Tags: Primaxin

Specific Anti-Infective Agents

Clinicians should be familiar with the general classes of antibiotics, their mechanisms of action, and their major toxicities. The differences between the specific antibiotics in each class can be subtle, often requiring the expertise of an infectious disease specialist to design the optimal anti-infective regimen. The general internist or physician-in-training should not attempt to memorize all the facts outlined here, but rather should read the pages that follow as an overview of anti-infectives. The chemistry, mechanisms of action, major toxicities, spectrum of activity, treatment indications, pharmacokinetics, dosing regimens, and cost are reviewed.

Antimicrobial therapy: general principles

A wide variety of antimicrobial agents is available to treat established infections caused by bacteria, fungi, viruses, or parasites. This section will cover the general principles of antimicrobial therapy and will also include illustrative clinical problems to emphasize proper decision-making in using antimicrobials.

Management of Bacterial Meningitis

Meningitis used to be a disease that occurred primarily in children younger than 12 years. The advent of a vaccine for Haemophilus influenzae has led to a marked change in the epidemiology of meningitis in developed countries.

Imipenem and Cilastatin

Imipenem and cilastatin sodium is a fixed combination of imipenem monohydrate (a semisynthetic carbapenem b-lactam antibiotic) and cilastatin sodium, 1, 35 which prevents renal metabolism of imipenem by dehydropeptidase I (DHP I).

Community-Acquired Pneumonia: Current Therapies

Many highly effective agents are available for the treatment of bacterial community-acquired pneumonia (community-acquired pneumonia) and other community-acquire respiratory tract infections (RTIs). Currently marketed antibiotics for community-acquired pneumonia demonstrate similar efficacy rates in clinical trials, and these agents have generally achieved clinical symptom resolution in 85-95% of trial participants.

Acute Exacerbations of Chronic Bronchitis: Current therapies

TABLE: Pharmacological Management of Underlying Disease During an Acute Exacerbation of Chronic Bronchitis summarizes the general pharmacological agents and classes used to manage acute exacerbations of chronic bronchitis. The primary therapies used in acute exacerbations of chronic bronchitis treat the causative infection (antibiotics), relieve symptoms (bronchodilators), and treat the underlying inflammation (corticosteroids). TABLE: Current Therapies Used for Acute Exacerbations of Chronic Bronchitis summarizes the leading antibiotic therapies used to treat the infection.

Imipenem

Imipenem is a carbapenem beta-lactam antibacterial, differing from the penicillins in that the 5-membered ring is unsaturated and contains a carbon rather than a sulfur atom.

Merrem: Carbapenem for Severe Infection

Carbapenem antibiotics were first discovered in the 1970s. The first and only marketed agent in this class was Primaxin, a combination product containing imipenem and the human renal dihyropeptidase-I (DHP-I) antagonist cilastatin.