Imipenem/cilastatin

Carbapenem antibiotic of last resort for multidrug-resistant bacterial infections; broadest-spectrum beta-lactam. Carbapenem beta-lactam antibiotic (imipenem-cilastatin). Mechanism: binds PBPs (especially PBP2) → inhibits bacterial cell wall synthesis (bactericidal). Cilastatin inhibits renal dehydropeptidase-I that degrades imipenem → maintains drug levels. Broadest-spectrum beta-lactam; active against ESBL-producing organisms, Pseudomonas, anaerobes. Last-resort antibiotic. Key information Carbapenem — reserve antibiotic. Use only based on culture/sensitivity. Administer IV over 30–60 min (rapid infusion causes seizures). Refrigerate reconstituted solution; use within 4 hours. Resistance risk — monitor.

IV only: reconstitute and dilute per instructions; infuse over 30–60 min. Do not administer as rapid IV bolus. Use immediately after reconstitution. Store at room temperature; protect from light. (short stability after reconstitution — check label). If a dose is missed This medication is administered by a veterinarian or veterinary staff in a clinical setting. Missed doses are managed by your veterinary team — contact your veterinarian to reschedule.

GI: nausea, vomiting, diarrhea. CNS: seizures (dose-dependent — especially with renal impairment; reduce dose for renal failure). Phlebitis (IV). Hypersensitivity (cross-reactive with penicillin ~5%). Superinfection with resistant organisms (Candida, MRSA). Hepatotoxicity (rare).

For animals Reduce dose or extend interval in renal impairment. — dose-reduce in renal impairment (encephalopathy/seizure risk at normal doses in CKD patients). Avoid in beta-lactam-hypersensitive patients. Reserve for multi-drug-resistant infections. Use with caution in hepatic impairment. For people handling this medication Wear gloves when handling. Wash hands thoroughly with soap and water after handling. Carbapenem injectable — Injectable — administered by veterinary staff only. Wash hands thoroughly with soap and water after handling. If accidentally self-injected, seek emergency medical attention immediately. Inform doctor if you have beta-lactam allergy. Wear gloves.

Contact your veterinarian immediately. Carbapenem overdose causes seizures, GI signs, and kidney damage. Supportive care required.