Imipenem

C difficile risk
High
Oral Bioavailability
N/A

Dosing

500 to 1000 mg IV every 6 to 8 hours

Maximum daily dose: 4 g or 50 mg/kg, whichever is less

0 - 30 eGFR30 - 50 eGFR50+ eGFR500 mg IV q12h500 mg IV q8hNo adjustment required

General Information

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

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.

  • 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