The carbapenems are a relatively new class of β-lactam antibiotics, related structurally to the penicillins and cephalosporins. The carbapenems currently available in this country are imipenem (formulated with cilastatin) and meropenem, which are parenteral drugs with a broad spectrum of activity against gram-positive and gram-negative aerobic organisms and many anaerobes. Many clinicians are enthusiastic about the addition of carbapenems to the antibacterial armamentarium because of their broad spectrum of activity and demonstrated efficacy in the treatment of many serious infections in adults. Meropenem is the only carbapenem approved for use in children younger than 12 years. Novel carbapenems in development promise to offer further advantages of oral administration, less frequent dosing, and enhanced activity against resistant organisms. However, despite their utility in the treatment of infections caused by drug-resistant organisms, more widespread use of carbapenems likely will be associated with an increase in resistance to this class of antibiotics. Carbapenems will play an increasingly important role in the care of the pediatric patient, but they should be used judiciously for the treatment of serious bacterial infections. Copyright © 2001 by W.B. Saunders Company