Intra-abdominal, lower resp tract, O & G, GUT, bone & joint, skin & soft tissue, endocarditis, septicemia & mixed infections due to susceptible organisms. Infections caused by bacteria resistant to cephalosporins, aminoglycosides &/or penicillins. As empiric therapy or prophylaxis in the prevention of certain post-op infections in patients undergoing (potentially or) contaminated surgical procedures.
IV infusionTherapyAdult & childn ≥40 kg Initially 1-2 g, total daily dose can be increased to 3 or 4 g (severe &/or life-threatening infections) given in 3-4 divided doses. Max: 50 mg/kg/day not to exceed 4 g daily. Infusion rate: Each dose of imipenem & cilastatin Na ≤500 mg should be infused over 20-30 min; >500 mg should be infused over 40-60 min. Prophylaxis for postsurgical infection 1 g on induction of anesth & 1 g 3 hr later. For high-risk surgery (eg, colorectal) 2 additional 500 mg doses may be given at 8 & 16 hr after induction. Renal insufficiency Lower doses required not to exceed 2 g daily. CrCl ≤5 mL/min/1.73 m2 Institute hemodialysis w/in 48 hr, administer at 12 hr intervals timed from the end of the hemodialysis session. Cystic fibrosis patient w/ normal renal function 90 mg/kg/day in divided doses, not exceeding 4 g/day. Childn & infant ≥3 mth 15 mg/kg 6 hrly. Max: 2 g.
Dosage adjustment in patients w/ renal insufficiency. Patients on hemodialysis. Partial cross allergenicity w/ other β-lactam antibiotics, penicillins & cephalosporins. History of GI disease, particularly colitis. Caution in patients w/ CNS disorders &/or compromised renal function in whom accumulation of drug could occur. If CNS symptoms occur, dosage of Tienam should be decreased or discontinued. Concomitant use w/ valproic acid/divalproex Na is generally not recommended. Pregnancy & lactation.
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