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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Imipenem is a carbapenem antibiotic derived from thienamycin. It is usually combined with cilastatin, which inhibits the renal metabolism of imipenem. Cilastatin has no antimicrobial activity. Imipenem is effective against Gram-positive and Gram-negative aerobic and anaerobic organisms. It is often effective as single-agent therapy for polymicrobial pelvic infections in women. No studies of imipenem use in pregnancy and birth defects are published. Imipenem—cilastatin combination was not teratogenic in rats or rabbits, according to the manufacturer package insert. This drug has few indications for use of this very ‘potent’ antibiotic in pregnant women. Potential maternal side effects include hypersensitivity, central nervous system toxicity, and pseudomembranous colitis.
Nosocomial Infections Caused by Acinetobacter spp. — Therapeutic Problems
Published in E. Bergogne-Bénézin, M.L. Joly-Guillou, K.J. Towner, Acinetobacter, 2020
Finally, some overall recommendations can be made for the treatment of Acinetobacter meningitis. Imipenem should be used for eradication of infections caused by multiresistant strains. Ticarcillin, ureidopenicillins or fluoroquinolones may be appropriate for use against susceptible strains. The combined use of an aminoglycoside administered by the i.v. and/or local route may not always be necessary, provided that high doses of ß-lactams or fluoroquinolones are used. Meropenem is a novel carbapenem antibiotic that is currently active against Acinetobacter, with CSF concentrations that range from 0.3-6.5 mg/L at 2.5-3.0 h following a 40 mg/kg infusion (Dagan et al., 1994). This agent may also be useful for the treatment of Acinetobacter meningitis caused by otherwise resistant strains.
Imipenem–Cilastatin and Imipenem–Relebactam
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Yoshiro Hayashi, David L. Paterson
Imipenem is most commonly administered in a dosage of 500 mg every 6 hour or less often 1 g every 8 hour, intravenously (Rodloff et al., 2006). Both dosing regimens result in approximately the same time above the MIC (Mouton et al., 2000). The maximum recommended dose of imipenem is 50 mg/kg/day.
Bacterial external ventricular catheter-associated infection
Published in Expert Review of Anti-infective Therapy, 2020
Kirsten R. I. S. Dorresteijn, Matthijs C. Brouwer, Korné Jellema, Diederik van de Beek
Carbapenems are indicated in the treatment of Gram-negative bacteria. The drug of choice is meropenem [1,15]. Imipenem is contra-indicated in children since it increases the risk of seizures [88]. The penetration of meropenem in the CSF is low with a high inter-individual variability in patients with mildly inflamed meninges [78]. A median CSF penetration of 9% was described in 21 patients with ventriculitis (range 3–16%) [89]. The corresponding peak and trough concentrations in CSF were 1.20 (0.00–6.20) mg/L and 1.28 (0.00–4.10) mg/L. If treatment failure is suspected, or if patients are infected with carbapenem-resistant strains, intraventricular administration of colistin or polymyxin B can be considered [1,15]. In a nested propensity-matched historical cohort study in 95 patients with post-neurosurgical Gram-negative meningitis caused by carbapenem-resistant bacteria, combined systemic and intrathecal/intraventricular administration of colistin or amikacin (n = 37), led to a decrease in mortality (OR 0.19, 95% CI 0.04–0.99) without any serious adverse events in the intrathecally/intraventricularly treated patient group [90].
Integrated metabolomics and 16S rRNA sequencing to investigate the regulation of Chinese yam on antibiotic-induced intestinal dysbiosis in rats
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Yaping Sun, Tong Liu, Yanpo Si, Bing Cao, Yanli Zhang, Xiaoke Zheng, Weisheng Feng
Lmipenem/cilastatin sodium as a mixture antibiotic which could prevent and treat some serious disease caused by aerobic/anaerobic bacteria for its more safety and less adverse reaction [21]. But current research shows that imipenem can cause kidney toxicity and even urolithiasis [22]. As well as it could induced an oxidative stress-status and histopathological changes in the testis and altered spermatogenesis in particular at both 50 and 80 mg/kg dose-levels [23]. A study on the analysis of urine samples collected from cynomolgus monkey dosed with imipenem revealed a significant increase of β-hydroxybutyrate and ketone bodies, indicating a disruption of energy metabolism resulting from the suppression of gut microflora [24]. Research shows: normal Wistar rats were exposed to a broad spectrum β-lactam antibiotic imipenem/cilastatin sodium, at 50 mg/kg/daily for 4 days, then 14 days after recovery, the flora and metabolites began to recover, but still not exactly the same as the normal group [25]. Imipenem has an extremely wide range of activities against aerobic and anaerobic gram-positive bacteria as well as gram-negative bacteria. Therefore, in our study, imipenem was selected to rapidly and completely remove microorganisms from the gastrointestinal tract.
Longitudinal change in serum inflammatory markers in women with tubo-ovarian abscess after successful surgical treatment: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2022
Koray Görkem Saçıntı, Yavuz Emre Şükür, Gizem Oruç, Batuhan Özmen, Murat Sönmezer, Bülent Berker, Cem Somer Atabekoğlu, Rusen Aytaç
All patients were hospitalised and initiated parenteral antibiotics following admission. They were treated at the beginning empirically with an antibiotic regimen that included cephalosporin (2 g IV per 12 hours) plus metronidazole (500 mg IV per 8 hours) or clindamycin (900 mg IV per 8 hours) plus gentamicin (2 mg/kg loading dose then 1.5 mg/kg per 8 hours IV or IM). The patients who had received antibiotics previously were managed using imipenem (500 mg IV per 6 hours) or piperacillin-tazobactam (2.25–4.5 g IV per 8 hours). Surgery was performed after at least 48 hours of parenteral antibiotic treatment. Depending on patient preferences and findings during surgical exploration, surgical procedures included abscess drainage, salpingectomy, oophorectomy, or hysterectomy.