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Summary
Imipenem is a broad-spectrum antibiotic effective against many bacteria, including Gram-positive and Gram-negative species. While generally well-tolerated, potential side effects include seizures and colonization with resistant organisms.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Imipenem is a novel carbapenem beta-lactam antibiotic.
- It exhibits broad-spectrum activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria.
Purpose of the Study:
- To evaluate the in vitro activity of imipenem against various bacterial pathogens.
- To assess the pharmacokinetic and safety profile of imipenem, particularly when combined with cilastatin.
Main Methods:
- In vitro susceptibility testing was performed against a range of clinically relevant bacteria.
- Pharmacokinetic studies assessed imipenem's serum half-life with and without cilastatin.
- Clinical efficacy and adverse events were monitored in patient studies.
Main Results:
- Imipenem demonstrated high in vitro activity against most bacteria, with minimal inhibitory concentrations (MICs) generally below 2 µg/ml.
- Enterococci and methicillin-resistant staphylococci showed variable susceptibility.
- Pseudomonas aeruginosa isolates exhibited a wide range of susceptibility.
- Combination with cilastatin increased the renal elimination of imipenem's active form.
- Clinical studies reported efficacy rates between 79% and 96%.
Conclusions:
- Imipenem is a potent antibiotic with broad-spectrum activity against many bacterial pathogens.
- Its pharmacokinetic profile is favorably altered by co-administration with cilastatin.
- While generally safe, potential adverse effects and resistance development warrant consideration.