Carbapenems are a class of broad-spectrum beta-lactam antibiotics, renowned for their exceptional ability to treat severe and multi-drug-resistant bacterial infections. Initially discovered in 1976 as thienamycin by Streptomyces cattleya, the compound's inherent instability led to the development of imipenem in 1985, the first clinically stable carbapenem. Since then, other carbapenems such as meropenem, ertapenem, and doripenem have emerged, enhancing the therapeutic arsenal against infections caused by resistant pathogens like Pseudomonas aeruginosa and Enterobacteriaceae.

In Egypt, carbapenems have become indispensable in hospital settings, especially in intensive care units, where they are used to treat life-threatening infections. However, the widespread and sometimes inappropriate use of these antibiotics has contributed to the alarming rise of carbapenem-resistant Enterobacteriaceae producing carbapenemases, such as NDM and OXA-48. This growing resistance underscores the urgency for optimized antibiotic stewardship and rigorous implementation of antimicrobial resistance control measures to safeguard the continued efficacy of carbapenems.

Side Effects of Carbapenems:

• Gastrointestinal issues (nausea, vomiting, diarrhea)

• Allergic reactions (rash, itching, anaphylaxis)

• Central nervous system effects (headache, dizziness, seizures)

• Hematologic effects (leukopenia, thrombocytopenia, anemia)

• Renal toxicity (renal impairment)

• Liver enzyme abnormalities (elevated liver enzymes)

• Superinfection (fungal or bacterial overgrowth)