A hospital carbapenem antibiotic combination for resistant infections
Imipenem with relebactam
A hospital antibiotic given by drip to treat serious infections caused by resistant Gram-negative bacteria.
What is Imipenem with relebactam?
Imipenem with relebactam is a strong hospital antibiotic given by drip into a vein to treat serious infections caused by resistant Gram-negative bacteria. It combines a carbapenem antibiotic (imipenem, given with a substance that protects it in the body) with relebactam, which blocks the bacterial defences that would otherwise destroy the antibiotic. It is reserved for difficult infections so it stays effective. Important safety points are cross-reactivity in people allergic to penicillins, a risk of seizures linked to carbapenems, and the possibility of antibiotic-associated diarrhoea.
Education and reference only. This is a plain-language guide to Imipenem with relebactam — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Imipenem with relebactam is a hospital antibiotic combination, given by drip into a vein, used to treat serious infections caused by certain resistant bacteria, particularly Gram-negative ones. Imipenem is a carbapenem, a powerful type of antibiotic; it is given together with a partner substance that stops the body breaking it down too quickly. Relebactam is added to block enzymes that some bacteria use to destroy the antibiotic, so the combination can work against bugs that would otherwise be resistant. It is a reserve antibiotic, used in hospital under specialist guidance for difficult infections.
How it works
Imipenem kills bacteria by stopping them building their cell wall, the protective layer they need to survive, so the bacteria break apart. Many resistant bacteria fight back by making enzymes called beta-lactamases that destroy this kind of antibiotic. Relebactam blocks some of those enzymes, protecting imipenem so it can do its job against otherwise resistant bugs. Because it is a reserve treatment for difficult infections, it is used carefully and only when needed, to help keep it working for the future.
Company & origin
Originated / developed by: Specialist manufacturer.
A hospital antibiotic combination used in the UK by drip into a vein to treat serious infections caused by resistant bacteria.
Practical use
How to take Imipenem with relebactam
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given in hospital as a drip into a vein, by trained staff, over the course advised.
- Tell the team about any allergy to penicillins or other antibiotics before it is given.
- Mention any history of seizures or kidney problems, as the dose may need adjusting.
- Report severe or persistent diarrhoea promptly, as this can sometimes be a serious gut infection.
- Complete the full course your team prescribes to give the best chance of clearing the infection.
Weighing it up
Advantages & disadvantages of Imipenem with relebactam
Advantages
- Works against serious infections caused by resistant Gram-negative bacteria that other antibiotics may not clear.
- Relebactam protects the antibiotic from bacterial enzymes, extending what it can treat.
- A valuable reserve option for difficult hospital infections.
Disadvantages
- Given only by drip in hospital, not as a tablet at home.
- People allergic to penicillins may also react to it, and carbapenems carry a small risk of seizures.
- Can disturb gut bacteria and cause diarrhoea, including serious C. difficile infection.
Practical use
Good to know
This is a reserve hospital antibiotic, used for serious infections caused by resistant bacteria, so it is given in hospital by drip and the dose is tailored to the infection and to how well the kidneys are working. Three safety points matter most. First, people who are allergic to penicillins can sometimes react to carbapenems too, so any allergy history is checked carefully. Second, carbapenems carry a small risk of seizures, especially in people with kidney problems or a history of fits, so this is watched for. Third, like many antibiotics, it can disturb the gut's natural bacteria and cause diarrhoea, including a more serious infection called Clostridioides difficile, so any severe or persistent diarrhoea should be reported. Using it only when truly needed helps slow the spread of resistance.
Who should not take it / use with caution
- People who have had a serious allergic reaction to carbapenems, or to this combination, should not receive it.
- It is used with caution in people allergic to penicillins, because of possible cross-reactivity.
- It is used with care, and at an adjusted dose, in people with kidney problems or a history of seizures.
Monitoring
- Checking kidney function, as the dose depends on it and it affects seizure risk.
- Watching for diarrhoea, allergic reactions and any neurological symptoms such as seizures.
- Reviewing how the infection responds, often guided by laboratory tests.
Side effects
- Diarrhoea, nausea or vomiting, including, less often, a more serious gut infection (C. difficile).
- Reactions where the drip is given, such as redness or irritation of the vein.
- Rarely, seizures, especially in those with kidney problems or a history of fits, and allergic reactions.
Key interactions
- It can interact with valproate, an epilepsy medicine, lowering its level and reducing seizure control.
- Tell the team about all your medicines, including those affecting the kidneys.
- Other antibiotics and medicines that affect seizure risk should be reviewed.
Available as: A powder made up into a solution given as a drip into a vein.
Answers
Imipenem with relebactam: frequently asked questions
What is imipenem with relebactam used for?
It is a hospital antibiotic given by drip to treat serious infections caused by resistant Gram-negative bacteria, used when other antibiotics may not work.
Why is relebactam added?
Relebactam blocks the enzymes some bacteria use to destroy the antibiotic, protecting imipenem so it can work against otherwise resistant bugs.
I am allergic to penicillin — can I have it?
People allergic to penicillins can sometimes react to carbapenems too, so tell the team about any allergy; they will weigh this up carefully.
Can it cause seizures?
Carbapenems carry a small risk of seizures, especially in people with kidney problems or a history of fits, so this is watched for.
Why might I get diarrhoea?
Like many antibiotics it can disturb the gut's natural bacteria; report severe or persistent diarrhoea, as it can sometimes be a serious infection.
The wider class
About Carbapenem antibiotic with beta-lactamase inhibitor
Imipenem with relebactam belongs to the carbapenem antibiotic with beta-lactamase inhibitor class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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