What is the recommended dose of intravenous (IV) cilastatin (Imipenem/Cilastatin)?

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Recommended Dosage of Intravenous (IV) Imipenem/Cilastatin

The recommended dose of intravenous imipenem/cilastatin for most infections is 500 mg every 6 hours or 1000 mg every 8 hours for patients with normal renal function (creatinine clearance ≥90 mL/min). 1

Dosing Based on Infection Severity and Pathogen Susceptibility

The appropriate dosing regimen depends on the suspected or confirmed pathogen susceptibility:

  • For susceptible bacterial species:

    • 500 mg every 6 hours OR
    • 1000 mg every 8 hours 1
  • For bacterial species with intermediate susceptibility:

    • 1000 mg every 6 hours 1
  • For severe infections like carbapenem-resistant Enterobacterales:

    • 1.25 g IV every 6 hours is recommended for bloodstream infections, complicated UTIs, and complicated intra-abdominal infections 2

Administration Guidelines

  • Doses ≤500 mg should be administered by IV infusion over 20-30 minutes
  • Doses >500 mg should be administered by IV infusion over 40-60 minutes
  • For patients who develop nausea during infusion, the rate may be slowed 1

Dosage Adjustment for Renal Impairment

Dosage must be reduced for patients with decreased renal function according to creatinine clearance:

Creatinine Clearance (mL/min) Dosage for Susceptible Pathogens
≥90 500 mg q6h or 1000 mg q8h
<90 to ≥60 400 mg q6h or 500 mg q6h
<60 to ≥30 300 mg q6h or 500 mg q8h
<30 to ≥15 200 mg q6h or 500 mg q12h
<15 Requires further dose reduction

1

Important Clinical Considerations

  • The maximum total daily dosage should not exceed 4 g/day 1
  • Imipenem is metabolized by renal dehydropeptidase I, which is why it's always co-administered with cilastatin (in a 1:1 ratio) to inhibit this metabolism and increase urinary recovery of active imipenem 3
  • Cilastatin is eliminated more slowly than imipenem in patients with renal impairment, necessitating dose adjustments 4
  • For patients on hemodialysis, both imipenem and cilastatin are efficiently removed during a 4-hour session, requiring a supplementary dose after dialysis 4

Monitoring and Adverse Effects

  • Routine monitoring should include complete blood count, renal function, and liver function tests throughout treatment 2
  • Common adverse effects: nausea, vomiting, diarrhea, rash, thrombophlebitis, and eosinophilia
  • Serious adverse effects: seizures, anaphylaxis, and C. difficile-associated diarrhea
  • Concomitant use of valproate should be avoided due to reduced serum concentrations of valproate 2

Treatment Duration

Treatment duration depends on the type of infection:

  • Bloodstream infections: 7-14 days
  • Complicated UTIs and intra-abdominal infections: 5-7 days 2

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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