Imipenem

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$35.28

Dosing

500 mg IV q6h

General Information

Acceptable Uses

Documented infections due to organisms producing inducible β-lactamases or Extended-Spectrum β-lactamases (ESBL) resistant to alternate agents.

Empiric Treatment of life-threatening infections where multi-drug resistant organisms suspected (i.e. severe sepsis, neutropenic patient with absolute neutrophil count < 0.5).

Therapy of P. aeruginosa infections where other agents cannot be used due to allergy or toxicity.

Unacceptable Uses

Therapy of documented or suspected infections due to MRSA, Enterococcus spp., Stenotrophomonas maltophilia, Chlamydia spp. and Mycoplasma spp.

Treatment of infections due to organisms susceptible to less costly and/or narrower-spectrum agents

Treatment of meningitis or other Central Nervous System Infection (Meropenem is only carbapenem with an indication for CNS infection)

Adverse Effects

Immediate and delayed-type allergy

GI disturbance

Cytopenias, positive Coombs

Liver enzyme abnormalities

CNS effects including confusional states and seizures

Major Interactions

May decrease serum concentrations of valproic acid

Ganciclovir/valganciclovir - may increase risk of seizures

Cyclosporine - may enhance neurotoxic effects of imipenem

Additional Information

IV Administration

  • 500 mg or less: dilute in 100 mL D5W or NS and administer over 30 min.

  • 750 mg or 1000 mg: dilute in 250 mL D5W or NS , infuse over 60 min

EH Prescribing Restrictions
None (Pharmacist reviews therapy)

Community IV Formulary (Metro Area)
NO - Limited stability

Pharmacology

Antimicrobial class: Carbapenem

Pregnancy category: C

CSF penetration: Not indicated for CNS infection - use meropenem