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Profile Profile Profile Uses and Administration Gramicidin/lmipenem 309 Graneodin N; Graneodin; Gripaben Caramelos; Kenacomb; t Incompatibility and stability. Intipenem is unstable at Nasomicina; Neo Coltirot; Pantometilt; Proetztotal; Tosedrin �-�P.�.�� ����---········································································· alkaline or acidic pH and the commercially available injec­ (details are given in Volume B) NF; Austral.: Kenacomb; Neosporint; Otocomb Otic; Otodex; ProprielaryPreparations tion of intipenem with cilastatin sodium for intravenous Sofradex; Soframycint; Austria: Volon A antibiotikahaltigt; V alpeda. use is buffered to provide, when reconstituted, a solution Belg. : Mycolog; Polyspectran Granticidinet; Braz.: Fonergin; Single-ingredient Preparations. UK: with pH 6.5 to 7.5. Licensed product information advises Londerm-Nt; Mud; Neolon D; Omcilon-A M; Oncibel; Oncileg; against mixing with other antibacterials. Onciplust; Canad.: Ak Spor; Antibiotic Cream; Antibiotic Plus; Complete Antibiotic Ointment; Diosporint; Neosporin; Opti­ lbafloxacin (BAN, USAN, r/NN) References. cort; Optimyxin Plus; Optimyxin; Polysporin Complete; Poly­ 1. Bigley FP, et al. Compatibility of imipenem-dlastatin sodium with Am Hosp Phann 1986; 43: 2803- sporin For Kids; Polysporin Plus Pain Relief; Polysporin Triple commonly used intravenous solutions. 9. J Antibiotic; Polysporin; Polytopic; ratio-Tria comb; Sofracort; 2. Smith GB, et al. Stability and kinetics of degradation of imipenem in Soframycin; Soframycin; Triple Antibiotic Ointment; Viaderm­ Pharm 1990; 79: 732-40. aqueous solution. Sd KC; Chile: Oftabiotico; China: Kenacomb 3. Pourroy B, et al. Incompatibility of imipenem-cilastatin and amoxicillin. J 66: Denm.: Kenalog Comp med Mycostatint; Sofradex;(:!i::!Jif Fin!ill!l<li.: Bafu­); Am Health-SystPharm 2009; 1253-4. cin; Polysporint; Ger.: Polyspectran; Gr.: Neo-Priphen; J Neosporin; Sofradex; Thilodexine-N; Hong Kong: Centacomb; Uses and Administration Dermawellt; In-quadeicren; Kenacombt; Neosporin; Polyneos­ pint; Polyoph; Polyspectrant; Sofradex; Triacombt; Hung.: lmipenem is a carbapenem beta -lactam antibacterial, Polysport; India: Kenacomb; Kenalog-S; Neosporin; Sofracort; differing from the penicillins in that the 5-membered ring Indon.: Blecidex; Isotic Enpigi; Neosyd; Sofradex; Irl. : is unsaturated and contains a carbon rather than a sulfur Graneodint; Kenacombt; Sofradex; Israel: Dermacombin; Ital.: Profile atom. Since imipenem is metabolised in the kidney by the Eta Biocortilen VC; Malaysia: Kenacomb; Pocin Gt; Sofradex; Ihafloxacin is a fluoroquinolone antibacterial that is used in enzyme dehydropeptidase I it is always given with cilastatin Mex.: Biotarson Nt; Biotarson Of; Graneodin D; Kenacomb; veterinary medicine for the treannent of susceptible (p. 260.3), an inhibitor of the enzyme; this enhances Neosporin; Polixin; Poly-Micron; Septilisin; Soperil; Sulned; infections in cats and dogs. urinary concentrations of active drug and was found to Mycologt; Sofradex; Sofradex; Kenacomb; Neth.: Norw. : NZ: protect against the nephrotoxicity of high doses of Sofradex; Soframycint; Viaderm-KC; Philipp. : Iporam; Kena­ imipenem seen in animal studies. combt; Lidex NGN; Neosporin; Novasorin; Oticom; Trispec; Imipenem is used for the treattnent of infections caused Pol. : Dicortineff; Triacomb; Port. : Dropcina; Rus.: Sofradex by susceptible Gram-positive and Gram-negative orgartisms; (Coljlpi\ZieKc); S.Afr.: Kenacombt; Sofradex; Singapore: because of its broad spectrum of activity, it may also be Sofradex; Spain: Flodermol; Fludroneft; Midacina; Oftalmo­ given in the treannent of polynticrobial infections or as well; Tivitist; Swed. : Bafucin; Switz.: Angidinet; Mycolog N; Neosporin; Sofradext; Topsym polyvalent; Tyrothricine Gra­ empirical therapy before the identification of causative + nticidinet; Thai.: Dermacombin; Kenacombt; Polyoph; organisms. Such infections include infections in immuno­ Sofradex; Topifram; Xanalin; Turk.: Neosporin; UAE: Panderm; comprontised patients (with neutropenia), intra-abdominal UK: Neosporint; Sofradex; Ukr.: Grammidin with Anaesthetic infections, bone and joint infections, lower-respiratory-tract Neo (fpllMMH,!UIH C AaecrernKOM Heo); USA: Neosporin; Ocu­ infections, skin and skin-structure infections, urinary-tract Spor-G; Ocutricin; Polymycin; Venez. : Kenacomb. infections and biliary-tract infections; it is not indicated for CNS infections. It may also be used for surgical infection Pharmacopoeial Preparations prophylaxis. lmipenem may be used as part of a multidrug USP 36: Neomycin and Polymyxin B Sulfates and Gramicidin regimen for the treatment of inhalation and gastrointestinal Cream; Neomycin and Polymyxin B Sulfates and Granticidin anthrax. For details of these infections and their treatment, Ophthalntic Solution; Neomycin and Polymyxin B Sulfates, see under Choice of Antibacterial, p. 172.2. Gramicidin, and Hydrocortisone Acetate Cream; Neomycin Commercial preparations contain intipenem and cila­ SuHate and Gramicidin Oinnnent; Nystatin, Neomycin Sulfate, statin, as the sodium salt, in a ratio of I to 1. Doses of the Gramicidin, and Triamcinolone Acetonide Cream; Nystatin, combination are expressed in terms of the amount of Neomycin Sulfate, Gramicidin, and Triamcinolone Acetonide anhydrous imipenem. Imipenem is given by intravenous Ointment. infusion; doses of 250 or 500 mg are infused over 20 to 30 minutes, and doses of 750 mg or 1 g over 40 to 60 minutes. Products for intramuscular use are available in some countries. NOTE. The name Mersarex has been used as a trade mark for The usual intravenous dose is 1 to 2 g daily in divided iclaprim mesylate. doses every 6 or 8 hours, depending on the severity of the infection. Usual doses are based on a body-weight of at least 70 kg; proportionate reduction of the dose is recommended for patients weighing less than this. Up to a maximum daily Iclaprim is a diaminopyrintidine antibacterial similar to dose of 50 mg/kg (not exceeding 4 g) has been given in life­ trimethoprim (p. 383.2) that has been investigated for the threatening infections or infections due to less sensitive treannent of complicated infections of the skin and skin organisms. Profile structure caused by Gram-positive bacteria, including lmipenem may be given intramuscularly in adults with ntild to moderate infections in doses of 500 or 750mg every Gramicidin S is an antibacterial polypeptide, produced by MRSA. 12 hours. Bad/Ius bri!Vis, and has similar properties to tyrothricin References. The dose of imipenem should be reduced in renal (p. 386.1). It is unsuitable for systemic use and is used 1. Sincak CA, Schmidt JM. Iclaprim, a novel diaminopyrimidine for the impairment and in those weighing less than 70 kg, see topically for the local treannent of susceptible infections and treatment of resistant gram-positive infections. Ann Pharmacother 2009; 43: 1107-14. p. 312.1. See also p. 311.3 for details of doses in children. as lozenges for infections of the mouth and throat. The 2. Sader HS, et al. Potency and bactericidal activity of iclaprim against hydrochloride is used similarly. recent clinical Gram-positive isolates. Antimicrob Aoents Chemother 2009; General reviews. 53: 2171-5. I. Balfour JA, et at. lmipenem/dlastatin: an update of its antibacterial activity, pharmacokinetics and therapeutic efficacy in the treatment of 3. Krievins D, et al. Multicenter, randomized study of the efficacy and serious infections. Drugs 1996; 51: 99-136. safety of intravenous iclaprim in complicated skin and skin structure �-�P.�.��-���-��---········································································· Antimicrob Aoents Chemother 2009; 53: 2834-40. 2. Hellinger WC, Brewer NS. Carbapenems and monobactams: imipenem, infections. 74: (details are given in Volume B) meropenem, and aztreonam. Mayo Clin Proc 1999; 420-34. ProprielaryPreparations 3. Norrby SR. Carbapenems in serious infections: a risk-benefit assessment. Druo Safety2000; Zl: 191-4. Single-ingredientPreparations. Rus.: Gramntidin (rpa.MMHJ1HH). 4. Rodloff AC, et al. Two decades of imipenem therapy. Antimicrob Chemother 2006; 58: 916-29. J Indon.: FG Ointmentt; FG 5. Zhanel GG, et al. Comparative review of the carbapenems. Drugs 2007; Multi-ingredient Preparations. 67: 1027-52. Troches; Gramntidin Neo Grammidin Rus.: (rpa.MMHJ1HH Heo); 6. Lo TS, et al. A review of the carbapenems in clinical use and clinical trials. with Anesthetic Neo (fpa.MMHJ1HH c Aaecl'eTIIKOM Heo); Ukr.: Recent Pat Antiinfect Druo Discov 2008; 3: 123-31. Gramntidin (fpi!MMH,!Uia); Grammidin Neo (fpa.MMHJ1HH Heo); 7. Kattan JN, et al. New developments in carbapenems. Clin Microbiol Infect Sofradex (Coljlp��,Z�exc)t. 2008; 14: 1102-11. 8. Masterton RG. The new treatment paradigm and the role of carbapenems. Int Antimicrob Aoents 2009; 33: 105-1 10. J Administration.For the suggestion that extended infusion of intipenem with cilastatin ntight increase its efficacy see under Meropenem, p. 323.3. Administration in children.lmipenem (with cilastatin, see Uses and Administration, above) may be given to children Description. lntipenemis the N-formintidoyl derivative of for the treatment of infections caused by susceptible thienamycin, an antibiotic produced by Streptomyces cattleya. Gram-positive and Gram-negative bacteria. It is given by intravenous infusion; doses less than or equal to 500 mg Pharmacopoeias. In Bur. (see p. vii), Jpn, and US. are infused over IS tci 30 minutes, and doses more than Ph. Bur. 8; (lmipenem Monohydrate). A white, almost 500 mg over 40 to 60 ntinutes.
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