Indications
Imipenem is a strong injectable antibiotic used in hospital for serious bacterial infections, especially those caused by bacteria resistant to other antibiotics. It is always given with Cilastatin. Uses include:
- Complicated infections inside the abdomen
- Pneumonia, including pneumonia caught in hospital or on a ventilator
- Complicated urinary tract and kidney infections
- Serious skin, soft tissue, bone and joint infections
- Infections of the womb and pelvis, including after childbirth
- Blood infections (septicaemia)
- Fever in people with a very low white blood cell count
How It Works
Imipenem belongs to the carbapenem group of antibiotics. It stops bacteria from building their cell wall, so they break apart and die. It works against a very wide range of bacteria. Cilastatin is added so the kidneys do not break Imipenem down too quickly.
Dosage and Administration
Imipenem is given by a doctor or nurse as a slow infusion (drip) into a vein, usually every 6 to 8 hours. The dose and length of treatment depend on the infection, body weight and kidney function, and are given as prescribed. Doses for children are worked out by weight.
Interactions
- Valproic acid (Sodium Valproate): Imipenem can sharply lower valproate levels, which may lead to fits. The two are usually not used together.
- Ganciclovir: higher risk of fits.
- Probenecid can raise Imipenem levels.
- Warfarin and other blood thinners may need closer monitoring.
Contraindications
Do not use if you are allergic to Imipenem, Cilastatin or any other carbapenem, or if you have had a severe allergic reaction (such as anaphylaxis) to a penicillin or cephalosporin.
Side Effects
Common: nausea, vomiting, diarrhoea, rash, and pain, redness or swelling of the vein where the drip goes in. Blood tests may show changes in liver enzymes or blood counts. Thrush can also occur.
Get urgent medical help (tell the doctor or nurse at once) if you notice:
- Fits (seizures), shaking, confusion or hallucinations
- Swelling of the face, lips or throat, difficulty breathing, or a widespread rash, blistering or peeling skin
- Severe, watery or bloody diarrhoea, during or after treatment
- Unusual bleeding or bruising
- Much less urine than usual
Pregnancy and Lactation
It is used in pregnancy only when the doctor decides the benefit clearly outweighs any risk. Small amounts pass into breast milk; the doctor will advise whether breastfeeding can continue. Watch the baby for diarrhoea or rash.
Precautions and Warnings
- Fits are more likely in people with epilepsy, head injury, stroke or other brain disorders, and in those with kidney problems. Tell the doctor about any of these.
- Kidney disease needs a lower dose.
- People allergic to penicillins or cephalosporins may also react to Imipenem.
- Long courses need blood tests for blood counts, liver and kidney function.
Overdose
Overdose is uncommon because it is given in hospital. Too much may cause fits, confusion or muscle twitching, especially with kidney problems. The medical team gives supportive treatment, and dialysis can remove the medicine from the blood.
Therapeutic Class
Carbapenem antibiotic.
Storage
Store unopened vials below 30°C in a dry place, away from light and out of the reach of children. Once mixed, hospital staff use it within the time stated in the product leaflet.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.