Clinical Pharmacology of Antibiotics: Review of Imipenem

Abstract

Imipenem, a new carbapenem g/ml. Although the MIC-90 of methicillin-resistant staphylococci may be <4 g/ml but bactericidal concentration may be much higher. Most Enterobacteriaceae are highly susceptible to imipenem with MIC-90 of 0.5 to 2.0 g/ml. Isolates of P. aeruginosa have variable susceptibility with MICs ranging from 0.25 to 16 g/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.