イミペネム・シラスタチンナトリウム

使用用途

• Susceptible infections
• Susceptible infections
• Tissue infections
• Sepsis, more resistant organisms
• Treatment of Nocardiosis
• Susceptible infections (Adult horses)
• Susceptible infections (Foals)
• Susceptible infections (Foals)
• Susceptible infections
• Susceptible infections
• Tissue infections
• Sepsis, more resistant organisms
• Treatment of Nocardiosis

投与方法

考えられる副作用

• Gastrointestinal upset (vomiting, anorexia, diarrhea)
• CNS toxicity (seizures, tremors)
• Hypersensitivity reactions (pruritus, fever, anaphylaxis)
• Infusion reactions (thrombophlebitis)
• Severe pain and potential neurovascular damage at IM injection sites
• Transient increases in BUN, serum creatinine, AST, ALT, and Alkaline Phosphatase
• Hypotension or tachycardia (rare)

注意事項と禁忌

• Patients with known hypersensitivity to imipenem, cilastatin, or other beta-lactam antibiotics (due to partial cross-reactivity)
• Caution in patients with renal impairment (dosage adjustment required)
• Caution in patients with underlying CNS disorders (e.g., seizures, head trauma) due to increased risk of neurotoxicity
• **CRITICAL WARNINGS:** * **Do NOT administer via rapid IV infusion.** Rapid infusion significantly increases the risk of CNS toxicity and seizures. Doses ≤ 500 mg should be given over 20-30 minutes; doses > 500 mg should be given over 40-60 minutes. * **Formulation Specificity:** The IV and IM dosage forms are **NOT interchangeable**. If giving IM or SC, the specific IM product must be used. * **Renal Impairment:** Animals with reduced renal function (including neonates and geriatrics) are at a higher risk for seizures. Dosages may need to be reduced or dosing intervals extended. * **IM Administration:** Can cause severe pain. It is recommended to dilute the IM form in 1% lidocaine (without epinephrine) to relieve associated pain.

薬物相互作用

• Aminoglycosides: Additive effects or synergy may result, particularly against Enterococcus, Staph. aureus, and Listeria monocytogenes. No synergy or antagonism noted against Enterobacteriaceae or Pseudomonas aeruginosa.
• Beta-Lactam Antibiotics: Antagonism may occur against several Enterobacteriaceae (including Pseudomonas aeruginosa, Klebsiella, Enterobacter, Serratia). Concurrent use is not recommended.
• Chloramphenicol: May antagonize the antibacterial effects of imipenem (based on in vitro evidence).
• Probenecid: May increase concentrations and elimination half-life of cilastatin, but not imipenem; concurrent use is not recommended.
• Trimethoprim/Sulfa: Synergy may occur against Nocardia asteroides when used in combination.

よくある質問