Imipenem/Cilastatin Steriscience (Cilastatin, Imipenem)

Imipenem/Cilastatin is a carbapenem antibiotic used to treat serious bacterial infections across several organ systems.

• Complicated intra‑abdominal infections: provides broad‑spectrum coverage to eradicate mixed aerobic and anaerobic pathogens.
• Complicated urinary tract infections: achieves bacterial eradication in resistant Gram‑negative and Gram‑positive organisms.
• Skin and soft tissue infections: delivers rapid bactericidal activity against common skin pathogens.
• Hospital‑acquired pneumonia (including ventilator‑associated): ensures effective treatment of multidrug‑resistant respiratory pathogens.
• Severe sepsis and septic shock: contributes to rapid bacterial clearance in critically ill patients.

• Imipenem binds to penicillin‑binding proteins, inhibiting bacterial cell‑wall synthesis and leading to cell lysis. Cilastatin co‑administers to inhibit renal dehydropeptidase‑I, preventing enzymatic degradation of imipenem and thereby extending its plasma concentration and antibacterial activity.

Adverse reactions to Imipenem/Cilastatin may vary from mild to severe and should be monitored during therapy.

Common Side Effects

• Nausea: mild gastrointestinal upset.
• Diarrhea: may be watery and self‑limiting.
• Rash: mild skin erythema or pruritus.
• Injection site pain: discomfort at the infusion site.

Serious or Rare Side Effects

• Seizures: risk increased in patients with renal impairment or CNS disorders.
• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Clostridioides difficile colitis: potentially life‑threatening intestinal infection.

When prescribing Imipenem/Cilastatin, clinicians should consider several precautionary measures to minimise risk.

• Renal function assessment: adjust dose in patients with impaired kidney function.
• History of seizures: avoid or monitor closely in individuals with prior seizure disorders.
• Allergy evaluation: confirm no known hypersensitivity to β‑lactam antibiotics.
• Concomitant valproic acid: monitor for reduced antiepileptic levels.
• Use in pregnancy: weigh potential benefits against unknown fetal risk.
• Store at 2‑8 °C: keep refrigerated, protect from light, do not freeze or shake.

Imipenem/Cilastatin can interact with other medicines, affecting efficacy or safety.

Major Interactions (Avoid)

• Valproic acid: may decrease valproate concentrations, risking seizure breakthrough.
• Carbapenem antibiotics with probenecid: can increase nephrotoxicity risk.

Moderate Interactions (Monitor Closely)

• Diuretics: may potentiate electrolyte disturbances.
• Anticoagulants (warfarin): monitor INR for possible changes.
• CNS depressants: observe for enhanced central nervous system effects.