Mechanism of action:

• Bactericidal effect cause rapid bacterial cell death by covalently binding to penicillin-binding proteins (PBPs) involved in the biosynthesis of mucopeptides in bacterial cell walls.
• Bactericidal effects result through inhibition of cellular growth and division and the loss of cell wall integrity,eventually causing cell wall lysis.

Indication of Ayapenam:

• Lower respiratory tract infections
• Urinary tract infections.
• Intra-abdominal infections.
• Gynaecologic infections.
• Bacterial septicaemia.
• Bone and joint infections.
• Skin and skin structure infections.
• Endocarditis.
• Prevention of post-operative infection.

Imipenem vs Meropenem:

• 1.5 g/day of imipenem/cilastatin is shown to be effective to 3g/day meropenem in clinical and bacteriological outcome, as well as in incidence of side effects.
• Treatment of intra-abdominal infections with imipenem/cilastatin is shown to be more effective & less costy than meropenem.
• Incidence of meropenem resistance higher than that of imipenem/cilastatin across clinically significant nosocomial pathogen.
• Over all imipenem/cilastatin showed better activity than meropenem in pseudomonas spp, acinetobacter spp, e-coli& klebsiella spp.
• Imipenem/cilastatin is the antibiotic of choice for preventing infections of pancreatic necrosis.