Evaluating imipenem + cilastatin + relebactam for the treatment of complicated urinary tract infections

ABSTRACT

Introduction

The addition of the β-lactamase inhibitor relebactam to imipenem restores the antibacterial activity against the majority of multidrug resistant Gram-negative bacteria. Complicated urinary tract infections (UTIs) are predominantly caused by Gram-negative uropathogens. The rise in antibiotic resistance, including to carbapenems, is an increasing challenge in daily practice.

Areas covered

In the current review, the use of imipenem/relebactam in complicated UTI is evaluated by discussing its chemistry, pharmacokinetics/dynamics, microbiology, safety, and clinical efficacy. The authors also provide their expert perspectives onto its use and its future place in the treatment armamentarium.

Expert opinion

With respect to complicated UTI, it should be noted that, to our knowledge, there are no data yet upon the clinical efficacy of imipenem/relebactam in patients with severe urosepsis or men with suspected prostatitis. Further studies upon these specific groups of UTI patients are needed including additional pharmacokinetic studies upon its tissue penetration of the prostate which is currently unknown. However, in our opinion, imipenem/relebactam can be used in complicated UTI when other treatment options are limited.

KEYWORDS:

• complicated urinary tract infection
• antibiotic resistance
• beta-lactamasse
• carbapenamase
• imipenem-relebactam

Article highlights

 

• The emergence of multi-drug resistant uropathogens in patients with complicated urinary tract infection is of great concern.

• Addition of the β-lactamase inhibitor relebactam to imipenem restores the antibacterial activity against the majority of multi-drug resistant Gram-negative bacteria, including carbapenemase producing uropathogens.

• Imipenem/relebactam is an effective and safe antibiotic for treatment of patients with urinary tract infection who have otherwise limited treatment options.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.