Imipenem/Cilastatin

Dosing

Infection caused by susceptible bacteria 500 mg IV q6h or 1 g IV q8h (max 4 g/d)

Infection caused by bacteria with intermediate susceptibility 1 g IV q6h (max 4 g/d)

Pediatric patients weighing <30 kg is not recommended

Age ≥3m 15-25 mg/kg IV q6h (max 4 g/d)

Age 4w-3m, BW ≥1.5 kg 25 mg/kg IV q6h (max 4 g/d)

Age 1-4w, BW ≥1.5 kg 25 mg/kg IV q8h (max 4 g/d)

Age <1w, BW ≥1.5 kg 25 mg/kg IV q12h (max 4 g/d)

General Information

  • Bacterial sepsis

  • Female genital infection

  • Bone infection - Infectious disorder of joint

  • Infection of skin and/or subcutaneous tissue

  • Infectious disease of abdomen

  • Infective endocarditis due to Staphylococcus aureus

  • Lower respiratory tract infection

  • Urinary tract infectious disease

Perform renal, hepatic, and hematopoietic function tests.

Susceptibility testing in patients with Pseudomonas aeruginosa infections.

Common

  • Phlebitis

  • Rash

  • Diarrhea

  • Nausea

  • Vomiting

  • Thrombophlebitis

Serious

  • Stevens-Johnson syndrome

  • Toxic epidermal necrolysis

  • C. difficile diarrhea

  • Seizure

  • Hypersensitivity reaction

  • Imipenem- may result in CNS toxicity

  • Valproic acid

  • Valganciclovir

  • Theophylline

  • Cholera vaccine, live

Antimicrobial class: Carbapenem

Pregnancy category: C

Average serum half life: 1 hour

Intermediate testing:

  • Enterobacteriaceae, MIC of 2 mcg/mL

  • Pseudomonas aeruginosa, MIC of 4 mcg/mL

  • Acinetobacter species, MIC of 4 mcg/mL

  • Anaerobes, MIC of 8 mcg/mL

Precautions:

  • Discontinue if Clostridium difficile-associated diarrhea or allergic reaction occurs.

  • Renal impairment increases the risk for CNS adverse events. Not recommended in patients on HD unless benefits outweighs potential risk of seizures.

  • Not recommended in children with CNS infections due to increased risk of seizure.

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