Which one of the following statement about imipenem is most accurate ?
**Core Concept**
Imipenem is a carbapenem antibiotic that exerts its antibacterial effect by inhibiting cell wall synthesis in susceptible bacteria. This mechanism is similar to other beta-lactam antibiotics, such as penicillins and cephalosporins, but imipenem's broad-spectrum activity and stability to beta-lactamases make it particularly effective against a wide range of Gram-positive and Gram-negative bacteria.
**Why the Correct Answer is Right**
Imipenem binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, preventing the cross-linking of peptidoglycan layers and ultimately leading to cell lysis and death. Its broad-spectrum activity is due to its ability to penetrate the outer membrane of Gram-negative bacteria and inhibit the synthesis of the bacterial cell wall in both Gram-positive and Gram-negative species. Additionally, imipenem is stable to many beta-lactamases, including those produced by bacteria that are resistant to other beta-lactam antibiotics.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not specify the mechanism of action or the spectrum of activity of imipenem.
**Option B:** This option is incorrect because it is incomplete and does not provide any information about the mechanism of action or the spectrum of activity of imipenem.
**Option C:** This option is incorrect because it is not a statement about imipenem, but rather a statement about another antibiotic.
**Clinical Pearl / High-Yield Fact**
Imipenem is often used in combination with cilastatin, a dehydropeptidase inhibitor, to prevent its degradation by the enzyme dehydropeptidase-I in the renal tubules, thereby increasing its bioavailability and reducing the risk of nephrotoxicity.
**Correct Answer:** C. Imipenem inhibits cell wall synthesis in susceptible bacteria by binding to penicillin-binding proteins.