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Imipenem
1Division of Infectious Diseases and Internal Medicine, Mayo Clinic Jacksonville, Florida.
Mayo Clinic Proceedings
|October 1, 1991
Summary
Imipenem, a novel carbapenem antibiotic, offers broad-spectrum activity against many bacteria, including difficult-to-treat gram-negative pathogens. Careful use is advised to prevent resistance and manage potential side effects like seizures.
Area of Science:
- Pharmacology
- Microbiology
- Infectious Diseases
Background:
- Imipenem represents the first carbapenem antibiotic, a new class of beta-lactam antimicrobials.
- It exhibits the broadest spectrum of antibacterial activity among systemically available antibiotics for human use.
Purpose of the Study:
- To review the clinical profile of imipenem, including its antibacterial spectrum, dosing, and toxicity.
- To provide guidance on appropriate use in treating specific bacterial infections.
Main Methods:
- Review of existing literature on imipenem's pharmacological and clinical properties.
- Analysis of its activity against various bacterial pathogens, including common nosocomial isolates.
Main Results:
- Imipenem is active against streptococci, methicillin-sensitive staphylococci, Neisseria, Haemophilus, anaerobes, and aerobic gram-negative pathogens like Pseudomonas.
- Resistance can emerge during P. aeruginosa treatment; P. maltophilia and P. cepacia are typically resistant.
- It also shows inhibitory activity against enterococci, similar to penicillins.
Conclusions:
- Imipenem is indicated for mixed bacterial infections and infections caused by resistant aerobic gram-negative bacteria unresponsive to other beta-lactams.
- Judicious use is crucial to avoid unnecessary toxicity and prevent the spread of imipenem resistance.
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