A Clinical Review and Critical Evaluation of Imipenem-Relebactam: Evidence to Date

Area of Science:

• Infectious Diseases
• Pharmacology
• Microbiology

Background:

• Imipenem-relebactam (I-R) is a novel combination therapy.
• It is indicated for complicated urinary tract infections, complicated intra-abdominal infections, and hospital-acquired or ventilator-associated bacterial pneumonia.
• I-R combines a beta-lactam antibiotic with a beta-lactamase inhibitor, administered with cilastatin.

Purpose of the Study:

• To evaluate the current evidence for imipenem-relebactam (I-R).
• To assess the efficacy and safety of I-R against multidrug-resistant organisms.
• To understand the clinical utility of I-R in treating serious bacterial infections.

Main Methods:

• A comprehensive literature search was conducted.
• Evidence from clinical trials and in vitro studies was reviewed.
• Safety and efficacy data were analyzed.

Main Results:

• I-R demonstrates in vitro activity against multidrug-resistant organisms, including carbapenem-resistant *Pseudomonas aeruginosa* and carbapenem-resistant Enterobacterales.
• FDA approval was granted based on positive Phase II trial results for complicated urinary tract and intra-abdominal infections.
• Common adverse events included nausea (6%), diarrhea (6%), and headache (4%).

Conclusions:

• Imipenem-relebactam (I-R) represents a significant advancement in treating infections caused by difficult-to-treat gram-negative bacteria.
• It is a valuable option for patients with limited or no alternative treatments for multidrug-resistant infections.
• The drug's profile supports its use in specific clinical scenarios involving resistant pathogens.