Can imipenem be taken with food?

Yes, imipenem can be taken with or without food. However, it is usually given as an injection by a healthcare professional, so food intake does not significantly affect its absorption.

What should I do if I miss a dose of imipenem?

If you miss a dose, take it as soon as possible. If it's almost time for the next dose, skip the missed one. Never double the dose. Consult your doctor for guidance.

Is imipenem used for MRSA infections?

No, imipenem is not effective against MRSA. MRSA is resistant to many beta-lactam antibiotics, including imipenem. Alternative treatments like vancomycin are typically used.

Is imipenem safe for children?

Yes, imipenem is used in children, but the dosage is carefully adjusted based on weight and age. A doctor should determine the appropriate treatment for safety and effectiveness.

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13-Aug-2024 Team Medicover General Medicine

Imipenem & Cilastatin: Uasge, Dosage & Effects

Imipenem & Cilastatin is a broad-spectrum carbapenem antibiotic used for severe bacterial infections. Unlike other beta-lactam antibiotics, imipenem resists degradation by most beta-lactamases, making it effective against resistant bacteria.

Cilastatin works by binding to penicillin-binding proteins (PBPs), disrupting cell wall synthesis and leading to bacterial death. Cilastatin prevents imipenem breakdown in the kidneys, enhancing its effectiveness.

Effective against Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Streptococcus pneumoniae, and Bacteroides fragilis.

What is Imipenem?

Imipenem is a beta-lactam antibiotic, part of the carbapenem class, which is known for its effectiveness against a broad spectrum of bacteria. It is often combined with cilastatin to prevent its degradation in the kidneys, enhancing its efficacy.

Used for respiratory, urinary, intra-abdominal, and skin infections. Always prescribed under medical supervision due to potential side effects and drug interactions.

Mechanism of Action

Imipenem inhibits bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) inside the bacterial cell wall, which are essential for the cell wall's structural integrity. By binding to these proteins, imipenem prevents the formation of peptidoglycan, a vital component of the cell wall, causing bacterial lysis and death.

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Role of Cilastatin

Cilastatin is not an antibiotic itself but is combined with imipenem to inhibit the enzyme dehydropeptidase I in the kidneys. This enzyme would otherwise degrade imipenem, reducing its effectiveness. By inhibiting this enzyme, cilastatin ensures higher concentrations of imipenem in the bloodstream, thereby enhancing its antibacterial activity.

Uses of Imipenem/Cilastatin

Imipenem/cilastatin is used to treat a variety of serious bacterial infections, including:

Their common uses include:

Complicated urinary tract infections (UTIs): Effective against multidrug-resistant bacteria.
Lower respiratory tract infections: Helps treat pneumonia and other lung infections.
Intra-abdominal infections: Targets bacteria causing peritonitis and abscesses.
Severe skin and soft tissue infections: Treats cellulitis and wound infections.
Gynecological infections: Effective for pelvic inflammatory disease (PID).
Sepsis and bloodstream infections: Crucial for life-threatening bacterial infections.

Imipenem and Cilastatin Dose

Adults: Typically 500 mg to 1 g every 6 to 8 hours via intravenous (IV) infusion, depending on infection severity.
Children: Dosage varies based on weight and age; usually 15-25 mg/kg every 6 hours.
Renal Impairment: Adjustments required to prevent toxicity.
Severe Infections: Higher doses may be necessary under medical supervision.
Administration: Given IV over 20-60 minutes for optimal absorption.

Always follow a doctor's prescription to ensure safety and effectiveness.

Imipenem and Cilastatin Side Effects

Imipenem and Cilastatin injection is a powerful antibiotic used to treat severe bacterial infections. While effective, it may cause certain side effects. Understanding these effects can help in early identification and proper management.

Common Side Effects

Nausea and vomiting: Mild discomfort that usually subsides with time.
Diarrhea: This can occur due to changes in gut bacteria.
Injection site reactions: Pain, redness, or swelling at the injection site.
Rash or itching: This may indicate a mild allergic reaction.

Serious Side Effects (Seek Medical Help Immediately)

Seizures: Higher risk in patients with a history of epilepsy.
Severe allergic reactions: Difficulty breathing, swelling of the face or throat.
Liver issues: Symptoms include yellowing of the skin or eyes.
Kidney problems: Decreased urine output or swelling in the legs.

Always consult a healthcare professional before starting or stopping Imipenem and Cilastatin injections.

Imipenem Drug Interactions

Imipenem/cilastatin may interact with other medications, potentially altering their effects. Some known interactions include:

Probenecid: This can increase the levels of imipenem in the blood, potentially leading to toxicity.
Valproic Acid: Imipenem/cilastatin can decrease the levels of valproic acid, reducing its effectiveness and increasing the risk of seizures.
Ganciclovir: Concurrent use with imipenem/cilastatin may increase the risk of seizures.

Always inform your healthcare provider about any other medications you are taking to avoid potential drug interactions.

Imipenem-Cilastatin Brand Name

Imipenem/cilastatin is available under several brand names, including:

Primaxin
Tienam
Zienam

These brands may vary in pricing and availability, but they all contain the same active ingredients.

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Imipenem/Cilastatin with Relebactam

Recently, a combination of imipenem/cilastatin with sulbactam has been developed to tackle antibiotic-resistant bacteria. Relebactam is a beta-lactamase inhibitor that protects imipenem from degradation by certain resistant bacteria, thereby extending its spectrum of activity.

Cost and Availability

The cost of imipenem/cilastatin ranges widely due to brand, dose, and where it is purchased. For example, the cost may vary widely for a 500 mg injection. We recommend checking with local pharmacies or online platforms for optimal pricing.

Conclusion

Imipenem/cilastatin is an antibiotic combination used in the treatment of many serious bacterial infections. It is an inhibitor of bacterial cell wall synthesis, and its effect is enhanced by cilastatin, which prevents its degradation in the kidneys. Though sometimes effective, its side effects and drug interactions are something to be conscious of.

Frequently Asked Questions

RX imipenem and cilastatin injection IP is used to treat various severe bacterial infections, including complicated urinary tract infections, lower respiratory tract infections, intra-abdominal infections, gynecological infections, septicemia, and bone and joint infections.

Imipenem is an antibiotic that kills bacteria by disrupting their cell walls, while cilastatin is a renal dehydropeptidase inhibitor that prevents the degradation of imipenem in the kidneys, thereby increasing the antibiotic's efficacy.

Imipenem is important because it is a broad-spectrum antibiotic effective against a wide range of bacteria, including many resistant strains. It is used in severe infections where other antibiotics may not be effective.

No, imipenem is not a penicillin. It is a carbapenem, which is a different class of beta-lactam antibiotics. Carbapenems, including imipenem, are known for their broad-spectrum activity and resistance to many beta-lactamases.