- Discussion:
- 0.5-1gm q6-8h IV;
- good for Pseudomonas, Enteric, Coag pos Staph (except for MRS) and Staph producing B lactamases, anaerobes, w/ enterococci/ NonEneterococciStrep; Poor activity against Coag neg Staph;
- mild infections: 250-500mg IV q6hr;
- severe infections: 500mg-1gm IV q6-8hr;
- maximum daily dose less than 4gm/day or 50mg/kg/day (which ever is lower);
- note: seizure activity with drug accumulation, adjust w/ renal failure decrease w/ renal failure;
- note: imipenen is associatted with acute tubular necrosis when administered alone, but this effect is diminished when cilastin is administered;
- 75% of drug will be excreted in to urine (w/ nl RF(x))
- Both imipenem and cilastatin are effectively removed by hemodialysis;
- some authorities believe that in patients with renal impairment, only patients who are undergoing dialysis should receive imipenem, and that doses should not be > than 2 gm daily;
- peds: < 3yrs: 100 mg/kg/24hr divided q6hr; > 3yrs: 60 mg/kg/24hrs divided q6hr