Imipenem/Cilastatin Hikma (Cilastatin, Imipenem)

Imipenem/Cilastatin Hikma is a broad‑spectrum carbapenem used for serious bacterial infections affecting various organ systems.

• Complicated intra‑abdominal infections: provides rapid bacterial eradication and clinical improvement.
• Complicated urinary tract infections: eliminates resistant uropathogens and resolves infection.
• Skin and soft‑tissue infections: treats deep tissue infections caused by gram‑negative and gram‑positive organisms.
• Lower respiratory tract infections (e.g., pneumonia): achieves high lung tissue concentrations for effective therapy.
• Febrile neutropenia: offers empiric coverage against high‑risk pathogens in immunocompromised patients.

• Imipenem binds to penicillin‑binding proteins, inhibiting the final stages of bacterial cell‑wall peptidoglycan synthesis, which leads to cell lysis. Cilastatin co‑administers to inhibit renal dehydropeptidase I, preventing enzymatic degradation of imipenem and thereby extending its antibacterial activity in the kidneys and systemic circulation.

Adverse reactions may occur with any intravenous antibiotic and should be monitored.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: may be watery and self‑limiting.
• Infusion site phlebitis: redness or pain at the injection site.
• Rash: non‑specific skin eruption.
• Elevated liver enzymes: transient increase in hepatic transaminases.

Serious or Rare Side Effects

• Seizures: especially in patients with renal impairment or CNS disorders.
• Anaphylaxis: acute, potentially life‑threatening hypersensitivity reaction.
• Clostridioides difficile colitis: severe diarrhea due to gut flora disruption.
• Severe neutropenia: marked reduction in white blood cells.
• Stevens‑Johnson syndrome: rare mucocutaneous blistering disorder.

Use Imipenem/Cilastatin Hikma with careful clinical assessment and monitoring.

• Renal function monitoring: adjust dosing in patients with impaired kidney function.
• CNS disorders caution: avoid in patients with a history of seizures.
• Hypersensitivity avoidance: do not use in individuals with known carbapenem allergy.
• Superinfection watch: monitor for secondary infections such as fungal overgrowth.
• Drug‑induced liver injury: assess liver enzymes periodically.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Imipenem/Cilastatin may alter the pharmacokinetics of several co‑administered drugs.

Major Interactions (Avoid)

• Valproic acid: carbapenems can reduce serum valproate levels, risking seizure breakthrough.
• Probenecid: may increase imipenem concentrations, heightening toxicity risk.
• High‑dose aminoglycosides: combined nephrotoxicity potential.

Moderate Interactions (Monitor Closely)

• Diuretics: may enhance electrolyte disturbances.
• Warfarin: monitor INR for possible anticoagulant effect changes.
• Oral contraceptives: reduced efficacy, advise additional contraceptive measures.