Treatment in adults and children from 1 year of age of infections caused by drug-sensitive microorganisms, such as: intra-abdominal infections; lower respiratory tract infections (severe pneumonia, including hospital and ventilator-associated pneumonia); intranasal and postpartum infections; complicated infections of the genitourinary system; complicated infections of the skin and soft tissues; infections of bones and joints; septicemia; endocarditis. The drug TIENAM can be used in the treatment of patients with neutropenia accompanied by a fever, a likely cause of which is a bacterial infection. Treatment of patients with bacteraemia associated with, or likely to be associated with, any of the above infections.
Composition and form of release
The active ingredients are imipenem and sodium cilastatin. It is produced in the form of a lyophilized powder for injection.
It is prescribed for the treatment of infections that affect: the genitourinary system, lower respiratory tract, abdominal cavity, soft tissue skin, bones and joints. Effective in the treatment of septicemia. It is ineffective for meningitis.
The effectiveness of treatment with Tienam is explained by the fact that it consists of a well-chosen combination of two drugs, one of which (imipenem) is a broad-spectrum antibiotic, including antibacterial, the second (cilastatin sodium), due to its properties, is able to increase the concentration of imipenem in the kidneys , which greatly enhances its effect.
Contraindicated in case of allergy to one of the active ingredients of Tienam. Do not administer intramuscularly to patients with renal insufficiency. It is forbidden to use lidocaine hydrochloride as an isotonic solution in combination with Tienam in patients in a state of shock or in patients with heart block.
Application during pregnancy and lactation
There is no recorded data on the complete safety of Tienam for the fetus.
Method of administration and dosage
It is administered intravenously or intramuscularly (deeply penetrating into the muscle) after a test for resistance to Tienam of the patient’s microflora. The introduction is carried out very slowly, for at least 20 minutes, with a dose of 1 gram per dose, the introduction is carried out within 60 minutes.
Average dose: 1-2 grams per day. The daily dose is divided into 3-4 doses. In severe cases, the dose can be increased to a maximum of 4 grams per day, then reduced in stages. In the treatment of urogenital infections, 500 milligrams are injected once into the muscle.
In case of impaired renal function, the dose is reduced to 0.25-0.5 g per dose, administering the drug at intervals of 6 to 12 hours.
For children weighing less than 40 kg, the dosage is prescribed at the rate of 15 micrograms per 1 kg of body weight, administered at intervals of 6 hours. Maximum per day, you can enter 2 grams.
There are no accurately recorded data. Hemodialysis is presumably effective. Symptomatic treatment is also recommended.
Tienam is generally well tolerated by patients. Side effects are similar with cephalosporins. In particular, allergic reactions, manifestations of rash, pruritus, urticaria, anaphylaxis, erythema, angioedema, candidiasis, toxic epidermal necrolysis are likely.
Possible side effects from the gastrointestinal tract: nausea, vomiting, pseudomembranous colitis, coloring of the tongue and teeth. Signs of eosonophilia, leukopenia, neutropenia, thrombocytopenia, thrombocytosis, hepatitis, polyuria, myoclonus, mental disorders, encephalopathy were rare.
Storage conditions and periods
The drug is able to retain its medicinal properties for up to 3 years, subject to storage conditions – out of direct sunlight and temperatures up to + 25 ° C.