Citrobacter koseri (C&W Gram Negative)




General Information

Pregnancy: Very limited data. Due to the known safety of other beta lactams in pregnancy, likely compatible.

Breastfeeding: Very limited data. Imipenem seems to transfer into breastmilk in very low amounts. In the information available currently, it does not appear cilastatin transfers into breastmilk in detectable amounts.

Treatment of infections caused by multi-drug resistant gram negative organisms.

  • Scr
  • Liver enzymes
  • CBC
  • Immediate and delayed-type allergy
  • GI disturbance
  • Anemia
  • Cytopenias, positive Coombs
  • Liver enzyme abnormalities
  • CNS effects including confusional states and seizures
  • May decrease serum concentrations of valproic acid
  • Ganciclovir/valganciclovir - may increase risk of seizures
  • Cyclosporine - may enhance neurotoxic effects of imipenem

Non formulary

Cilastatin prevents renal metabolism of imipenem by competitive inhibition of dehydropeptidase along the brush border of the renal tubules.

Antimicrobial class: Carbapenem