INEMPLUS 500

Indications

• Severe bacterial infections
• Intra-abdominal infections
• Pneumonia
• Urinary tract infections
• Skin and soft tissue infections
• Bone and joint infections
• Meningitis

Dosage

Children: Refer to the BNF for Children for specific dosing guidelines for paediatric patients, as doses vary based on age and weight.

Adults: The usual adult dose for imipenem ranges from 250 mg to 1 g administered intravenously every 6 to 8 hours, depending on the severity and type of infection.

Mechanism of action

Imipenem acts as an antimicrobial by inhibiting cell wall synthesis in various Gram-positive and Gram-negative bacteria. This mechanism is achieved through binding to penicillin-binding proteins (PBPs), particularly PBP-2, PBP-1a, and PBP-1b in E. coli and selected strains of Pseudomonas aeruginosa. The binding prevents the addition of peptidoglycan polymer to the bacterial cell wall, ultimately leading to cell lysis and death.

Pharmacodynamics

As a beta-lactam antibiotic, imipenem exhibits bactericidal properties by disrupting the synthesis of the bacterial cell wall. This activity is effective against a broad spectrum of pathogens, providing a crucial therapeutic option for serious infections, particularly those caused by resistant organisms.

Pharmacokinetics

Imipenem is typically administered intravenously due to its instability in acidic environments. It has a rapid distribution throughout the body, with peak plasma concentrations occurring shortly after administration. The drug is primarily excreted unchanged by the kidneys, and dose adjustments may be needed in patients with renal impairment. The half-life of imipenem is approximately 1 hour.

Contra-indications

• Hypersensitivity to imipenem or any of its components
• History of severe allergic reactions to other beta-lactam antibiotics

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Rash
• Seizures
• Superinfection
• Allergic reactions

Interactions

• Probenecid may increase plasma concentrations of imipenem
• Valproic acid may have decreased effectiveness when used with imipenem

Precautions

• Use with caution in patients with a history of seizures
• Assess renal function prior to use
• Monitor for signs of superinfection

Pregnancy

Use during pregnancy only if the potential benefit justifies the potential risk to the fetus, as there are no adequate and well-controlled studies in pregnant women.

Breast-feeding

Imipenem is excreted in breast milk, caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place, protected from light. Reconstituted solutions should be used promptly or stored in a refrigerator and discarded after 24 hours.

Formulations

• Powder for injection

Mechanism of action

Imipenem acts as an antimicrobial through the inhibition of cell wall synthesis of various gram-positive and gram-negative bacteria. This inhibition of cell wall synthesis in gram-negative bateria is attained by binding to penicillin-binding proteins (PBPs). In E. coli and selected strains of P. aeruginosa, imipenem has shown to have the highest affinity to PBP-2, PBP-1a, and PBP-1b. This inhibition of PBPs prevents the bacterial cell from adding to the peptidoglycan polymer which forms the bacterial cell wall eventually leading to cell death.

Pharmacodynamics

Imipenem is a beta-lactam antibiotic belongings to the subgroup of carbapenems. Imipenem is active against aerobic and anaerobic Gram positive as well as Gram negative bacteria including <i>Pseudomonas aeruginosa</i> and the <i>Enterococcus</i>. It exerts a bactericidal effects by disrupting cell wall synthesis.