Prepenem

Imipenem 500 mg, cilastatin Na 500 mg

Susceptible infections eg, intra-abdominal, complicated & uncomplicated UTI, lower resp tract, bone & joint, gynecological, skin & skin structure, bacterial septicemia, endocarditis & polymicrobic infections. Presumptive therapy for mixed infections prior to identification of causative organisms.

IV infusion Administer over 15-30 min for doses ≤500 mg & over 40-60 min for doses >500 mg. Adults w/ normal renal function weighing >70 kg Max total daily dose: 50 mg/kg daily or 4 g daily, whichever is lower. Fully susceptible organisms including gm +ve & -ve aerobes & anaerobes Mild infection: 250 mg every 6 hr. Total daily dose: 1 g. Moderate infection: 500 mg every 8 hr. Total daily dose: 1.5 g or 500 mg every 6 hr. Total daily dose: 2 g. Severe, life threatening infection: 500 mg every 6 hr. Total daily dose: 2 g. Uncomplicated UTI: 250 mg every 6 hr. Total daily dose: 1 g. Complicated UTI: 500 mg every 6 hr. Total daily dose: 2 g. Moderately susceptible organisms, primarily some strains of Pseudomonas aeruginosa Mild infection: 500 mg every 6 hr. Total daily dose: 2 g. Moderate infection: 500 mg every 6 hr. Total daily dose: 2 g or 1 g every 8 hr. Total daily dose: 3 g. Severe, life threatening infection: 1 g every 8 hr. Total daily dose: 3 g or 1 g every 6 hr. Total daily dose: 4 g. Uncomplicated UTI: 250 mg every 6 hr. Total daily dose: 1 g. Complicated UTI: 500 mg every 6 hr. Total daily dose: 2 g. Patients >12 yr w/ cystic fibrosis Up to 90 mg/kg daily in divided doses. Max: 40 g daily. Childn ≥3 mth Non-CNS infections 15-25 mg/kg every 6 hr. Fully susceptible infections Max: 2 g daily. Moderately susceptible infections 4 g daily. Childn ≤3 mth weighing >1,500 gm Non-CNS infections 4 wk-3 mth: 25 mg/kg every 6 hr. 1-4 wk: 25 mg/kg every 8 hr. <1 wk: 25 mg/kg every 12 hr. Adults w/ 1 g total daily dose weighing ≥70 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 250 mg every 8 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 12 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 60 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 125 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 12 hr, CrCl 6-20 mL/min/1.73 m² 125 mg every 12 hr. 50 kg w/ CrCl 21-≥71 mL/min/1.73 m² 125 mg every 6 hr, CrCl 6-20 mL/min/1.73 m² 125 mg every 12 hr. 40 kg w/ CrCl ≥71 mL/min/1.73 m² 125 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 125 mg every 8 hr, CrCl 21-40 mL/min/1.73 m² 125 mg every 12 hr, CrCl 6-20 mL/min/1.73 m² 125 mg every 12 hr. 30 kg w/ CrCl 41-≥71 mL/min/1.73 m² 125 mg every 8 hr, CrCl 6-40 mL/min/1.73 m² 125 mg every 12 hr. 1.5 g total daily dose weighing ≥70 kg w/ CrCl ≥71 mL/min/1.73 m² 500 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 250 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 60 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 6 hr, CrCl 21-70 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 50 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-40 mL/min/1.73 m² 250 mg every 12 hr. 40 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 125 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 125 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 125 mg every 12 hr. 30 kg w/ CrCl ≥71 mL/min/1.73 m² 125 mg every 6 hr, CrCl 21-70 mL/min/1.73 m² 125 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 125 mg every 12 hr. 2 g total daily dose weighing ≥70 kg w/ CrCl ≥71 mL/min/1.73 m² 500 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 500 mg every 8 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 6 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 60 kg w/ CrCl ≥71 mL/min/1.73 m² 500 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 250 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 50 kg w/ CrCl 41-≥71 mL/min/1.73 m² 250 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 40 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-40 mL/min/1.73 m² 250 mg every 12 hr. 30 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 125 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 125 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 125 mg every 12 hr. 3 g total daily dose weighing ≥70 kg w/ CrCl ≥71 mL/min/1.73 m² 1,000 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 500 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 500 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 500 mg every 12 hr. 60 kg w/ CrCl ≥71 mL/min/1.73 m² 750 mg every 8 hr, CrCl 21-70 mL/min/1.73 m² 500 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 500 mg every 12 hr. 50 kg w/ CrCl ≥71 mL/min/1.73 m² 500 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 500 mg every 8 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 6 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 40 kg w/ CrCl ≥71 mL/min/1.73 m² 500 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 250 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 30 kg w/ CrCl ≥71 mL/min/1.73 m² 250 mg every 6 hr, CrCl 21-70 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 4 g total daily dose weighing ≥70 kg w/ CrCl ≥71 mL/min/1.73 m² 1,000 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 750 mg every 8 hr, CrCl 21-40 mL/min/1.73 m² 500 mg every 6 hr, CrCl 6-20 mL/min/1.73 m² 500 mg every 12 hr. 60 kg w/ CrCl ≥71 mL/min/1.73 m² 1,000 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 750 mg every 8 hr, CrCl 21-40 mL/min/1.73 m² 500 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 500 mg every 12 hr. 50 kg w/ CrCl ≥71 mL/min/1.73 m² 750 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 500 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 500 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 500 mg every 12 hr. 40 kg w/ CrCl ≥71 mL/min/1.73 m² 500 mg every 6 hr, CrCl 41-70 mL/min/1.73 m² 500 mg every 8 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 6 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr. 30 kg w/ CrCl ≥71 mL/min/1.73 m² 500 mg every 8 hr, CrCl 41-70 mL/min/1.73 m² 250 mg every 6 hr, CrCl 21-40 mL/min/1.73 m² 250 mg every 8 hr, CrCl 6-20 mL/min/1.73 m² 250 mg every 12 hr.

Hypersensitivity.

Hypersensitivity (anaphylactic) reactions. Not indicated in patients w/ meningitis. Superinfection. Mild to life threatening pseudomembranous colitis. Antibiotic-associated colitis. Shock. Confusional states, myoclonic activity & seizures. Patients w/ diarrhea subsequent to antibacterial administration; CNS disorders (eg, brain lesions or history of seizures) &/or compromised renal function; known factors that predispose to convulsive activity; seizure disorders. Perform skin test before administration. Evaluate patients neurogically, institute anticonvulsant therapy & re-examine dosage if focal tremors, myoclonus or seizures occur. Not to be administered in patients w/ CrCl <5 mL/min/1.73 m² unless hemodialysis is instituted w/in 48 hr. Patients on hemodialysis. Pregnancy & lactation. Not recommended in childn w/ CNS infections; <30 kg w/ impaired renal function.

Nausea, diarrhea, vomiting, rash, fever, hypotension, seizures, dizziness, pruritus, urticaria, somnolence. SJS, TEN.

Generalized seizures w/ ganciclovir.

Other Beta-Lactams

J01DH51 - imipenem and cilastatin ; Belongs to the class of carbapenems. Used in the systemic treatment of infections.

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