What is Imipenem-Cilastatin-Relebactam: Uses, Dosage, Side Effects and More

Imipenem-cilastatin-relebactam is a powerful antibiotic combination given through an IV to fight serious bacterial infections. This medication combines three components that work together to tackle infections that many other antibiotics can't handle, making it an important tool when you're dealing with complex or resistant bacterial infections.

You'll typically receive this medication in a hospital setting where healthcare professionals can monitor your response closely. Think of it as one of the stronger weapons in medicine's arsenal against tough bacterial infections that haven't responded to other treatments.

What is Imipenem-Cilastatin-Relebactam?

Imipenem-cilastatin-relebactam is a triple-combination antibiotic that brings together three different components to create a more effective treatment. Imipenem is the main infection-fighting component, cilastatin helps protect the antibiotic from being broken down too quickly in your kidneys, and relebactam helps overcome bacterial resistance mechanisms.

This combination is particularly valuable because many bacteria have developed ways to resist single antibiotics. By combining these three components, the medication can often succeed where other antibiotics have failed. It's like having a specialized team working together rather than just one person trying to solve a complex problem.

The medication is relatively new to the market, representing advances in antibiotic development designed to address the growing challenge of antibiotic-resistant infections. Your doctor will typically consider this option when dealing with serious infections that need immediate, powerful treatment.

What is Imipenem-Cilastatin-Relebactam Used For?

This antibiotic combination treats serious bacterial infections, particularly those affecting your urinary tract, lungs, and abdomen. Your doctor might prescribe it when you have complicated urinary tract infections, hospital-acquired pneumonia, or severe intra-abdominal infections that haven't responded to other treatments.

The medication is especially useful for infections caused by bacteria that have developed resistance to other antibiotics. These situations often arise in hospital settings where you might encounter more aggressive or resistant bacterial strains. Your healthcare team will choose this treatment based on specific testing that shows which bacteria are causing your infection.

Common conditions treated include complicated pyelonephritis (severe kidney infection), ventilator-associated pneumonia, and serious abdominal infections following surgery. Less commonly, doctors might use it for bloodstream infections or other severe bacterial infections when laboratory testing suggests it's the best option.

In rare cases, this medication might be used for infections involving resistant gram-negative bacteria or when you have multiple types of bacteria causing infection simultaneously. Your doctor will make this decision based on culture results and the severity of your condition.

How Does Imipenem-Cilastatin-Relebactam Work?

This medication works by attacking bacteria in multiple ways, making it much harder for them to survive and multiply. Imipenem disrupts the bacteria's cell wall construction, essentially preventing them from maintaining their protective outer barrier, which causes them to die.

Cilastatin plays a protective role by preventing your kidneys from breaking down the imipenem too quickly. Without cilastatin, your body would eliminate the antibiotic before it has enough time to fight the infection effectively. This component ensures the medication stays active in your system longer.

Relebactam tackles bacterial resistance by blocking enzymes that bacteria use to destroy antibiotics. Many bacteria have developed these defense mechanisms over time, but relebactam essentially disarms these defenses, allowing the imipenem to do its job more effectively.

Together, these three components create a powerful combination that can overcome many bacterial resistance mechanisms. This makes it particularly effective against infections that have proven difficult to treat with standard antibiotics, giving your body the support it needs to fight serious infections.

How Should I Take Imipenem-Cilastatin-Relebactam?

You'll receive this medication through an intravenous (IV) line in a hospital or clinical setting where trained healthcare professionals can administer it safely. The medication is given as a slow infusion over 30 minutes to 2 hours, depending on your specific situation and the dose your doctor prescribes.

Your healthcare team will determine the exact timing and frequency based on your kidney function, the severity of your infection, and your body weight. Most people receive doses every 6 to 8 hours, but this can vary depending on your individual needs and how well your kidneys are working.

You don't need to worry about taking this medication with food since it goes directly into your bloodstream through the IV. However, staying well-hydrated during treatment can help your kidneys process the medication more effectively. Your healthcare team will monitor your fluid intake and may adjust it based on your condition.

The infusion process is generally comfortable, though you might notice some mild irritation at the IV site. Let your healthcare team know immediately if you experience any unusual sensations, pain, or swelling around the IV area during the infusion.

How Long Should I Take Imipenem-Cilastatin-Relebactam?

Most people receive this medication for 5 to 14 days, depending on the type and severity of their infection. Your doctor will determine the exact duration based on how quickly your infection responds to treatment and your overall health condition.

For uncomplicated urinary tract infections, you might need treatment for 5 to 7 days. More serious infections, such as hospital-acquired pneumonia or severe abdominal infections, often require 7 to 14 days of treatment. Your healthcare team will monitor your progress closely and adjust the duration as needed.

Your doctor will use several factors to determine when to stop treatment, including your temperature, laboratory test results, and overall clinical improvement. They'll also consider whether the infection has completely cleared and whether you're ready to transition to oral antibiotics if continued treatment is needed.

In some cases, treatment might be extended beyond the typical timeframe if your infection is particularly severe or if you have underlying health conditions that affect your immune system. Your healthcare team will keep you informed about the expected duration and any changes to your treatment plan.

What Are the Side Effects of Imipenem-Cilastatin-Relebactam?

Like all powerful medications, this antibiotic combination can cause side effects, though most people tolerate it well when properly monitored. The most common side effects are generally mild and manageable with proper care and attention from your healthcare team.

Here are the side effects you might experience, keeping in mind that your healthcare team is well-prepared to help you manage any that occur:

Common side effects include:

• Nausea and vomiting
• Diarrhea or loose stools
• Headache
• Irritation or pain at the IV site
• Elevated liver enzymes (detected through blood tests)
• Changes in blood cell counts

Less common but more serious side effects include:

• Severe diarrhea that might indicate C. difficile infection
• Allergic reactions including rash, itching, or swelling
• Seizures, particularly in people with kidney problems or brain conditions
• Significant changes in kidney function
• Severe skin reactions

Your healthcare team monitors you closely for these effects and can quickly address any concerns that arise. Most side effects are temporary and resolve once treatment is complete, but don't hesitate to report any unusual symptoms you experience.

Who Should Not Take Imipenem-Cilastatin-Relebactam?

This medication isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. People with known allergies to carbapenem antibiotics, beta-lactam antibiotics, or any components of this medication should not receive it.

If you have severe kidney disease, your doctor will need to adjust your dose significantly or might choose a different antibiotic altogether. People with a history of seizures or brain conditions require special consideration, as this medication can potentially trigger seizures, especially when kidney function is compromised.

Your healthcare team will be particularly cautious if you have a history of severe diarrhea or colitis after taking antibiotics, as this medication can sometimes cause serious intestinal infections. They'll also consider your overall health status and any other medications you're taking that might interact with this treatment.

Pregnant and breastfeeding women require special consideration, though the medication may be used when the benefits outweigh the risks. Your doctor will discuss these considerations with you and help determine the safest approach for your specific situation.

Imipenem-Cilastatin-Relebactam Brand Name

This medication is available under the brand name Recarbrio in the United States and many other countries. The brand name makes it easier to identify and discuss with your healthcare team, though you might see it referred to by its generic name in medical records or discussions.

Recarbrio was developed specifically to address the growing challenge of antibiotic-resistant infections and represents one of the newer additions to the carbapenem antibiotic family. Your healthcare team will typically use whichever name is most familiar to them, but both refer to the same medication.

When discussing your treatment with different healthcare providers, you can use either name, though providing both the brand name and generic name can help ensure clear communication about your medication history.

Imipenem-Cilastatin-Relebactam Alternatives

Several alternative antibiotics might be considered depending on your specific infection and bacterial sensitivities. Other carbapenem antibiotics like meropenem, imipenem-cilastatin (without relebactam), or doripenem might be options for some infections.

For certain types of infections, your doctor might consider newer antibiotics like ceftazidime-avibactam, meropenem-vaborbactam, or ceftolozane-tazobactam. These are also combination antibiotics designed to overcome bacterial resistance, though each has its own specific strengths and applications.

Traditional antibiotics like piperacillin-tazobactam or fluoroquinolones might be alternatives for less complex infections or when bacterial testing shows they would be effective. Your doctor will choose the most appropriate option based on your specific infection, overall health, and laboratory results.

The choice of alternative depends heavily on what bacteria are causing your infection and which antibiotics they're sensitive to. Your healthcare team will use laboratory testing to guide these decisions and ensure you receive the most effective treatment.

Is Imipenem-Cilastatin-Relebactam Better Than Meropenem?

Both medications are powerful carbapenem antibiotics, but they each have specific advantages depending on your situation. Imipenem-cilastatin-relebactam has the added benefit of relebactam, which helps overcome certain types of bacterial resistance that meropenem alone might not be able to handle.

For infections caused by bacteria that produce specific resistance enzymes, imipenem-cilastatin-relebactam might be more effective than meropenem. However, meropenem has been used longer and has extensive clinical experience, making it a trusted choice for many types of serious infections.

Your doctor will choose between these medications based on laboratory testing that shows which bacteria are causing your infection and what resistance mechanisms they might have. Sometimes meropenem is perfectly adequate, while other times the enhanced coverage of imipenem-cilastatin-relebactam is necessary.

Both medications are considered highly effective for serious infections, and the choice often comes down to the specific characteristics of your infection rather than one being universally better than the other. Your healthcare team will make this decision based on your individual circumstances.