Imipenem+Cilastatin

Therapeutic Category Antibiotic Pharmacologic class: Carbapenem Use\ Indications Treatment of respiratory tract, urinary tract, intra-abdominal, gynecologic, bone and joint, skin structure, and polymicrobic infections as well as bacterial septicemia and endocarditis. Antibacterial activity includes resistant gram-negative bacilli ( Pseudomonas aeruginosa and Enterobacter sp), gram-positive bacteria (methicillin-sensitive Staphylococcus aureus and Streptococcus sp) and anaerobes. Pharmacological Effects Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested. Cilastatin prevents renal metabolism of imipenem by competitive inhibition of dehydropeptidase along the brush border of the renal tubules. Adverse Reaction Gastrointestinal: Nausea/diarrhea/vomiting Local: Phlebitis

Precautions/Warnings/Contraindication Dosage adjustment required in patients with impaired renal function; safety and efficacy in children <12 years of age have not yet been established; prolonged use may result in superinfection; use with caution in patients with a history of seizures or hypersensitivity to beta-lactams; elderly patients often require lower doses Pregnancy category: C Interactions: Increased toxicity: Beta-lactam antibiotics, probenecid may increase toxic potential Dosing Adults: I.V.: Mild to moderate infection: 250-500 mg every 6-8 hours Severe infections with only moderately susceptible organisms: 1 g every 6-8 hours Dosing adjustment in renal impairment

Brand Available: Cilapen 500mg I.V Tienam 500mg I.V