Panipenem

Panipenem is an injectable carbapenem antibiotic used to treat serious bacterial infections. It is a synthetic beta-lactam antibiotic with a broad spectrum of activity against both Gram-positive and Gram-negative bacteria, including many resistant strains. Panipenem is often administered in combination with betamipron to prevent renal tubular damage, as panipenem alone is rapidly metabolized by dehydropeptidase-I (DHP-I) in the kidneys, resulting in nephrotoxicity. The combination product is marketed under various trade names.

Mechanism of Action: Panipenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), which are enzymes responsible for the transpeptidation step of peptidoglycan synthesis. This binding prevents the cross-linking of peptidoglycans, leading to cell wall weakening and subsequent bacterial cell death.

Spectrum of Activity: Panipenem demonstrates potent antibacterial activity against a wide range of bacteria, including:

• Aerobic Gram-positive bacteria: Staphylococcus aureus (including methicillin-sensitive strains), Streptococcus pneumoniae, Streptococcus pyogenes, Enterococcus faecalis (some strains).
• Aerobic Gram-negative bacteria: Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa (some strains), Enterobacter species.
• Anaerobic bacteria: Bacteroides fragilis, Clostridium perfringens.

Clinical Uses: Panipenem is typically reserved for the treatment of severe infections caused by susceptible bacteria, particularly when other antibiotics are ineffective or inappropriate due to resistance. These infections may include:

• Pneumonia
• Sepsis
• Intra-abdominal infections
• Urinary tract infections
• Skin and soft tissue infections

Administration: Panipenem is administered intravenously. Dosage and duration of treatment depend on the type and severity of the infection, as well as patient-specific factors such as renal function.

Adverse Effects: Common side effects of panipenem include nausea, vomiting, diarrhea, and injection site reactions. More serious adverse effects are rare but can include seizures, allergic reactions (including anaphylaxis), and Clostridium difficile-associated diarrhea.

Contraindications: Panipenem is contraindicated in patients with a known hypersensitivity to carbapenems or beta-lactam antibiotics. Caution should be exercised in patients with a history of seizures or renal impairment.