Imipenem/Cilastatin/Relebactam: A Review in Gram-Negative Bacterial Infections

Imipenem/cilastatin/relebactam (Recarbrio (TM)) is an intravenously administered combination of the carbapenem imipenem, the renal dehydropeptidase-I inhibitor cilastatin, and the novel beta-lactamase inhibitor relebactam. Relebactam is a potent inhibitor of class A and class C beta-lactamases, conferring imipenem activity against many imipenem-nonsusceptible strains. Imipenem/cilastatin/relebactam is approved in the USA and EU for the treatment of hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) in adults and other gram-negative infections, including complicated urinary tract infections (cUTIs) [including pyelonephritis] and complicated intra-abdominal infections (cIAIs), in adults with limited or no alternative treatment options. In pivotal phase II and III trials, imipenem/cilastatin/relebactam was noninferior to piperacillin/tazobactam in patients with HABP/VABP and to imipenem/cilastatin in patients with cUTIs and cIAIs. It was also effective in imipenem-nonsusceptible infections. Imipenem/cilastatin/relebactam was generally well tolerated, with a safety profile consistent with that of imipenem/cilastatin. Available evidence indicates that imipenem/cilastatin/relebactam is an effective and generally well tolerated option for gram-negative infections in adults, including critically ill and/or high-risk patients, and a potential therapy for infections caused by carbapenem-resistant pathogens.

Automated summary

Imipenem/cilastatin/relebactam is an effective option for treating gram-negative infections in adults, showing noninferiority to piperacillin/tazobactam in HABP/VABP patients and efficacy against imipenem-nonsusceptible infections. It is generally well tolerated and has potential as a therapy for infections caused by carbapenem-resistant pathogens.