Imipenem

Imipenem is an intravenous β-lactam antibiotic developed in 1985. It is broad spectrum, and therefore sometimes referred to as "Gorilla-cillin." Imipenem belongs to the subgroup of carbapenems. It is derived from a compound called thienamycin, which is produced by the bacteria Streptomyces cattleya. Imipenem has a broad spectrum of activity against aerobic and anaerobic Gram positive as well as Gram negative bacteria. It is particularly important for its activity against Pseudomonas aeruginosa and the Enterococcus species. It is not active against methicillin-resistant Staphylococcus aureus, however. Imipenem and other drugs in the carbapenem class are commonly referred to as "magic bullets." Their use is typically restricted in order to avoid widespread bacterial resistance.

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Method of action

Imipenem acts as an antimicrobial through inhibiting cell wall synthesis of various gram-positive and gram-negative bacteria. It remains very stable in the presence of beta-lactamase (both penicillinase and cephalosporinase) produced by some bacteria, and is a strong inhibitor of beta-lactamases from some gram-negative bacteria that are resistant to most beta-lactam antibiotics.

Co-administration with cilastatin

Imipenem is rapidly degraded by the renal enzyme dehydropeptidase when administered alone, and is always co-administered with cilastatin to prevent this inactivation.

Adverse effects

Common adverse drug reactions are nausea and vomiting. People who are allergic to penicillin and other beta-lactam antibiotics should not take imipenem. Imipenem can also cause seizures.

References

^  Clissold SP, Todd PA, Campoli Richards DM. Imipenem/Cilastatin: A reivew of its anti-bacterial activity, pharmacokinetic properties and therapeutic efficacy. Drugs 1987; 33: 183-241.

See also

• Imipenem/cilastatin