Comparative review of imipenem/cilastatin versus meropenem

Link to article at PubMed

Med Mal Infect. 2020 Jun;50(4):316-322. doi: 10.1016/j.medmal.2020.01.001. Epub 2020 Feb 5.


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.

PMID:32035719 | DOI:10.1016/j.medmal.2020.01.001

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