Imipenem/Cilastin/Primaxin



- Discussion:
    - 0.5-1gm q6-8h IV;
    - good for Pseudomonas, Enteric, Coag pos Staph (except for MRS) and Staph producing B lactamases, anaerobes, w/ enterococci/ NonEneterococciStrep; Poor activity against Coag neg Staph;
    - mild infections: 250-500mg IV q6hr;
    - severe infections: 500mg-1gm IV q6-8hr;
    - maximum daily dose less than 4gm/day or 50mg/kg/day (which ever is lower);
    - note: seizure activity with drug accumulation, adjust w/ renal failure decrease w/ renal failure;
    - note: imipenen is associatted with acute tubular necrosis when administered alone, but this effect is diminished when cilastin is administered;
    - 75% of drug will be excreted in to urine (w/ nl RF(x))
    - Both imipenem and cilastatin are effectively removed by hemodialysis;
    - some authorities believe that in patients with renal impairment, only patients who are undergoing dialysis should receive imipenem, and that doses should not be > than 2 gm daily;
    - peds: < 3yrs: 100 mg/kg/24hr divided q6hr;  > 3yrs: 60 mg/kg/24hrs divided q6hr



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, December 6, 2012 3:48 pm