Primaxin

Adult Dosing .

Dosage forms:  INJ

Special Note

[strength clarification]

Info: doses expressed as imipenem amt; 500 mg imipenem/cilastatin contains 500 mg imipenem + 500 mg cilastatin

infections, bacterial

[500 mg IV q6h]

Max: 4 g/day; Alt: 1000 mg IV q6-8h; Info: dose, duration varies w/ infection type, pathogen susceptibility

intra-abdominal infections

[500 mg IV q6h]

Max: 4 g/day; Alt: 1000 mg IV q6-8h; Info: dose, duration varies w/ infection type, pathogen susceptibility

UTI

[500 mg IV q6h]

Max: 4 g/day; Alt: 1000 mg IV q6-8h; Info: for uncomplicated and complicated UTI; dose, duration varies w/ infection type, pathogen susceptibility

pneumonia

[hospital-acquired or ventilator-assoc.]

Dose: 500 mg IV q6h x7 days; Max: 4 g/day; Info: may extend duration based on clinical response; refer to IDSA guidelines

[community-acquired]

Dose: 500 mg IV q6h x7 days; Max: 4 g/day; Info: for inpatient tx; refer to IDSA guidelines

febrile neutropenia, chemo-induced (off-label)

[500 mg IV q6h]

Max: 4 g/day; Info: for empiric tx

anthrax, systemic (off-label)

[1 g IV q6h for at least 2wk]

Max: 4 g/day; Info: not 1st-line agent; part of multi-drug regimen; switch to PO abx for post-exposure prophylaxis if inhalational exposure

renal dosing

[if usual dose 500 mg q6h]

CrCl 60-89: 400 mg q6h; CrCl 30-59: 300 mg q6h; CrCl 15-29: 200 mg q6h; CrCl <15: avoid unless HD w/in 48h; Info: caution advised, incr. seizure risk if CrCl <30

HD: 200 mg q6h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 250 mg q12h; supplement not defined

[if usual dose 1000 mg q8h]

CrCl 60-89: 500 mg q6h; CrCl 30-59: 500 mg q8h; CrCl 15-29: 500 mg q12h; CrCl <15: avoid unless HD w/in 48h; Info: caution advised, incr. seizure risk if CrCl <30

HD: 500 mg q12h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 250 mg q12h; supplement not defined

[if usual dose 1000 mg q6h]

CrCl 60-89: 750 mg q8h; CrCl 30-59: 500 mg q6h; CrCl 15-29: 500 mg q12h; CrCl <15: avoid unless HD w/in 48h; Info: caution advised, incr. seizure risk if CrCl <30

HD: 500 mg q12h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 250 mg q12h; supplement not defined

hepatic dosing

[no adjustment]

Peds Dosing .

Dosage forms:  INJ

Special Note

[strength clarification]

Info: doses expressed as imipenem amt; 500 mg imipenem/cilastatin contains 500 mg imipenem + 500 mg cilastatin

infections, non-CNS bacterial

[<1 wk old, >1500 g]

Dose: 50 mg/kg/day IV divided q12h; Max: 4 g/day; Info: duration varies w/ infection type, severity

[1-4 wk old, >1500 g]

Dose: 75 mg/kg/day IV divided q8h; Max: 4 g/day; Info: duration varies w/ infection type, severity

[1-3 mo, >1500 g]

Dose: 100 mg/kg/day IV divided q6h; Max: 4 g/day; Info: duration varies w/ infection type, severity

[3 mo and older]

Dose: 60-100 mg/kg/day IV divided q6h; Max: 4 g/day; Info: dose, duration varies w/ infection type, severity

anthrax, systemic (off-label)

[neonates >32 wk gestation]

Dose: 40-75 mg/kg/day IV divided q8-12h for at least 2wk; Max: 4 g/day; Info: dose depends on infection site, gestational and post-natal age; not 1st-line agent; part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure

[1 mo and older]

Dose: 100 mg/kg/day IV divided q6h for at least 2wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure

renal dosing

[<30 kg]

renal impairment: avoid use

[>30 kg]

CrCl 30-50: give 50% usual divided dose q8h; CrCl 10-29: give 50% usual divided dose q12h; CrCl <10: give 50% usual divided dose q24h; CrCl <5: avoid unless HD w/in 48h

HD: give 50% usual divided dose q24h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: give 50% usual divided dose q24h; supplement not defined

hepatic dosing

[no adjustment]