Document Type
Article
Publication Date
2-26-2025
Keywords
carbapenem-resistant, gram-negative, imipenem-cilastatin-relebactam, multidrug-resistant, Pseudomonas aeruginosa
Abstract
Background: Multidrug-resistant (MDR) gram-negative infections are a substantial threat to patients and public health. Imipenem-cilastatin-relebactam (IMI/REL) is a β-lactam/β-lactamase inhibitor with expanded activity against MDR Pseudomonas aeruginosa and carbapenem-resistant Enterobacterales. This study aims to describe the patient characteristics, prescribing patterns, and clinical outcomes associated with IMI/REL. Methods: This was a retrospective, multicenter, observational study of patients ≥18 years old who received IMI/REL for ≥48 hours for a suspected or confirmed gram-negative infection. The primary outcome was clinical success, defined as improvement or resolution of infection-related signs or symptoms while receiving IMI/REL and the absence of 30-day microbiologic failure. Multivariable logistic regression analysis was performed to identify independent predictors of clinical success. Results: The study included 151 patients from 24 US medical centers. IMI/REL was predominantly prescribed for lower respiratory tract infections, accounting for 52.3% of cases. Most patients were infected with a carbapenem-nonsusceptible pathogen (85.4%); P aeruginosa was frequently targeted (72.2%). Clinical success was achieved in 70.2% of patients. Heart failure, receipt of antibiotics within the past 90 days, intensive care unit admission at time of index culture collection, and isolation of difficult-to-treat resistant P aeruginosa were independently associated with a reduced odds of clinical success. Adverse events were reported in 6.0% of patients, leading to discontinuation of IMI/REL in 3 instances. Conclusions: This study provides a comprehensive analysis of the real-world effectiveness and safety of IMI/REL. Comparative studies and investigations of specific subgroups will further enhance our understanding of IMI/REL in treating MDR infections.
Publisher Attribution
© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Recommended Citation
Caniff, Kaylee E.; Rebold, Nicholas; Xhemali, Xhilda; Tran, Nikki; Eubank, Taryn A.; Garey, Kevin W.; Guo, Yi; Chang, Mei; Barber, Katie E.; Krekel, Tamara; Biagi, Mark; Kufel, Wesley D.; Carr, Amy; Hayes, Jillian; Carlson, Travis J.; Frens, Jeremy; Venugopalan, Veena; Lucas, Kristen; Kunz Coyne, Ashlan J.; Sanders, James; Chandler, Elisabeth; Li, Rosanna; Antosz, Kayla; Justo, Julie Ann; Benefield, Russell; Moore, W Justin; Ross, Jennifer; Adams, Jenna; Albarillo, Fritzie; Stefanos, Sylvia; Hobbs, Athena L V; Mercuro, Nicholas; Raux, Brian; Zeitler, Kristen; and Rybak, Michael J., "Real-World Applications of Imipenem-Cilastatin-Relebactam: Insights From a Multicenter Observational Cohort Study" (2025). Pharmacy Faculty Scholarship. 71.
https://orb.binghamton.edu/pharmacy_fac/71
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Comments
https://doi.org/10.1093/ofid/ofaf112