Carbapenema

Estrutura básica de carbapenema.

Carbapenema ou Carbapenem é uma classe de antibióticos beta-lactâmicos com um espectro bactericida muito amplo e uma estrutura a qual propicia uma alta resistência a beta-lactamases, enzimas produzidas por bactérias que podem inibir a ação das penicilinas.

Antibióticos de carbapenemas foram originalmente desenvolvidos da tienamicina, um produto derivado naturalmente do Streptomyces cattleya.[1]

Farmacocinética

Sua administração é de apenas por via intravenosa, pois a absorção oral é muito baixa. Podem ser excretados ativos tratando infecçoes urinárias. Em regra, passam a placenta e leite. Penetram pouco pela barreira hemato-encefálica.

Pode ser usado por via intramuscular, mas sua absorção é mais imprevisível e causa flebite, dor e eritema no local, portanto é melhor dar preferência à via intravenosa.

Indicaçoes

Servem contra gram-positivos e gram-negativos, com resistências como beta-lactamase, aeróbicos ou anaeróbicos e infecçoes hospitalares ou da comunidade.[2] Eles são geralmente utilizados em hospitais para tratar infecções severas e polimicrobianas. Não se recomenda seu uso rotineiro em bactérias sem resistências, pois essa prática estimularia o desenvolvimento de bactérias resistentes a carbapenem (por Seleção natural).

Mecanismo de ação

Atuam contra as enzimas que sintetizam a parede bacteriana (PBP 1, 2 e 3), causando poucos efeitos colaterais.[3]

Fármacos desse grupo

Todos do grupo carbapenem terminam com "penem", exemplos [3]:

Referências

  1. ↑ Birnbaum J, Kahan FM, Kropp H, MacDonald JS (1985). «Carbapenems, a new class of beta-lactam antibiotics. Discovery and development of imipenem/cilastatin». Am. J. Med. 78 (6A): 3-21. PMID 3859213 
  2. ↑ http://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-los-carbapenems-disponibles-propiedades-diferencias-13188595
  3. ↑ a b Zhanel GG et al. Comparative review of the carbapenems. Drugs. 2007;67(7):1027-52. [1]

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