Name of the Procedure:

Common Name: Injection of imipenem and cilastatin
Medical Term: Injection, cilastatin sodium; imipenem, per 250 mg (HCPCS Code J0743)

Summary

The imipenem and cilastatin injection is a medical procedure where a combination antibiotic is administered to fight severe bacterial infections. This injection is designed to combat a broad spectrum of bacteria and is typically given to patients with resistant or complicated infections.

Purpose

Conditions Addressed: Severe bacterial infections, including those resistant to other antibiotics. It's often used for intra-abdominal infections, lower respiratory tract infections, urinary tract infections, and skin and soft tissue infections.
Goals: The primary goal is to eliminate or significantly reduce the bacterial infection, leading to symptom relief and prevention of complications.

Indications

Symptoms/Conditions: Patients with severe bacterial infections that do not respond to conventional antibiotics.
Criteria: Ideal for patients with confirmed or suspected resistant infections, those hospitalized with severe conditions, or immune-compromised individuals at high risk for complications.

Preparation

Instructions:

• Fasting is generally not required.
• Patients should inform their healthcare provider about all medications they are currently taking, including over-the-counter drugs and supplements.
• No specific diagnostic tests are needed solely for the preparation of this injection, but the underlying infection should be diagnosed and confirmed by relevant tests.

Procedure Description

1. Preparation: The healthcare provider prepares the injection by combining cilastatin sodium and imipenem powder with a suitable diluent.
2. Administration: The injection is usually given intravenously (IV), which involves inserting a needle into a vein. It may also be administered intramuscularly (IM) in specific cases.
3. Monitoring: The patient's vital signs and response to the injection are monitored during and after the administration.

Tools/Equipment: Syringe, needles, IV setup, diluent.
Anesthesia/Sedation: Not typically required.

Duration

The administration typically takes a few minutes, but the entire process, including preparation and monitoring, might take up to 30 minutes.

Setting

The injection is typically administered in a hospital or outpatient clinic.

Personnel

Involved Healthcare Professionals:

• Registered Nurses (RNs)
• Physicians or Nurse Practitioners (NPs) to prescribe and oversee treatment
• Pharmacists for preparation and dosage verification

Risks and Complications

Common Risks:

• Pain or swelling at the injection site
• Nausea, vomiting, or diarrhea

Rare Risks:

• Allergic reactions including rash, itching, or anaphylaxis
• Seizures, particularly in patients with brain disorders or compromised kidney function
• Blood cell disorders

Management: Immediate medical attention for severe allergic reactions, adjusted dosage under medical supervision for those with pre-existing conditions.

Benefits

Expected Benefits: Effective eradication of the bacterial infection.
Timeline: Symptom improvement can be seen within a few days of treatment, with complete recovery depending on the infection severity and patient condition.

Recovery

Post-procedure Care:

• Follow instructions on taking any additional medications.
• Monitor for side effects and report them to the healthcare provider.
• Stay hydrated and rest as needed.

Recovery Time: Varies from a few days to several weeks, depending on the infection's severity and the patient's health status.
Follow-up: Appointments may be required to assess the effectiveness and any side effects.

Alternatives

Other Options:

• Other antibiotics, depending on the specific bacteria and resistance patterns.
• Oral antibiotics for less severe infections or initial therapy.

Pros and Cons:

• Imipenem and cilastatin injection: Fast-acting, effective against a wide spectrum of bacteria.
• Oral antibiotics: Easier to administer but may not be suitable for severe or resistant infections.

Patient Experience

During Procedure: Slight discomfort or pain at the injection site.
After Procedure: Possible side effects include gastrointestinal upset. Follow-up care and monitoring will ensure any adverse effects are managed promptly.

Pain Management: Administration can be paired with comfort measures and pain management protocols as needed.