This drug is resistant with respect to a broad spectrum of beta-lactamases. Its spectrum of activity is analogous to that of the third-generation cephalosporin cefotaxime (18.104.22.168), although it is more active with respect to some staphylococci, enterococci, and also a few enterobacteria. Synonyms of this drug are cefrom, cedixen, and others.
Besides penicillins and cephalosporins, which are synthesized by mycelial fungi, substances also belonging to the beta-lactam antibiotic group include those that are produced by streptomycetes, which are called penems. This class of antibiotics is chemically similar to derivatives of penicillanic acid; however, it differs from the others in the presence of an endocyclic double bond conjugated with the carboxyl group, which gives them a certain familiarity with cephalosporanic acid; in the presence of a five-membered ring of the S-alkyl substituent instead of two methyl groups in the second position, and in the absence of an amino group in the sixth position. Penems SCH-29482 (r = CH2CH3) and -34343 (R = CH2CH2OCONH2) have not yet found use in medicine.
Carbapenems are representatives of another class of antibiotics that differ from penems in the absence of a sulfur atom in the penem ring. They include: thienamicin (R = CH2CH2NH2), olivanic acid (R = CH=CHNH2), and imipenem (R = CH2CH2NHC=NH).
Imipenem: Imipenem, [5^-[5a,6a(^)]]-6-(1-hydroxyethyl)-3-[[2-[(iminomethyl)amino] ethyl]thio]-7-oxo-1-azabicyclo[3.2.0]hept-2-en-2-carboxylic acid (22.214.171.124), is the only car-bapenem presently used in clinics. It is synthesized from thienamycin isolated from Streptomyces cattleya by reacting it with the methyl formimidate [179-182].
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