Questions About PD
1 answer
We lack robust evidence about the optimal dosage of imipenem/cilastatin in the PD population, and a careful evaluation of potential risks of neurotoxicity vs. efficacy as well as the pharmacokinetic properties of imipenem/cilastatin should be considered when prescribing the drug, as discussed by Van Gelder et al, Perit Dial Int 2017 and Szeto et al, Perit Dial Int 2017.
In my personal view, the suggested dose of 500 mg IV q12h seems reasonable as (i) it is the dose recommended for patients with stage V CKD not on dialysis and for those treated with hemodialysis, and as (ii) it also corresponds to the dose recommended by Van Gelder et al, and approved by Szeto et al.
Discussion with specialists in infectious disease at your institution may also be helpful to validate the proposed regimen based on the above-mentioned references or to consider potential alternatives – if available.