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Clinical Pharmacology of Antibiotics: Review of Imipenem

Published online by Cambridge University Press:  02 January 2015

Mark Eggleston ,
Soon-young Park  and
Richard H. Parker
Mark Eggleston
Affiliation:
College of Pharmacy and Pharmacal Sciences, Howard University, Washington, D.C
Soon-young Park*
Affiliation:
College of Pharmacy and Pharmacal Sciences, Howard University, Washington, D.C
Richard H. Parker*
Affiliation:
College of Pharmacy and Pharmacal Sciences, Howard University, Washington, D.C
*
College of Medicine, Howard University, Washington, D.C. 20059
College of Medicine, Howard University, Washington, D.C. 20059
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Abstract

Imipenem, a new carbapenem ß-lactam broad-spectrum antibiotic, is highly active in vitro against most aerobic and anaerobic gram-positive and gram-negative bacteria isolated from infectious diseases of human beings. Except for enterococci and methicillin-resistant staphylococci most gram-positive cocci are inhibited by <2 μg/ml. Although the MIC-90 of methicillin-resistant staphylococci may be <4 μg/ml, these bacteria are usually resistant to imipenem by modified testing methods. The enterococcus, S. faecalis, has an MIC-90 of <8 μg/ml but bactericidal concentration may be much higher. Most Enterobacteriaceae are highly susceptible to imipenem with MIC-90 of 0.5 to 2.0 μg/ml. Proteus species are less susceptible with MICs of 4 to 8 μg/ml. Isolates of P. aeruginosa have variable susceptibility with MICs ranging from 0.25 to 16 μg/ml. Pseudomonas maltophilia and P. cepacia are usually resistant to imipenem. Except for Clostridium species, most strict anaerobes are susceptible to <1.0 μg/ml of imipenem. When combined with cilastatin (1:1 ratio), the renal elimination of the active form is increased. The serum half-life in normal renal function is about 1 hour and increases to 3.4 hours in anuria. Major adverse effects are similar to those of cephalosporins except for seizures in some patients. Colonization with fungi and drug-resistant bacteria occurs in about 5% of imipenem-treated patients. Clinical studies have demonstrated efficacy in 79% to 96% of patients treated.

Type
Special Sections
Information
Infection Control & Hospital Epidemiology , Volume 7 , Issue 6 , June 1986 , pp. 333 - 338
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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