Infectious Disease Compendium

Imipenem (Primaxin®)

Dosing

CrCl Formula

CrCl > 80: 500 mg - 1 g iv q 6 h.

CrCl 80-50: 500 mg iv q 6 - 8 h.

CrCl 50-10: 500 mg q 8 - 12 h.

CrCl < 10: 250 - 500 mg iv q 12 h.

Hemodialysis: 250 - 500 mg after then q 12.

Peritoneal dialysis:

Important side effects

1) seizures if not dosed for CrCl.

2) 30% chance of cross-reaction if a type 1 reaction to penicillin. Did you see that? 30%!. Holy spit. (Surprise, I actually censored myself).

Important drug interactions

Cyclosporine, ganciclovir, theophylline.

Rants and Screeds

Pearls

It is combined with cilastatin, an inhibitor of renal dehydropeptidase, an enzyme that rapidly metabolized imipenem

Pseudomonas can develop resistance on therapy and very rapidly due to the loss of porin.

Treatment of choice

Use for

Damn near anything. Anthrax, Arthritis, Cellulitis, Cystic fibrosis, Diverticulosis/itis, Endocarditis, gynecologic infections, Intraabdominal infections, Meningitis, Neutropenic fever, Osteomyelitis, Peritonitis, Pneumonia, Sepsis, UTI.

Don't use for

Class

Carbapenem

Last update 11/27/19