From the FDA Drug Label
1.7 Skin and Skin Structure Infections Imipenem and Cilastatin for Injection, USP (I.V.) is indicated for the treatment of skin and skin structure infections caused by susceptible strains of ... Serratia species, ... Imipenem and Cilastatin for Injection, USP (I.V.) can be used to treat skin and skin structure infections caused by Serratia marcescens.
- The drug is indicated for use in treating infections caused by susceptible strains of Serratia species, which includes Serratia marcescens.
- It is essential to note that the treatment should only be used when the infection is proven or strongly suspected to be caused by susceptible bacteria 1.
From the Research
Treatment for Serratia marcescens skin infections should include carbapenems or aminoglycosides in combination with third-generation cephalosporin, as recommended by the most recent study 2. The choice of antibiotic should be based on susceptibility testing, and initial empiric therapy may include fluoroquinolones like ciprofloxacin or levofloxacin.
- Key considerations for treatment include:
- Local wound care with regular cleaning and possible debridement of necrotic tissue
- Drainage of any abscesses
- Follow-up cultures to ensure the infection is resolving
- Potential for resistance development, particularly in immunocompromised patients
- The most recent study 2 suggests that carbapenems or aminoglycosides in combination with third-generation cephalosporin may be effective against Serratia marcescens infections, with a mortality rate of 31% in the studied cases.
- Other studies, such as 3, have investigated the activity of various β-lactam/β-lactamase inhibitors against carbapenem-resistant Serratia marcescens, but the most recent and highest-quality study 2 prioritizes carbapenems or aminoglycosides in combination with third-generation cephalosporin.
- It is essential to note that S. marcescens is naturally resistant to several antibiotics, including ampicillin and first-generation cephalosporins, and can develop resistance during treatment 4.
- Therefore, carbapenems or aminoglycosides in combination with third-generation cephalosporin should be considered as the primary treatment option for Serratia marcescens skin infections, based on the most recent and highest-quality evidence 2.