- Imipenem-cilastatin (Primaxin) is includes a carbapenem antibiotic (imipenem) plus a dehydropeptidase-I (DHP-I) inhibitor (cilastatin) that prevents inactivation of imipenem by renal DHP-I
- It kills bacteria in a time-dependent fashion by interfering with the bacterial cell wall in susceptible organisms
- Coverage is broad, including multi-drug resistant Pseudomonas sp. and Acinetobacter sp.
- Has activity versus many atypical Mycobacteria
- Beware seizure risk, especially with higher doses
- Adjust dose/frequency for kidney dysfunction
- Frequently imipenem-cilastatin is non-formulary, and meropenem is the anti-pseudomonal carbapenem of choice