Two decades of imipenem therapy

Area of Science:

• Infectious Diseases
• Pharmacology
• Antimicrobial Stewardship

Background:

• Imipenem, the first carbapenem, was developed over 20 years ago to address the need for potent, broad-spectrum antimicrobials.
• Antibiotic resistance necessitates careful selection of initial antimicrobial therapy for serious infections.

Purpose of the Study:

• To review the factors supporting imipenem's continued appropriateness as a de-escalation therapy agent.
• To highlight imipenem's role in minimizing resistance development through early aggressive treatment.

Main Methods:

• Review of clinical data and in vitro activity of imipenem.
• Analysis of imipenem's role in de-escalation strategies for common serious infections.

Main Results:

• Imipenem has demonstrated sustained clinical efficacy, tolerability, and in vitro activity for two decades.
• Imipenem is effective for nosocomial pneumonia, intra-abdominal infections, sepsis, and febrile neutropenia.

Conclusions:

• Imipenem is a valuable agent for de-escalation therapy, balancing efficacy with resistance mitigation.
• The established safety and efficacy of imipenem support its continued use in modern antimicrobial stewardship.