Classification
Imipenem belongs to the group of substances called carbapenems. These antibiotics currently have the broadest spectrum of action. Imipenem is also known under the trade name ZienamR.
Effect
Carbapenems (meropenem, imipenem) are among the most widely used antibiotics and reach almost all gram-positive and negative pathogens. This substance is also often given to patients who have been infected by the germ Pseudomonas aerogenosa.
Side effects
Since not only pathological germs are killed by Imipenem, but also bacteria that are natural in the oral and intestinal flora, there is a risk of fungal infection if Imipenem is used for a long time. The fungi usually spread in the areas where the natural bacteria have been killed (mouth, throat and intestines). In this case, an anti-fungal medication must be added to the imipenem. Particularly in patients with pre-existing nerve damage to the central nervous system, there is a risk of further nerve damage, which can manifest itself in the form of seizures. Patients with pre-existing kidney damage are also more at risk of getting nerve damage under Imipenem.
Fields of application
Carbapenems have a broad spectrum of activity in both the gram-positive and gram-negative range. Bacteria that grow particularly well under exclusion of air (anaerobes) are also among the treatable germs of imipenem. In the past, imipenem was merely a reserve antibiotic.
Today it is increasingly included in the initial therapy. It is used, for example, in cases of blood poisoning (sepsis) and life-threatening infections, such as severe pneumonia. Imipenem is also used for mixed infections and infections with unclear germs. Imipenem is not effective for mycoplasma, MRSA, Clostridium difficile and some enterococci. For Pseudomonas, carbapenem must be combined with aminoclycosides.
Interactions
In combination with virustatics (treatment of viruses) seizures can occur.
Contraindications
Imipenem should not be given to pregnant women and children. In cases of existing renal insufficiency and known cramping, Imipenem should only be administered under special consideration. Imipenem should not be given in cases of known hypersensitivity to carbapenems.
