New evidence in severe pneumonia: imipenem/ cilastatin/relebactam

Abstract

Imipenem combined with beta-lactamase inhibitor relebactam (IMI/REL) has an extensive bactericidal activity against Gram-negative pathogens producing class A or class C beta-lactamases, not active against class B and class D. The phase 3 clinical trial (RESTORE-IMI-2), double-blind, randomized, evaluated IMI/REL vs. piperacillin-tazobactam (PIP/TAZ) for treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), demonstrated non-inferiority at all-cause mortality at 28 days (15.9% vs 21.3%), favorable clinical response at 7-14 days end of treatment (61% vs 59.8%) and with minor serious adverse effects (26.7% vs 32%). IMI/REL is a therapeutic option in HAP and VAP at approved dosage imipenem 500 mg, cilastatin 500 mg and relebactam 250 mg once every 6h, by an IV infusion over 30 min.

Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia: A Literature Review

“…Imipenem–relebactam represents a recently approved combination for HAP/VAP treatment between a novel BLI, which is structurally linked to avibactam, and a carbapenem, with potent activity on Ambler classes A and C, but with limited efficacy against Ambler class D and no documented activity on metallo-β-lactamases. However, the spectrum of this combination includes both ESBL-producing Enterobacterales and P. aeruginosa , but no activity against A. baumannii or S. maltophilia has been certified yet [ 47 , 48 , 51 ]. For this reason, the main recommendation for using the imipenem–relebactam combination remains respiratory infections caused by carbapenem-resistant Gram-negative bacilli [ 47 ].…”

Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

“…The release of inflammatory factors is closely related to infection and inflammation, and in patients with severe pneumonia, the degree of inflammatory response is often closely related to the development of the disease. Inflammatory factors such as C-reactive protein (CRP) and procalcitonin (PCT) are widely used in clinical practice to guide the diagnosis and treatment of infectious diseases[ 22 ]. Therefore, during the treatment of patients with severe pneumonia, monitoring changes in the levels of inflammatory factors has certain clinical significance for judging the patient's condition and guiding treatment.…”