Imipenem with Cilastatin
-Imipenem with Cilastatin is a combination of antibiotics that includes Imipenem, a broad-spectrum carbapenem antibiotic, and Cilastatin, a renal dehydropeptidase inhibitor. This combination is designed to enhance the stability and effectiveness of imipenem by preventing its breakdown in the kidneys. -Imipenem/cilastatin belongs to carbapenem group. It is effective in patients with nosocomial infections, since they have an extremely wide antibacterial spectrum and strong activity against gram-positive and -negative aerobic and anaerobic bacteria, including many resistant pathogens.Lower respiratory tract infections, Urinary tract infections, intraabdominal infections, Gynaecological infections, Bacterial septicemia, Bone and joint infections, Skin and Skin structure infections, Endocarditis, Polymicrobial infections.
-Dosage is determined based on the specific infection, patient factors, and susceptibility of the causative bacteria. The combination is typically administered intravenously. -250-500mg givben IV over 40 to 60 minutes. It is recommended that the maximum total dosage should not exceed 50mg/kg/day or 4.0g/day.
-Hypersensitivity: Avoid in patients with known hypersensitivity to imipenem, cilastatin, or other beta-lactam antibiotics. -Allergic Reactions: Caution in patients with a history of severe allergic reactions to penicillins or other beta-lactam antibiotics.
Should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus. Imipenem has been detected in human milk. If the use of Imipenem is deemed essential, the patient should stop nursing. Clinical data are insufficient to recommend the use of PRIMAXIN for children under 3 months of age or paediatric patients with impaired renal function (serum creatinine>2mg/dL).
Imipenem is generally well tolerated. In controlled clinical studies, it was found to be tolerated as well as cefazolin, cephalothin, and cefotaxime. The most common adverse reactions have been local reactions.
Generalised seizures have been reported in patients who received ganciclovir and imipenem IV. These medicines should not be used concomitantly unless the potential benefits outweigh the risks. Decreased serum levels of valproic acid with coadministration of carbapenem antibiotics have been reported dururing post-marketing and in some cases breakthrough seizures levels of valproic acid should be considered if imipenem is to be co-administered with valproic acid.
