of acute pyelonephritis or hospital-acquired UTIs. [15]
The antibacterial spectrum of ceftazidime/avibactam includes nearly all Enterobacteriaceae, including ceftazidime-resistant strains. The activity of ceftazidime/avibactam against the important hospital pathogen Pseudomonas aeruginosa is variable, due to the potential presence of other resistance mechanisms in addition to β-lactamase production.