PRIMAXIN IV
PRIMAXIN IV- imipenem and cilastatin sodium injection, powder, for solution
Merck Sharp & Dohme LLC
1 INDICATIONS AND USAGE
1.1 Lower Respiratory Tract Infections
PRIMAXIN for intravenous use is indicated for the treatment of lower respiratory tract infections caused by susceptible strains of Staphylococcus aureus (penicillinase-producing isolates), Acinetobacter species, Enterobacter species, Escherichia coli , Haemophilus influenzae , Haemophilus parainfluenzae , Klebsiella species, Serratia marcescens.
1.2 Urinary Tract Infections (complicated and uncomplicated)
PRIMAXIN is indicated for the treatment of urinary tract infections (complicated and uncomplicated) caused by susceptible strains of Enterococcus faecalis , Staphylococcus aureus (penicillinase-producing isolates), Enterobacter species, Escherichia coli , Klebsiella species, Morganella morganii , Proteus vulgaris , Providencia rettgeri , Pseudomonas aeruginosa.
1.3 Intra-Abdominal Infections
PRIMAXIN is indicated for the treatment of intra-abdominal infections caused by susceptible strains of Enterococcus faecalis , Staphylococcus aureus (penicillinase-producing isolates), Staphylococcus epidermidis , Citrobacter species, Enterobacter species, Escherichia coli , Klebsiella species, Morganella morganii , Proteus species, Pseudomonas aeruginosa , Bifidobacterium species, Clostridium species, Eubacterium species, Peptococcus species, Peptostreptococcus species, Propionibacterium species, Bacteroides species including B. fragilis , Fusobacterium species.
1.4 Gynecologic Infections
PRIMAXIN is indicated for the treatment of gynecologic infections caused by susceptible strains of Enterococcus faecalis , Staphylococcus aureus (penicillinase-producing isolates), Staphylococcus epidermidis , Streptococcus agalactiae (Group B streptococci), Enterobacter species, Escherichia coli , Gardnerella vaginalis , Klebsiella species, Proteus species, Bifidobacterium species, Peptococcus species, Peptostreptococcus species, Propionibacterium species, Bacteroides species including B. fragilis.
1.5 Bacterial Septicemia
PRIMAXIN is indicated for the treatment of bacterial septicemia caused by susceptible strains of Enterococcus faecalis , Staphylococcus aureus (penicillinase-producing isolates), Enterobacter species, Escherichia coli , Klebsiella species, Pseudomonas aeruginosa , Serratia species, Bacteroides species including B. fragilis.
1.6 Bone and Joint Infections
PRIMAXIN is indicated for the treatment of bone and joint infections caused by susceptible strains of Enterococcus faecalis , Staphylococcus aureus (penicillinase-producing isolates), Staphylococcus epidermidis , Enterobacter species, Pseudomonas aeruginosa.
1.7 Skin and Skin Structure Infections
PRIMAXIN is indicated for the treatment of skin and skin structure infections caused by susceptible strains of Enterococcus faecalis , Staphylococcus aureus (penicillinase-producing isolates), Staphylococcus epidermidis , Acinetobacter species, Citrobacter species, Enterobacter species, Escherichia coli , Klebsiella species, Morganella morganii , Proteus vulgaris , Providencia rettgeri , Pseudomonas aeruginosa , Serratia species, Peptococcus species, Peptostreptococcus species, Bacteroides species including B. fragilis , Fusobacterium species.
1.8 Endocarditis
PRIMAXIN is indicated for the treatment of endocarditis caused by susceptible strains of Staphylococcus aureus (penicillinase-producing isolates).
1.9 Limitations of Use
- PRIMAXIN is not indicated in patients with meningitis because safety and efficacy have not been established.
- PRIMAXIN is not recommended in pediatric patients with CNS infections because of the risk of seizures [see Dosage and Administration (2.2), Warnings and Precautions (5.2), and Use in Specific Populations (8.4)].
- PRIMAXIN is not recommended in pediatric patients less than 30 kg with impaired renal function, as no data are available [see Use in Specific Populations (8.4), and Dosage and Administration (2.2)].
- Periodic assessment of organ system functions, including renal, hepatic and hematopoietic, is advisable during prolonged therapy.
1.10 Usage
To reduce the development of drug-resistant bacteria and maintain the effectiveness of PRIMAXIN and other antibacterial drugs, PRIMAXIN should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
2 DOSAGE AND ADMINISTRATION
2.1 Dosage in Adults
For Intravenous Injection Only
- The dosage of PRIMAXIN in adult patients should be based on suspected or confirmed pathogen susceptibility as shown in Table 1 below. The dosage recommendations for PRIMAXIN represent the quantity of imipenem to be administered. An equivalent amount of cilastatin is also present in the solution.
- These doses should be used for patients with creatinine clearance of greater than or equal to 90 mL/min. A reduction in dose must be made for patients with creatinine clearance less than 90 mL/min as shown in Table 3 [see Dosage and Administration (2.3)].
- Recommend that the maximum total daily dosage not exceed 4 g/day.
- Administer 500 mg by intravenous infusion over 20 to 30 minutes.
- Administer 1000 mg by intravenous infusion over 40 to 60 minutes.
- In patients who develop nausea during the infusion, the rate of infusion may be slowed.
Suspected or Proven Pathogen Susceptibility | Dosage of PRIMAXIN |
---|---|
If the infection is suspected or proven to be due to a susceptible bacterial species | 500 mg every 6 hoursOR 1000 mg every 8 hours |
If the infection is suspected or proven to be due to bacterial species with intermediate susceptibility [see Microbiology (12.4)] | 1000 mg every 6 hours |
2.2 Dosage in Pediatric Patients
PRIMAXIN is not recommended in pediatric patients with CNS infections because of the risk of seizures [see Use in Specific Populations (8.4)].
PRIMAXIN is not recommended in pediatric patients <30 kg with renal impairment, as no data are available [see Use in Specific Populations (8.4)].
Based on studies in adults, the maximum total daily dose in pediatric patients should not exceed 4 g/day [see Dosage and Administration (2.1)].
The recommended dosage for pediatric patients with non-CNS infections is shown in Table 2 below:
Age | Dose (mg/kg) *, † | Frequency (hours) |
---|---|---|
Greater than or equal to 3 Months of Age | ||
15-25 mg/kg | Every 6 hours | |
Less than or equal to 3 months of age (Greater than or equal to 1,500 g body weight) | ||
4 weeks to 3 months of age | 25 mg/kg | Every 6 hours |
1 to 4 weeks of age | 25 mg/kg | Every 8 hours |
Less than 1 week of age | 25 mg/kg | Every 12 hours |
All MedLibrary.org resources are included in as near-original form as possible, meaning that the information from the original provider has been rendered here with only typographical or stylistic modifications and not with any substantive alterations of content, meaning or intent.