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Additionally, studies have shown that the combination of fosfomycin and -lactams leads to a more pronounced reduction in the functional expression or activity of PBPs, further elucidating the mechanistic basis for their synergistic antibacterial effect ( FIGURE 2 4.1.1 Combinations with carbapenems Carbapenems (such as meropenem and imipenem) are considered last-resort antibiotics for treating bacterial infections