Definition

A parenteral antibiotic preparation containing imipenem, cilastatin sodium and relebactam, with bactericidal activity. Imipenem, a broad spectrum beta-lactam carbapenem antibiotic, binds to and inactivates penicillin-binding proteins (PBP) on the inner membrane of the bacterial cell wall, thereby interfering with the cross-linkage of peptidoglycan chains critical for bacterial cell wall strength and rigidity. Cilastatin sodium, a renal dehydropeptidase inhibitor, reduces the breakdown of imipenem by renal dehydropeptidase. Relebactam, a beta-lactamase inhibitor, reduces the breakdown of imipenem by certain serine beta-lactamases among gram-negative bacteria. Imipenem is active against a wide range of gram-positive and gram-negative organisms, and the imipenem, cilastatin sodium and relebactam combination may be used to treat infections caused by resistant gram-negative bacteria.