IMIPENEM-CILASTATIN
Guidelines for Use
It is considered appropriate to use Imipenem-Cilastatin for the following conditions.
1. Gram-negative pneumonias — single agent.
2. Gram-negative sepsis from intraperitoneal sources.
3. Mixed flora sepsis from intraperitoneal sources.
4. Infection with multi-resistant bacteria.
5. Severe infection in other sites with potential of staph, gram-negative anaerobe or aerobes.
Imipenem is not indicated or approved for use at the University Hospital for the following:
1. Prophylaxis of any kind.
2. Primary therapy for usual infections.
Strong supporting evidence must indicate that other, more specific antibiotics are unsuitable for treatment before Imipenem is indicated for use at The University Hospital of Arkansas.
Dose:
25 mg/kg/day in divided doses — usually every 6 hours. Doses greater than 500 mg every 6 hours are discouraged and the UAMS maximum dosage limit is 3 gram daily.
Significant unusual reactions:
Myoclonic activity, confusional states, or seizures have been reported. Most often, these occur in patients with CNS disorders with renal impairment. This can occur, however, in patients with no documented CNS disorders.
NOTE: Any CNS reactions should be reported as adverse reaction to the pharmacy committee.
Monitor:
Any antibiotic used in combination with Imipenem.
