Imipenem-cilastatin

Information about Imipenem-cilastatin

Imipenem is a broad spectrum carbapenem antibiotic which is used for severe bacterial infections caused by susceptible organisms.

Liver safety of Imipenem-cilastatin

Because imipenem is rapidly inactivated by renal dehydropeptidase I (DHP-1), it is given in combination with cilastatin, a DHP-I inhibitor which increases half-life and tissue penetration of imipenem. Parenterally administered imipenem/cilastatin has been associated with transient, mild serum aminotransferase elevations, but it is a rare cause of clinically apparent liver disease with jaundice.

Mechanism of action of Imipenem-cilastatin

Imipenem (im" i pen' em) is a broad spectrum beta-lactam antibiotic which is used for severe bacterial infections caused by susceptible organisms. Because imipenem is rapidly inactivated by renal dehydropeptidase I (DHP-1), it is given in combination with cilastatin (sye" la stat' in), a DHP-I inhibitor which increases half-life and tissue penetration of imipenem. Imipenem-cilastatin, like other carbapenems, binds to bacterial penicillin binding proteins and interferes with bacterial cell wall integrity and synthesis.

It is a broad spectrum antibiotic with activity against many aerobic and anaerobic gram-positive and gram-negative organisms, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus agalactiae, viridans group streptococci, Enterococcus faecalis, Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis and Peptostreptococcus species.

FDA approval information for Imipenem-cilastatin

Imipenem/cilastatin was approved for use in the United States in 1985. Imipenem-cilastatin is indicated for the treatment of severe or complicated skin, tissue, joint, respiratory tract, intraabdominal, urinary tract and urogenital infections as well as meningitis, endocarditis and sepsis due to susceptible organisms. Its use is generally restricted to severe infections largely in hospitalized patients.

Dosage and administration for Imipenem-cilastatin

The recommended dosage is 250 mg to 1 gram given intravenously every 6 to 8 hours or in intramuscular doses of no more than 1.5 g daily, usually for 5 to 14 days. The combination of imipenem and cilastatin is available generically and under the brand name Primaxin as 250 mg or 500 mg infusion bottles for IV use or 500 mg or 750 mg vials of lyophilized powder for im injection.

Side effects of Imipenem-cilastatin

The most common side effects of imipenem are diarrhea, nausea, vomiting, skin rash, pruritus and injection site reactions.

• Dailymed label info on Imipenem-cilastatin
• FDA Imipenem-cilastatin

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