imipenem cilastatin (Primaxin)

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[1][2][3][4][5]

Introduction

Imipenem is derived from a compound produced by Streptomyces cattleya. The compound thienamycin is unstable, but the N-formimidoyl derivative imipenem is stable. Imipenem is the most active non-penicillin, non-cephalosporin antibiotic against a wide variety of bacteria. It is marketed in combination with cilastatin, a drug that inhibits the degradation of imipenem with formation of a nephrotoxic metabolite by a renal tubular dipeptidase.

Indications

Dosage

0.5 g IV every 6 hours

Dosage adjustment in renal failure

Table

creatinine clearance dosage
> 50-90 mL/min 250-500 mg every 6-8 hours
10-50 mL/min* 250 mg every 8-12 hours
< 10 mL/min# 125-250 mg every 12 hours

* same dose for continuous arteriovenous hemofiltration

# dose after hemodialysis

Pharmacokinetics

1/2life 0.25 hours

elimination via kidney

elimination by hemodialysis = +

1/2life = 0.25 hours

Antimicrobial activity

Gram positive

Gram negative

Anaerobes

Adverse effects

Drug interactions

Laboratory

More general terms

Additional terms

Component of

References

  1. ↑ The Pharmacological Basis of Therapeutics, 8th ed. Gilman et al, eds. Permagon Press/McGraw Hill pg 1092
  2. ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  3. ↑ Sanford Guide to antimicrobial therapy 1997, 2001
  4. ↑ 4.0 4.1 4.2 4.3 Deprecated Reference
  5. ↑ Department of Veterans Affairs, VA National Formulary

Database

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