Comparative review of imipenem/cilastatin versus meropenem

Abstract

Introduction: Carbapenems are broad-spectrum antibacterial molecules. Imipenem-cilastatin and meropenem are the two main molecules used in French healthcare services.

Objective: We aimed to evaluate the relative strengths and weaknesses of these two molecules by considering their pharmacokinetic, pharmacodynamic, microbiological, and clinical properties. We demonstrated that imipenem-cilastatin and meropenem are not alike.

Method: Review of the literature by querying the MEDLINE network.

Results: Imipenem-cilastatin is the first marketed molecule of the carbapenem class. It is more effective against Gram-positive cocci. Its stability does not allow for long infusions and its main adverse effect on the central nervous system limits its use. Meropenem is more effective against Gram-negative bacilli. Its stability and its milder adverse effects distinguish it from imipenem-cilastatin.

Conclusion: Meropenem is preferred for daily use in healthcare services when carbapenems are to be used.

Keywords: Antibiotic stewardship; Carbapenem; Imipenem/cilastatin; Meropenem.