Bacterial sepsis; Infection of bone; Infection of skin and/or subcutaneous tissue; Infectious disease of abdomen; Infective endocarditis; Lower respiratory tract infection; Urinary tract infectious disease.

Antibiotic, Carbapenem
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested. Cilastatin prevents renal metabolism of imipenem by competitive inhibition of dehydropeptidase along the brush border of the renal tubules.

1.Protein binding: Imipenem: ~20%; cilastatin: ~40%.
2.Metabolism: Imipenem is metabolized in the kidney by dehydropeptidase I; cilastatin prevents imipenem metabolism by this enzyme.
3.Half-life elimination: IV: Adults (both drugs): ~60 minutes.
4.Excretion: Both drugs: Urine (~70% as unchanged drug).

Hypersensitivity to imipenem/cilastatin or any component of the formulation.

Available evidence is inconclusive or inadequate for determining fetal risk when used in pregnant women.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

Red spots, Local pain and lumps, Rash, Itching, Nausea, Vomiting, Diarrhea, Leukopenia

Bloodstream infection
IV: 500 mg every 6 hours (IDSA [Mermel 2009]); for empiric therapy in patients with neutropenia, severe burns, sepsis, or septic shock, give as part of an appropriate combination regimen.
Skin and soft tissue infection, moderate to severe
Non-necrotizing infection: IV: 500 mg every 6 hours. Usual duration (including oral step-down therapy) is 5 to 14 days based on severity and clinical response.
Intra-abdominal infection
1.Cholecystitis, acute uncomplicated: IV: 500 mg every 6 hours or 1 g every 8 hours.
2.Other intra-abdominal infection (eg, cholangitis, complicated cholecystitis, appendicitis, diverticulitis, intra-abdominal abscess): IV: 500 mg every 6 hours or 1 g every 8 hours.
Endocarditis
IV: 500 mg every 6 hours or 1 g every 8 hours , as part of an appropriate combination regimen, for 6 weeks.
Pneumonia
Community-acquired pneumonia:IV: 500 mg every 6 hours as part of an appropriate combination regimen.
Urinary tract infection, complicated
IV: 500 mg every 6 hours. Switch to an appropriate oral regimen once symptoms improve if culture and susceptibility results allow.

CrCl (mL/minute)	If the usual recommended dose is 500 mg every 6 hours	If the usual recommended dose is 1 g every 8 hours	If the usual recommended dose is 1 g every 6 hours
60 to <130	No dosage adjustment necessary	No dosage adjustment necessary	No dosage adjustment necessary
>30 to <60	250 mg every 6 hours or 500 mg every 8 hours	500 mg every 8 hours	500 mg every 6 hours
>15 to <30	250 mg every 8 hours or 500 mg every 12 hours	250 mg every 8 hours or 500 mg every 12 hours	250 mg every 6 hours

There are no dosage adjustments provided in the manufacturer's labeling.