imipeneem

Imipenem is a broad-spectrum antibiotic belonging to the carbapenem class. It is administered intravenously, often in combination with cilastatin, a dehydropeptidase-I inhibitor. Cilastatin prevents the rapid renal excretion of imipenem, thereby increasing its concentration in the bloodstream and prolonging its therapeutic effect. This combination is effective against a wide range of Gram-positive and Gram-negative bacteria, including many aerobic and anaerobic species. Imipenem works by inhibiting bacterial cell wall synthesis, a mechanism common to penicillin-like antibiotics. It binds to penicillin-binding proteins (PBPs), which are enzymes essential for the cross-linking of peptidoglycans in the bacterial cell wall. This inhibition leads to the weakening and eventual lysis of the bacterial cell. Due to its broad spectrum of activity and potent bactericidal effects, imipenem is typically reserved for serious or life-threatening infections, particularly those caused by multidrug-resistant organisms. It is often used to treat complicated intra-abdominal infections, pneumonia, and skin and soft tissue infections. Potential side effects include gastrointestinal disturbances, rash, and hypersensitivity reactions. Imipenem is generally well-tolerated, but caution is advised in patients with a history of penicillin allergy. Its use is guided by susceptibility testing to ensure optimal efficacy and to minimize the development of antibiotic resistance.