imipenemrelebaktam

Imipenemrelebaktam is a fixed‑dose intravenous antibiotic combination that includes imipenem, cilastatin, and relebactam. It is marketed as a single product (often referred to as imipenem/cilastatin/relebactam) and is used to treat certain serious infections caused by Gram‑negative bacteria. The cilastatin component inhibits renal dehydropeptidase I to prevent imipenem degradation in the kidney, while relebactam is a β-lactamase inhibitor that protects imipenem from degradation by specific β-lactamases, thereby restoring or enhancing its activity.

The therapy broadens the spectrum of imipenem by countering certain β-lactamases, particularly some class A and class C enzymes. It retains activity against many Enterobacterales and Pseudomonas aeruginosa, including some strains that produce β-lactamases such as KPC and AmpC. It does not have activity against metallo-β-lactamases and is not active against many Gram-positive pathogens (for example, MRSA). The combination is used in settings where resistant Gram-negative infections are suspected or proven.

Indications typically include complicated intra‑abdominal infections, complicated urinary tract infections, and hospital-acquired bacterial pneumonia, including ventilator-associated pneumonia, in adults. Dosing is intravenous and depends on the infection type and renal function; renal impairment necessitates dose adjustment. Safety considerations align with other β-lactams and include nausea, diarrhea, headache, and potential infusion‑related reactions. C. difficile infection risk can occur with broad-spectrum agents. As with other carbapenems, hypersensitivity in patients with known penicillin or cephalosporin allergy is a concern, and seizure risk may rise with high doses or reduced renal function. Overall, imipenemrelebaktam is used to treat select resistant Gram‑negative infections where its β‑lactamase–protected activity provides a clinical advantage.