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Drug overview for PRIMAXIN (imipenem/cilastatin sodium):
Generic name: IMIPENEM/CILASTATIN SODIUM (IM-i-PEN-em/SYE-la-STAT-in)
Drug class: Beta-Lactams
Therapeutic class: Anti-Infective Agents
Imipenem and cilastatin sodium is a fixed combination of imipenem monohydrate (a semisynthetic carbapenem beta-lactam antibiotic) and cilastatin sodium (a renal dehydropeptidase inhibitor that prevents renal metabolism of imipenem).
Imipenem and cilastatin sodium is used for the treatment of lower respiratory tract, intra-abdominal, gynecologic, skin and skin structure, or bone and joint infections caused by susceptible gram-negative and gram-positive bacteria. The drug also is used for the treatment of complicated or uncomplicated urinary tract infections, septicemia, or endocarditis caused by susceptible bacteria. Because of its wide spectrum of activity, one of the principal uses of IV imipenem and cilastatin is the treatment of polymicrobial bacterial infections.
The drug is useful for empiric IV therapy of serious nosocomial infections that may include both gram-positive and gram-negative aerobic bacteria as well as anaerobic bacteria. IV imipenem and cilastatin generally should not be used for the treatment of monobacterial infections when an anti-infective agent with a narrower spectrum of activity would be effective when used alone or for the treatment of most community-acquired infections caused by organisms susceptible to other anti-infective agents. IV imipenem and cilastatin has been effective in the treatment of monobacterial and polymicrobial bacterial infections that failed to respond to other anti-infective agents, including cephalosporins, penicillins, and/or aminoglycosides. The manufacturer states that the drug should not be used in the treatment of meningitis because safety and efficacy of the drug in these infections have not been definitely established.
Generic name: IMIPENEM/CILASTATIN SODIUM (IM-i-PEN-em/SYE-la-STAT-in)
Drug class: Beta-Lactams
Therapeutic class: Anti-Infective Agents
Imipenem and cilastatin sodium is a fixed combination of imipenem monohydrate (a semisynthetic carbapenem beta-lactam antibiotic) and cilastatin sodium (a renal dehydropeptidase inhibitor that prevents renal metabolism of imipenem).
Imipenem and cilastatin sodium is used for the treatment of lower respiratory tract, intra-abdominal, gynecologic, skin and skin structure, or bone and joint infections caused by susceptible gram-negative and gram-positive bacteria. The drug also is used for the treatment of complicated or uncomplicated urinary tract infections, septicemia, or endocarditis caused by susceptible bacteria. Because of its wide spectrum of activity, one of the principal uses of IV imipenem and cilastatin is the treatment of polymicrobial bacterial infections.
The drug is useful for empiric IV therapy of serious nosocomial infections that may include both gram-positive and gram-negative aerobic bacteria as well as anaerobic bacteria. IV imipenem and cilastatin generally should not be used for the treatment of monobacterial infections when an anti-infective agent with a narrower spectrum of activity would be effective when used alone or for the treatment of most community-acquired infections caused by organisms susceptible to other anti-infective agents. IV imipenem and cilastatin has been effective in the treatment of monobacterial and polymicrobial bacterial infections that failed to respond to other anti-infective agents, including cephalosporins, penicillins, and/or aminoglycosides. The manufacturer states that the drug should not be used in the treatment of meningitis because safety and efficacy of the drug in these infections have not been definitely established.
DRUG IMAGES
PRIMAXIN 500 MG VIAL
The following indications for PRIMAXIN (imipenem/cilastatin sodium) have been approved by the FDA:
Indications:
Bacterial endocarditis
Bacterial pneumonia
Bacterial sepsis
Bacterial urinary tract infection
Bone infection
Diabetic foot infection
Enterobacter pneumonia
Escherichia coli pneumonia
Female genital tract infection
Gram-negative aerobic bacillary pneumonia
Haemophilus influenzae pneumonia
Infectious disease of abdomen
Infectious disorder of joint
Inflammatory disease of female pelvic organs
Intra-abdominal abscess
Klebsiella pneumonia
Lower respiratory infection
Peritonitis
Skin and skin structure infection
Professional Synonyms:
Abdominal abscess
Bacteremia with sepsis
Bacterial septicemia
E. coli pneumonia
Gynecologic infection
H. flu pneumonia
H. influenzae pneumonia
Hemophilus influenzae pneumonia
Infection of skin and/or subcutaneous tissue
Infection of the lungs due to Enterobacter
Influenza Bacillus pneumonia
Intra-abdominal infection
Joint infection
Lower respiratory tract infection
Pfeiffer's Bacillus pneumonia
Pneumonia due to E. coli
Pneumonia due to Escherichia coli
Pneumonia due to gram-negative organism
Pneumonia due to Haemophilus influenzae
Pneumonia due to Klebsiella species
Pneumonia due to Klebsiella spp.
Skin and soft tissue skin infection
Indications:
Bacterial endocarditis
Bacterial pneumonia
Bacterial sepsis
Bacterial urinary tract infection
Bone infection
Diabetic foot infection
Enterobacter pneumonia
Escherichia coli pneumonia
Female genital tract infection
Gram-negative aerobic bacillary pneumonia
Haemophilus influenzae pneumonia
Infectious disease of abdomen
Infectious disorder of joint
Inflammatory disease of female pelvic organs
Intra-abdominal abscess
Klebsiella pneumonia
Lower respiratory infection
Peritonitis
Skin and skin structure infection
Professional Synonyms:
Abdominal abscess
Bacteremia with sepsis
Bacterial septicemia
E. coli pneumonia
Gynecologic infection
H. flu pneumonia
H. influenzae pneumonia
Hemophilus influenzae pneumonia
Infection of skin and/or subcutaneous tissue
Infection of the lungs due to Enterobacter
Influenza Bacillus pneumonia
Intra-abdominal infection
Joint infection
Lower respiratory tract infection
Pfeiffer's Bacillus pneumonia
Pneumonia due to E. coli
Pneumonia due to Escherichia coli
Pneumonia due to gram-negative organism
Pneumonia due to Haemophilus influenzae
Pneumonia due to Klebsiella species
Pneumonia due to Klebsiella spp.
Skin and soft tissue skin infection
The following dosing information is available for PRIMAXIN (imipenem/cilastatin sodium):
Dosage of imipenem and cilastatin is usually expressed in terms of the imipenem content of the fixed combination; dosage of imipenem monohydrate is expressed in terms of anhydrous imipenem.
Dosage of imipenem (administered as imipenem and cilastatin sodium) recommended in adults is based on imipenem susceptibility of the suspected or confirmed causative organism(s) and the patient's renal function. (For information on definitions of susceptibility to imipenem, see In Vitro Susceptibility Testing under Spectrum.)
For the treatment of infections suspected or proven to be caused by bacteria susceptible to imipenem in adults with creatinine clearance of 90 mL/minute or greater, the manufacturer recommends a dosage of 500 mg of imipenem IV every 6 hours or 1 g IV every 8 hours.
For the treatment of infections suspected or proven to be caused by bacteria with intermittent susceptibility to imipenem in adults with creatinine clearance of 90 mL/minute or greater, the manufacturer recommends a dosage of 1 g of imipenem IV every 8 hours.
The manufacturer states that the maximum IV dosage of imipenem for adults is 4 g daily.
Dosage of imipenem (administered as imipenem and cilastatin sodium) recommended in pediatric patients is based on the age of the patient.
For the treatment of infections (other than CNS infections) in neonates 4 weeks of age or younger who weigh at least 1.5 kg, the manufacturer recommends a dosage of 25 mg/kg IV every 12 hours in those younger than 1 week of age and 25 mg/kg IV every 8 hours in those 1-4 weeks of age.
For the treatment of infections (other than CNS infections) in infants 4 weeks to 3 months of age who weigh at least 1.5 kg, the manufacturer recommends a dosage of 25 mg/kg IV every 6 hours.
For the treatment of infections (other than CNS infections) in pediatric patients 3 months of age or older, the manufacturer recommends a dosage of 25 mg/kg IV every 6 hours.
The manufacturer states that, based on studies in adults, the maximum IV dosage of imipenem for pediatric patients is 4 g daily.
Dosage of imipenem (administered as imipenem and cilastatin) must be reduced in adults with creatinine clearance less than 90 mL/minute. (See Table 1.)
The manufacturer states that imipenem and cilastatin is not recommended in pediatric patients with renal impairment who weigh less than 30 kg since data are not available.
Table 1. Dosage of Imipenem for Adults with Creatinine Clearance (Clcr) less than 90 mL/minute
Imipenem Clcr 60 to <90 Clcr 30 to <60 Clcr 15 to <30 Susceptibility mL/minute mL/minute mL/minute Infections 400 mg every 6 300 mg every 6 200 mg every 6 suspected or hours OR 500 mg hours OR 500 mg hours OR 500 mg proven to be every 6 hours every 8 hours every 12 hours caused by susceptible bacteria Infections 750 mg every 8 500 mg every 6 500 mg every 12 suspected or hours hours hours proven to be caused by bacteria with intermediate susceptibility
Calculate Clcr based on the Cockcroft-Gault method.
Patients with Clcr 15 to <30 mL/minute may be at increased risk of seizures.
Imipenem and cilastatin sodium should not be used in patients with creatinine clearance less than 15 mL/minute unless hemodialysis is initiated within 48 hours.
Imipenem and cilastatin sodium should be used in hemodialysis patients only if benefits outweigh the potential risk for seizures. (See Precautions and Contraindications under Cautions.) If the drug is used in patients with creatinine clearances less than 15 mL/minute undergoing hemodialysis, imipenem dosage recommended for patients with creatinine clearances of 15 to less than 30 mL/minute should be used (see Table 1). Because both imipenem and cilastatin are cleared from the circulation during hemodialysis, the drug should be administered after hemodialysis and at intervals timed from the end of that hemodialysis session.
Dialysis patients, especially those with underlying CNS disease, should be carefully monitored during imipenem and cilastatin treatment.
The manufacturer states that information is insufficient to recommend use of imipenem and cilastatin in patients receiving peritoneal dialysis.
Dosage of imipenem (administered as imipenem and cilastatin sodium) recommended in adults is based on imipenem susceptibility of the suspected or confirmed causative organism(s) and the patient's renal function. (For information on definitions of susceptibility to imipenem, see In Vitro Susceptibility Testing under Spectrum.)
For the treatment of infections suspected or proven to be caused by bacteria susceptible to imipenem in adults with creatinine clearance of 90 mL/minute or greater, the manufacturer recommends a dosage of 500 mg of imipenem IV every 6 hours or 1 g IV every 8 hours.
For the treatment of infections suspected or proven to be caused by bacteria with intermittent susceptibility to imipenem in adults with creatinine clearance of 90 mL/minute or greater, the manufacturer recommends a dosage of 1 g of imipenem IV every 8 hours.
The manufacturer states that the maximum IV dosage of imipenem for adults is 4 g daily.
Dosage of imipenem (administered as imipenem and cilastatin sodium) recommended in pediatric patients is based on the age of the patient.
For the treatment of infections (other than CNS infections) in neonates 4 weeks of age or younger who weigh at least 1.5 kg, the manufacturer recommends a dosage of 25 mg/kg IV every 12 hours in those younger than 1 week of age and 25 mg/kg IV every 8 hours in those 1-4 weeks of age.
For the treatment of infections (other than CNS infections) in infants 4 weeks to 3 months of age who weigh at least 1.5 kg, the manufacturer recommends a dosage of 25 mg/kg IV every 6 hours.
For the treatment of infections (other than CNS infections) in pediatric patients 3 months of age or older, the manufacturer recommends a dosage of 25 mg/kg IV every 6 hours.
The manufacturer states that, based on studies in adults, the maximum IV dosage of imipenem for pediatric patients is 4 g daily.
Dosage of imipenem (administered as imipenem and cilastatin) must be reduced in adults with creatinine clearance less than 90 mL/minute. (See Table 1.)
The manufacturer states that imipenem and cilastatin is not recommended in pediatric patients with renal impairment who weigh less than 30 kg since data are not available.
Table 1. Dosage of Imipenem for Adults with Creatinine Clearance (Clcr) less than 90 mL/minute
Imipenem Clcr 60 to <90 Clcr 30 to <60 Clcr 15 to <30 Susceptibility mL/minute mL/minute mL/minute Infections 400 mg every 6 300 mg every 6 200 mg every 6 suspected or hours OR 500 mg hours OR 500 mg hours OR 500 mg proven to be every 6 hours every 8 hours every 12 hours caused by susceptible bacteria Infections 750 mg every 8 500 mg every 6 500 mg every 12 suspected or hours hours hours proven to be caused by bacteria with intermediate susceptibility
Calculate Clcr based on the Cockcroft-Gault method.
Patients with Clcr 15 to <30 mL/minute may be at increased risk of seizures.
Imipenem and cilastatin sodium should not be used in patients with creatinine clearance less than 15 mL/minute unless hemodialysis is initiated within 48 hours.
Imipenem and cilastatin sodium should be used in hemodialysis patients only if benefits outweigh the potential risk for seizures. (See Precautions and Contraindications under Cautions.) If the drug is used in patients with creatinine clearances less than 15 mL/minute undergoing hemodialysis, imipenem dosage recommended for patients with creatinine clearances of 15 to less than 30 mL/minute should be used (see Table 1). Because both imipenem and cilastatin are cleared from the circulation during hemodialysis, the drug should be administered after hemodialysis and at intervals timed from the end of that hemodialysis session.
Dialysis patients, especially those with underlying CNS disease, should be carefully monitored during imipenem and cilastatin treatment.
The manufacturer states that information is insufficient to recommend use of imipenem and cilastatin in patients receiving peritoneal dialysis.
No enhanced Administration information available for this drug.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| PRIMAXIN 500 MG VIAL | Maintenance | Adults infuse 500 mg over 20-30 minute(s) by intravenous route every 8 hours |
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| IMIPENEM-CILASTATIN 500 MG VL | Maintenance | Adults infuse 500 mg over 20-30 minute(s) by intravenous route every 8 hours |
The following drug interaction information is available for PRIMAXIN (imipenem/cilastatin sodium):
There are 1 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
| Drug Interaction | Drug Names |
|---|---|
| Live Typhoid Vaccine/Antimicrobials SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: The antimicrobial may be active against the organism in the live-vaccine. Antimicrobial therapy may prevent the vaccine organism from replicating enough to trigger an immune response.(1) CLINICAL EFFECTS: Vaccination may be ineffective. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Do not give oral typhoid vaccine until 72 hours after the last dose of antimicrobial. If possible, to optimize vaccine effectiveness, do not start antibacterial drugs for 72 hours after the last dose of oral typhoid vaccine. A longer interval should be considered for long-acting antimicrobials, such as azithromycin.(3) DISCUSSION: Because antimicrobial therapy may prevent sufficient vaccine-organism replication to generate an immune response, the manufacturer of live-attenuated typhoid vaccine and the Centers for Disease Control (CDC) state that the vaccine should not be administered to patients receiving antimicrobial therapy.(1-3) |
VIVOTIF |
There are 4 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Imipenem-Cilastatin/Ganciclovir,Valganciclovir SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: The exact mechanism is unknown, but may involve additive or synergistic effects on the seizure threshold. CLINICAL EFFECTS: Concurrent use of imipenem-cilastatin with ganciclovir may result in generalized seizures.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer of imipenem-cilastatin states that imipenem-cilastatin and ganciclovir should not be coadministered unless the potential benefits outweigh the risks of seizures.(1) DISCUSSION: Generalized seizures have been reported in patients who received ganciclovir and imipenem-cilastatin.(1) |
GANCICLOVIR SODIUM, VALCYTE, VALGANCICLOVIR HCL |
| Valproic Acid/Carbapenem Antibiotics SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: The exact mechanism is unknown. Carbapenems may inhibit the absorption of valproic acid from the gastrointestinal tract.(1-3) Meropenem may accelerate the renal excretion of valproate.(4) Carbapenems may increase valproic acid intake by erythrocytes.(5,6) Carbapenems may inhibit the metabolite of valproic acid, valproic acid-glucuronide, from being converted back into the active parent form.(7-9) CLINICAL EFFECTS: Concurrent use of carbapenems and valproic acid without supplemental antiepileptic therapy is not recommended because it results in rapid, significant reductions in serum levels of valproic acid to non-therapeutic levels which may result in seizures. Dose escalation of valproic acid formulations does not counteract the decrease in serum levels and patients will require additional antiepileptic therapy. The effects may persist for several days beyond discontinuation of the carbapenem. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Avoid the use of carbapenem antibiotics in patients maintained on valproic acid when possible. If concurrent therapy is warranted, patients will require the addition of a supplemental anti-epileptic agent until valproic acid levels return to therapeutic range. DISCUSSION: In a retrospective review of an 18 month period, charts of 39 patients who received concurrent therapy with valproate and meropenem were examined. A pharmacokinetic interaction was observed in all 39 patients, with an average decrease in valproate levels of 66%. The decrease occurred within 24 hours of the initiation of concurrent therapy. Electroclinical deterioration was seen in 55% of patients.(10) A prospective study evaluated ICU patients given levetiracetam or valproic acid to control seizures. Twenty-four of the 35 patients required meropenem. Each patient that was on valproic acid had valproic acid levels decrease following the addition of meropenum. (13) In a study in 23 healthy male subjects, concurrent doripenem (500 mg every 8 hours) decreased the maximum concentration, (Cmax) area-under-curve (AUC), and minimum concentration (Cmin) of valproic acid by 44.5%, 63% and 77.7%, respectively.(14) There are several case reports of decreased valproic acid levels following the addition of meropenem to therapy.(4,11,12,15-21) Some patients experienced increased seizures.(4 ,11,15,16,20) In some cases, decreased levels persisted despite increased doses of valproic acid.(11,12,15,17,18,21) Others required additional anti-seizure medications during concurrent therapy.(16) Decreased valproic acid levels have also been reported during concurrent ertapenem.(22-25) Seizures were reported in two patients.(22,25) In one patient, valproic acid levels returned to therapeutic levels within three days of discontinuation of ertapenem, despite no change in valproic acid dose.(25) Decreased valproic acid levels have also been reported during concurrent imipenem.(26) A retrospective study evaluated 52 patients given valproic acid and a carbapenem over a five year period. Patients received either ertapenem, imipenem/cilastatin, or meropenem (9, 17, and 26 patients, respectively). The average serum valproic acid concentration before and after carbapenem use was 58.6 +/- 19.2 and 23.7 +/- 16.3 mg/dL, respectively, which represented a decrease of 60% +/- 23% (p<0.001). Valproic acid concentrations were reduced with both intravenous and oral formulations of valproic acid (52% +/- 16% and 61% +/-24%, respectively). Valproic acid serum concentrations were subtherapeutic (<50 mg/L) in 90% of patients during carbapenem concurrent use. Use during ertapenem, imipenem/cilastatin, and meropenem decreased valproic acid concentrations by 72% +/- 17%, 42% +/- 22%, and 67% +/- 19%, respectively.(28) A retrospective study in 54 patients treated with valproic acid for at least three months for seizure control were evaluated for changes in valproic acid with concurrent carbapenem therapy. The mean change in valproic acid levels was 80%, 68%, and 51% in the meropenem, ertapenem, and imipenem group, respectively. During concurrent therapy, 48.1% of patients experienced aggravation of seizures and 25.9% died. Valproic acid levels of those experiencing aggravation of seizures were 17.7 +/- 9.9 mcg/mL versus 17.9 +/- 12.6 mcg/mL in those without aggravation (p=0.944).(29) A retrospective study in 381 neurosurgery inpatients evaluated valproic acid levels with concurrent meropenem therapy. Patients were grouped based on valproic acid dose of 1.2 g/day or 1.6 g/day with and without meropenem. In both 1.2 g/day and 1.6 g/day valproic acid groups, valproic acid levels were decreased after initiation of meropenem (67.3 +/- 4.6 mcg/mL v. 15.3 +/- 1.9 mcg/mL; 78.2% decrease, p<0.001 for 1.2 g/day valproic acid; 67.6 +/- 1.2 mcg/mL v. 18.1 +/- 2.6 mcg/mL; 72.5% decrease, p<0.001 for 1.6 g/day valproic acid. Valproic acid concentrations recovered to levels comparable to valproic acid alone more than seven days after meropenem discontinuation.(30) |
DEPAKOTE, DEPAKOTE ER, DEPAKOTE SPRINKLE, DIVALPROEX SODIUM, DIVALPROEX SODIUM ER, SODIUM VALPROATE, VALPROATE SODIUM, VALPROIC ACID |
| Sodium Iodide I 131/Myelosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Sodium iodide I 131 can cause depression of the hematopoetic system. Myelosuppressives and immunomodulators also suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of sodium iodide I 131 with agents that cause bone marrow depression, including myelosuppressives or immunomodulators, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of sodium iodide I 131 states that concurrent use with bone marrow depressants may enhance the depression of the hematopoetic system caused by large doses of sodium iodide I 131.(1) Sodium iodide I 131 causes a dose-dependent bone marrow suppression, including neutropenia or thrombocytopenia, in the 3 to 5 weeks following administration. Patients may be at increased risk of infections or bleeding during this time. Monitor complete blood counts within one month of therapy. If results indicate leukopenia or thrombocytopenia, dosimetry should be used to determine a safe sodium iodide I 131 activity.(1) DISCUSSION: Hematologic disorders including death have been reported with sodium iodide I 131. The most common hematologic disorders reported include anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia.(1) |
HICON, SODIUM IODIDE I-131 |
| Fecal Microbiota Spores/Antibiotics SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Fecal microbiota spores is a suspension of live bacterial spores, which may be compromised by concurrent use of antibiotics.(1) CLINICAL EFFECTS: Antibiotics may decrease the effectiveness of fecal microbiota spores.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Antibiotics should not be used concurrently with fecal microbiota spores. Antibacterial treatment should be completed for 2 to 4 days before initiating treatment with fecal microbiota spores.(1) DISCUSSION: Antibiotics may compromise the effectiveness of fecal microbiota spores. |
VOWST |
There are 0 moderate interactions.
The following contraindication information is available for PRIMAXIN (imipenem/cilastatin sodium):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 0 contraindications.
There are 9 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Chronic kidney disease stage 2 (mild) GFR 60-89 ml/min |
| Chronic kidney disease stage 3A (moderate) GFR 45-59 ml/min |
| Chronic kidney disease stage 3B (moderate) GFR 30-44 ml/min |
| Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min |
| Chronic kidney disease stage 5 (failure) GFr<15 ml/min |
| Clostridioides difficile infection |
| Kidney disease with likely reduction in glomerular filtration rate (GFr) |
| Lower seizure threshold |
| Seizure disorder |
There are 0 moderate contraindications.
The following adverse reaction information is available for PRIMAXIN (imipenem/cilastatin sodium):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 34 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Thrombophlebitis |
None. |
| Rare/Very Rare |
|---|
|
Acute hepatic failure Acute renal failure Agranulocytosis Anaphylaxis Anemia Angioedema Bone marrow depression Clostridioides difficile infection Drug fever Dyskinesia Dyspnea Encephalopathy Erythema multiforme Hemolytic anemia Hemorrhagic colitis Hepatitis Hyperbilirubinemia Hypotension Increased alanine transaminase Increased aspartate transaminase Jaundice Leukopenia Myoclonus Neutropenic disorder Oliguria Pancytopenia Seizure disorder Skin rash Stevens-johnson syndrome Tachycardia Thrombocytopenic disorder Toxic epidermal necrolysis Urticaria |
There are 36 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Diarrhea Injection site erythema Injection site pain Nausea Pruritus of skin Vomiting |
None. |
| Rare/Very Rare |
|---|
|
Acute abdominal pain Acute cognitive impairment Agitation Arthralgia Candidiasis Dental discoloration Dizziness Drowsy Dysgeusia Eosinophilia Gastritis General weakness Glossitis Hallucinations Headache disorder Hearing loss Heartburn Hypertrophic thickening of tongue Injection site sequelae Palpitations Paresthesia Polyuria Proteinuria Sialorrhea Sore throat Tinnitus Tremor Urine discoloration Vertigo Vulvovaginitis |
The following precautions are available for PRIMAXIN (imipenem/cilastatin sodium):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Both imipenem and cilastatin cross the placenta and are distributed into cord blood and amniotic fluid in humans. Data available from small numbers of postmarketing cases of imipenem and cilastatin use during pregnancy are insufficient to identify any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes. Developmental toxicity studies in animals (mice, rats, rabbits, monkeys) using imipenem and cilastatin (alone or in combination) administered at doses 0.4-2.9
times the recommended human dose (based on body surface area) showed no evidence of drug-induced fetal malformations. Embryofetal development studies using imipenem and cilastatin in cynomolgus monkeys at doses similar to the recommended human dose (based on body surface area) showed an increase in embryonic loss.
times the recommended human dose (based on body surface area) showed no evidence of drug-induced fetal malformations. Embryofetal development studies using imipenem and cilastatin in cynomolgus monkeys at doses similar to the recommended human dose (based on body surface area) showed an increase in embryonic loss.
Imipenem is distributed into milk. Data are insufficient regarding the presence of imipenem and cilastatin in human milk and data are not available on possible effects on the breast-fed child or effects on milk production. The developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for imipenem and cilastatin and any potential adverse effects on the breast-fed child from the drug or from the underlying maternal condition.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for PRIMAXIN (imipenem/cilastatin sodium):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for PRIMAXIN (imipenem/cilastatin sodium)'s list of indications:
| Bacterial endocarditis | |
| I33.0 | Acute and subacute infective endocarditis |
| Bacterial pneumonia | |
| J15.9 | Unspecified bacterial pneumonia |
| Bacterial sepsis | |
| A02.1 | Salmonella sepsis |
| A20.7 | Septicemic plague |
| A22.7 | Anthrax sepsis |
| A26.7 | Erysipelothrix sepsis |
| A32.7 | Listerial sepsis |
| A40 | Streptococcal sepsis |
| A40.0 | Sepsis due to streptococcus, group A |
| A40.1 | Sepsis due to streptococcus, group B |
| A40.3 | Sepsis due to streptococcus pneumoniae |
| A40.8 | Other streptococcal sepsis |
| A40.9 | Streptococcal sepsis, unspecified |
| A41 | Other sepsis |
| A41.0 | Sepsis due to staphylococcus aureus |
| A41.01 | Sepsis due to methicillin susceptible staphylococcus aureus |
| A41.02 | Sepsis due to methicillin resistant staphylococcus aureus |
| A41.1 | Sepsis due to other specified staphylococcus |
| A41.2 | Sepsis due to unspecified staphylococcus |
| A41.3 | Sepsis due to hemophilus influenzae |
| A41.4 | Sepsis due to anaerobes |
| A41.5 | Sepsis due to other gram-negative organisms |
| A41.50 | Gram-negative sepsis, unspecified |
| A41.51 | Sepsis due to escherichia coli [e. coli] |
| A41.52 | Sepsis due to pseudomonas |
| A41.53 | Sepsis due to serratia |
| A41.54 | Sepsis due to acinetobacter baumannii |
| A41.59 | Other gram-negative sepsis |
| A41.8 | Other specified sepsis |
| A41.81 | Sepsis due to enterococcus |
| A41.89 | Other specified sepsis |
| A41.9 | Sepsis, unspecified organism |
| A42.7 | Actinomycotic sepsis |
| A54.86 | Gonococcal sepsis |
| O03.37 | Sepsis following incomplete spontaneous abortion |
| O08.82 | Sepsis following ectopic and molar pregnancy |
| O85 | Puerperal sepsis |
| O86.04 | Sepsis following an obstetrical procedure |
| P36 | Bacterial sepsis of newborn |
| P36.0 | Sepsis of newborn due to streptococcus, group B |
| P36.1 | Sepsis of newborn due to other and unspecified streptococci |
| P36.10 | Sepsis of newborn due to unspecified streptococci |
| P36.19 | Sepsis of newborn due to other streptococci |
| P36.2 | Sepsis of newborn due to staphylococcus aureus |
| P36.3 | Sepsis of newborn due to other and unspecified staphylococci |
| P36.30 | Sepsis of newborn due to unspecified staphylococci |
| P36.39 | Sepsis of newborn due to other staphylococci |
| P36.4 | Sepsis of newborn due to escherichia coli |
| P36.5 | Sepsis of newborn due to anaerobes |
| P36.8 | Other bacterial sepsis of newborn |
| P36.9 | Bacterial sepsis of newborn, unspecified |
| R65.2 | Severe sepsis |
| T81.12 | Postprocedural septic shock |
| T81.12xA | Postprocedural septic shock, initial encounter |
| T81.44 | Sepsis following a procedure |
| T81.44xA | Sepsis following a procedure, initial encounter |
| Bacterial urinary tract infection | |
| N30.0 | Acute cystitis |
| N30.00 | Acute cystitis without hematuria |
| N30.01 | Acute cystitis with hematuria |
| N30.9 | Cystitis, unspecified |
| N30.90 | Cystitis, unspecified without hematuria |
| N30.91 | Cystitis, unspecified with hematuria |
| N39.0 | Urinary tract infection, site not specified |
| O23.0 | Infections of kidney in pregnancy |
| O23.00 | Infections of kidney in pregnancy, unspecified trimester |
| O23.01 | Infections of kidney in pregnancy, first trimester |
| O23.02 | Infections of kidney in pregnancy, second trimester |
| O23.03 | Infections of kidney in pregnancy, third trimester |
| O23.1 | Infections of bladder in pregnancy |
| O23.10 | Infections of bladder in pregnancy, unspecified trimester |
| O23.11 | Infections of bladder in pregnancy, first trimester |
| O23.12 | Infections of bladder in pregnancy, second trimester |
| O23.13 | Infections of bladder in pregnancy, third trimester |
| O23.2 | Infections of urethra in pregnancy |
| O23.20 | Infections of urethra in pregnancy, unspecified trimester |
| O23.21 | Infections of urethra in pregnancy, first trimester |
| O23.22 | Infections of urethra in pregnancy, second trimester |
| O23.23 | Infections of urethra in pregnancy, third trimester |
| O23.3 | Infections of other parts of urinary tract in pregnancy |
| O23.30 | Infections of other parts of urinary tract in pregnancy, unspecified trimester |
| O23.31 | Infections of other parts of urinary tract in pregnancy, first trimester |
| O23.32 | Infections of other parts of urinary tract in pregnancy, second trimester |
| O23.33 | Infections of other parts of urinary tract in pregnancy, third trimester |
| O23.4 | Unspecified infection of urinary tract in pregnancy |
| O23.40 | Unspecified infection of urinary tract in pregnancy, unspecified trimester |
| O23.41 | Unspecified infection of urinary tract in pregnancy, first trimester |
| O23.42 | Unspecified infection of urinary tract in pregnancy, second trimester |
| O23.43 | Unspecified infection of urinary tract in pregnancy, third trimester |
| O23.90 | Unspecified genitourinary tract infection in pregnancy, unspecified trimester |
| O23.91 | Unspecified genitourinary tract infection in pregnancy, first trimester |
| O23.92 | Unspecified genitourinary tract infection in pregnancy, second trimester |
| O23.93 | Unspecified genitourinary tract infection in pregnancy, third trimester |
| P39.3 | Neonatal urinary tract infection |
| T83 | Complications of genitourinary prosthetic devices, implants and grafts |
| T83.5 | Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system |
| T83.51 | Infection and inflammatory reaction due to urinary catheter |
| T83.59 | Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system |
| T83.6 | Infection and inflammatory reaction due to prosthetic device, implant and graft in genital tract |
| Bone infection | |
| H05.02 | Osteomyelitis of orbit |
| H05.021 | Osteomyelitis of right orbit |
| H05.022 | Osteomyelitis of left orbit |
| H05.023 | Osteomyelitis of bilateral orbits |
| H05.029 | Osteomyelitis of unspecified orbit |
| H70 | Mastoiditis and related conditions |
| H70.0 | Acute mastoiditis |
| H70.00 | Acute mastoiditis without complications |
| H70.001 | Acute mastoiditis without complications, right ear |
| H70.002 | Acute mastoiditis without complications, left ear |
| H70.003 | Acute mastoiditis without complications, bilateral |
| H70.009 | Acute mastoiditis without complications, unspecified ear |
| H70.01 | Subperiosteal abscess of mastoid |
| H70.011 | Subperiosteal abscess of mastoid, right ear |
| H70.012 | Subperiosteal abscess of mastoid, left ear |
| H70.013 | Subperiosteal abscess of mastoid, bilateral |
| H70.019 | Subperiosteal abscess of mastoid, unspecified ear |
| H70.09 | Acute mastoiditis with other complications |
| H70.091 | Acute mastoiditis with other complications, right ear |
| H70.092 | Acute mastoiditis with other complications, left ear |
| H70.093 | Acute mastoiditis with other complications, bilateral |
| H70.099 | Acute mastoiditis with other complications, unspecified ear |
| H70.1 | Chronic mastoiditis |
| H70.10 | Chronic mastoiditis, unspecified ear |
| H70.11 | Chronic mastoiditis, right ear |
| H70.12 | Chronic mastoiditis, left ear |
| H70.13 | Chronic mastoiditis, bilateral |
| H70.2 | Petrositis |
| H70.20 | Unspecified petrositis |
| H70.201 | Unspecified petrositis, right ear |
| H70.202 | Unspecified petrositis, left ear |
| H70.203 | Unspecified petrositis, bilateral |
| H70.209 | Unspecified petrositis, unspecified ear |
| H70.21 | Acute petrositis |
| H70.211 | Acute petrositis, right ear |
| H70.212 | Acute petrositis, left ear |
| H70.213 | Acute petrositis, bilateral |
| H70.219 | Acute petrositis, unspecified ear |
| H70.22 | Chronic petrositis |
| H70.221 | Chronic petrositis, right ear |
| H70.222 | Chronic petrositis, left ear |
| H70.223 | Chronic petrositis, bilateral |
| H70.229 | Chronic petrositis, unspecified ear |
| H70.8 | Other mastoiditis and related conditions |
| H70.89 | Other mastoiditis and related conditions |
| H70.891 | Other mastoiditis and related conditions, right ear |
| H70.892 | Other mastoiditis and related conditions, left ear |
| H70.893 | Other mastoiditis and related conditions, bilateral |
| H70.899 | Other mastoiditis and related conditions, unspecified ear |
| H70.9 | Unspecified mastoiditis |
| H70.90 | Unspecified mastoiditis, unspecified ear |
| H70.91 | Unspecified mastoiditis, right ear |
| H70.92 | Unspecified mastoiditis, left ear |
| H70.93 | Unspecified mastoiditis, bilateral |
| H75.0 | Mastoiditis in infectious and parasitic diseases classified elsewhere |
| H75.00 | Mastoiditis in infectious and parasitic diseases classified elsewhere, unspecified ear |
| H75.01 | Mastoiditis in infectious and parasitic diseases classified elsewhere, right ear |
| H75.02 | Mastoiditis in infectious and parasitic diseases classified elsewhere, left ear |
| H75.03 | Mastoiditis in infectious and parasitic diseases classified elsewhere, bilateral |
| M46.2 | Osteomyelitis of vertebra |
| M46.20 | Osteomyelitis of vertebra, site unspecified |
| M46.21 | Osteomyelitis of vertebra, occipito-atlanto-axial region |
| M46.22 | Osteomyelitis of vertebra, cervical region |
| M46.23 | Osteomyelitis of vertebra, cervicothoracic region |
| M46.24 | Osteomyelitis of vertebra, thoracic region |
| M46.25 | Osteomyelitis of vertebra, thoracolumbar region |
| M46.26 | Osteomyelitis of vertebra, lumbar region |
| M46.27 | Osteomyelitis of vertebra, lumbosacral region |
| M46.28 | Osteomyelitis of vertebra, sacral and sacrococcygeal region |
| M46.5 | Other infective spondylopathies |
| M46.50 | Other infective spondylopathies, site unspecified |
| M46.51 | Other infective spondylopathies, occipito-atlanto-axial region |
| M46.52 | Other infective spondylopathies, cervical region |
| M46.53 | Other infective spondylopathies, cervicothoracic region |
| M46.54 | Other infective spondylopathies, thoracic region |
| M46.55 | Other infective spondylopathies, thoracolumbar region |
| M46.56 | Other infective spondylopathies, lumbar region |
| M46.57 | Other infective spondylopathies, lumbosacral region |
| M46.58 | Other infective spondylopathies, sacral and sacrococcygeal region |
| M46.59 | Other infective spondylopathies, multiple sites in spine |
| M86 | Osteomyelitis |
| M86.0 | Acute hematogenous osteomyelitis |
| M86.00 | Acute hematogenous osteomyelitis, unspecified site |
| M86.01 | Acute hematogenous osteomyelitis, shoulder |
| M86.011 | Acute hematogenous osteomyelitis, right shoulder |
| M86.012 | Acute hematogenous osteomyelitis, left shoulder |
| M86.019 | Acute hematogenous osteomyelitis, unspecified shoulder |
| M86.02 | Acute hematogenous osteomyelitis, humerus |
| M86.021 | Acute hematogenous osteomyelitis, right humerus |
| M86.022 | Acute hematogenous osteomyelitis, left humerus |
| M86.029 | Acute hematogenous osteomyelitis, unspecified humerus |
| M86.03 | Acute hematogenous osteomyelitis, radius and ulna |
| M86.031 | Acute hematogenous osteomyelitis, right radius and ulna |
| M86.032 | Acute hematogenous osteomyelitis, left radius and ulna |
| M86.039 | Acute hematogenous osteomyelitis, unspecified radius and ulna |
| M86.04 | Acute hematogenous osteomyelitis, hand |
| M86.041 | Acute hematogenous osteomyelitis, right hand |
| M86.042 | Acute hematogenous osteomyelitis, left hand |
| M86.049 | Acute hematogenous osteomyelitis, unspecified hand |
| M86.05 | Acute hematogenous osteomyelitis, femur |
| M86.051 | Acute hematogenous osteomyelitis, right femur |
| M86.052 | Acute hematogenous osteomyelitis, left femur |
| M86.059 | Acute hematogenous osteomyelitis, unspecified femur |
| M86.06 | Acute hematogenous osteomyelitis, tibia and fibula |
| M86.061 | Acute hematogenous osteomyelitis, right tibia and fibula |
| M86.062 | Acute hematogenous osteomyelitis, left tibia and fibula |
| M86.069 | Acute hematogenous osteomyelitis, unspecified tibia and fibula |
| M86.07 | Acute hematogenous osteomyelitis, ankle and foot |
| M86.071 | Acute hematogenous osteomyelitis, right ankle and foot |
| M86.072 | Acute hematogenous osteomyelitis, left ankle and foot |
| M86.079 | Acute hematogenous osteomyelitis, unspecified ankle and foot |
| M86.08 | Acute hematogenous osteomyelitis, other sites |
| M86.09 | Acute hematogenous osteomyelitis, multiple sites |
| M86.1 | Other acute osteomyelitis |
| M86.10 | Other acute osteomyelitis, unspecified site |
| M86.11 | Other acute osteomyelitis, shoulder |
| M86.111 | Other acute osteomyelitis, right shoulder |
| M86.112 | Other acute osteomyelitis, left shoulder |
| M86.119 | Other acute osteomyelitis, unspecified shoulder |
| M86.12 | Other acute osteomyelitis, humerus |
| M86.121 | Other acute osteomyelitis, right humerus |
| M86.122 | Other acute osteomyelitis, left humerus |
| M86.129 | Other acute osteomyelitis, unspecified humerus |
| M86.13 | Other acute osteomyelitis, radius and ulna |
| M86.131 | Other acute osteomyelitis, right radius and ulna |
| M86.132 | Other acute osteomyelitis, left radius and ulna |
| M86.139 | Other acute osteomyelitis, unspecified radius and ulna |
| M86.14 | Other acute osteomyelitis, hand |
| M86.141 | Other acute osteomyelitis, right hand |
| M86.142 | Other acute osteomyelitis, left hand |
| M86.149 | Other acute osteomyelitis, unspecified hand |
| M86.15 | Other acute osteomyelitis, femur |
| M86.151 | Other acute osteomyelitis, right femur |
| M86.152 | Other acute osteomyelitis, left femur |
| M86.159 | Other acute osteomyelitis, unspecified femur |
| M86.16 | Other acute osteomyelitis, tibia and fibula |
| M86.161 | Other acute osteomyelitis, right tibia and fibula |
| M86.162 | Other acute osteomyelitis, left tibia and fibula |
| M86.169 | Other acute osteomyelitis, unspecified tibia and fibula |
| M86.17 | Other acute osteomyelitis, ankle and foot |
| M86.171 | Other acute osteomyelitis, right ankle and foot |
| M86.172 | Other acute osteomyelitis, left ankle and foot |
| M86.179 | Other acute osteomyelitis, unspecified ankle and foot |
| M86.18 | Other acute osteomyelitis, other site |
| M86.19 | Other acute osteomyelitis, multiple sites |
| M86.2 | Subacute osteomyelitis |
| M86.20 | Subacute osteomyelitis, unspecified site |
| M86.21 | Subacute osteomyelitis, shoulder |
| M86.211 | Subacute osteomyelitis, right shoulder |
| M86.212 | Subacute osteomyelitis, left shoulder |
| M86.219 | Subacute osteomyelitis, unspecified shoulder |
| M86.22 | Subacute osteomyelitis, humerus |
| M86.221 | Subacute osteomyelitis, right humerus |
| M86.222 | Subacute osteomyelitis, left humerus |
| M86.229 | Subacute osteomyelitis, unspecified humerus |
| M86.23 | Subacute osteomyelitis, radius and ulna |
| M86.231 | Subacute osteomyelitis, right radius and ulna |
| M86.232 | Subacute osteomyelitis, left radius and ulna |
| M86.239 | Subacute osteomyelitis, unspecified radius and ulna |
| M86.24 | Subacute osteomyelitis, hand |
| M86.241 | Subacute osteomyelitis, right hand |
| M86.242 | Subacute osteomyelitis, left hand |
| M86.249 | Subacute osteomyelitis, unspecified hand |
| M86.25 | Subacute osteomyelitis, femur |
| M86.251 | Subacute osteomyelitis, right femur |
| M86.252 | Subacute osteomyelitis, left femur |
| M86.259 | Subacute osteomyelitis, unspecified femur |
| M86.26 | Subacute osteomyelitis, tibia and fibula |
| M86.261 | Subacute osteomyelitis, right tibia and fibula |
| M86.262 | Subacute osteomyelitis, left tibia and fibula |
| M86.269 | Subacute osteomyelitis, unspecified tibia and fibula |
| M86.27 | Subacute osteomyelitis, ankle and foot |
| M86.271 | Subacute osteomyelitis, right ankle and foot |
| M86.272 | Subacute osteomyelitis, left ankle and foot |
| M86.279 | Subacute osteomyelitis, unspecified ankle and foot |
| M86.28 | Subacute osteomyelitis, other site |
| M86.29 | Subacute osteomyelitis, multiple sites |
| M86.3 | Chronic multifocal osteomyelitis |
| M86.30 | Chronic multifocal osteomyelitis, unspecified site |
| M86.31 | Chronic multifocal osteomyelitis, shoulder |
| M86.311 | Chronic multifocal osteomyelitis, right shoulder |
| M86.312 | Chronic multifocal osteomyelitis, left shoulder |
| M86.319 | Chronic multifocal osteomyelitis, unspecified shoulder |
| M86.32 | Chronic multifocal osteomyelitis, humerus |
| M86.321 | Chronic multifocal osteomyelitis, right humerus |
| M86.322 | Chronic multifocal osteomyelitis, left humerus |
| M86.329 | Chronic multifocal osteomyelitis, unspecified humerus |
| M86.33 | Chronic multifocal osteomyelitis, radius and ulna |
| M86.331 | Chronic multifocal osteomyelitis, right radius and ulna |
| M86.332 | Chronic multifocal osteomyelitis, left radius and ulna |
| M86.339 | Chronic multifocal osteomyelitis, unspecified radius and ulna |
| M86.34 | Chronic multifocal osteomyelitis, hand |
| M86.341 | Chronic multifocal osteomyelitis, right hand |
| M86.342 | Chronic multifocal osteomyelitis, left hand |
| M86.349 | Chronic multifocal osteomyelitis, unspecified hand |
| M86.35 | Chronic multifocal osteomyelitis, femur |
| M86.351 | Chronic multifocal osteomyelitis, right femur |
| M86.352 | Chronic multifocal osteomyelitis, left femur |
| M86.359 | Chronic multifocal osteomyelitis, unspecified femur |
| M86.36 | Chronic multifocal osteomyelitis, tibia and fibula |
| M86.361 | Chronic multifocal osteomyelitis, right tibia and fibula |
| M86.362 | Chronic multifocal osteomyelitis, left tibia and fibula |
| M86.369 | Chronic multifocal osteomyelitis, unspecified tibia and fibula |
| M86.37 | Chronic multifocal osteomyelitis, ankle and foot |
| M86.371 | Chronic multifocal osteomyelitis, right ankle and foot |
| M86.372 | Chronic multifocal osteomyelitis, left ankle and foot |
| M86.379 | Chronic multifocal osteomyelitis, unspecified ankle and foot |
| M86.38 | Chronic multifocal osteomyelitis, other site |
| M86.39 | Chronic multifocal osteomyelitis, multiple sites |
| M86.4 | Chronic osteomyelitis with draining sinus |
| M86.40 | Chronic osteomyelitis with draining sinus, unspecified site |
| M86.41 | Chronic osteomyelitis with draining sinus, shoulder |
| M86.411 | Chronic osteomyelitis with draining sinus, right shoulder |
| M86.412 | Chronic osteomyelitis with draining sinus, left shoulder |
| M86.419 | Chronic osteomyelitis with draining sinus, unspecified shoulder |
| M86.42 | Chronic osteomyelitis with draining sinus, humerus |
| M86.421 | Chronic osteomyelitis with draining sinus, right humerus |
| M86.422 | Chronic osteomyelitis with draining sinus, left humerus |
| M86.429 | Chronic osteomyelitis with draining sinus, unspecified humerus |
| M86.43 | Chronic osteomyelitis with draining sinus, radius and ulna |
| M86.431 | Chronic osteomyelitis with draining sinus, right radius and ulna |
| M86.432 | Chronic osteomyelitis with draining sinus, left radius and ulna |
| M86.439 | Chronic osteomyelitis with draining sinus, unspecified radius and ulna |
| M86.44 | Chronic osteomyelitis with draining sinus, hand |
| M86.441 | Chronic osteomyelitis with draining sinus, right hand |
| M86.442 | Chronic osteomyelitis with draining sinus, left hand |
| M86.449 | Chronic osteomyelitis with draining sinus, unspecified hand |
| M86.45 | Chronic osteomyelitis with draining sinus, femur |
| M86.451 | Chronic osteomyelitis with draining sinus, right femur |
| M86.452 | Chronic osteomyelitis with draining sinus, left femur |
| M86.459 | Chronic osteomyelitis with draining sinus, unspecified femur |
| M86.46 | Chronic osteomyelitis with draining sinus, tibia and fibula |
| M86.461 | Chronic osteomyelitis with draining sinus, right tibia and fibula |
| M86.462 | Chronic osteomyelitis with draining sinus, left tibia and fibula |
| M86.469 | Chronic osteomyelitis with draining sinus, unspecified tibia and fibula |
| M86.47 | Chronic osteomyelitis with draining sinus, ankle and foot |
| M86.471 | Chronic osteomyelitis with draining sinus, right ankle and foot |
| M86.472 | Chronic osteomyelitis with draining sinus, left ankle and foot |
| M86.479 | Chronic osteomyelitis with draining sinus, unspecified ankle and foot |
| M86.48 | Chronic osteomyelitis with draining sinus, other site |
| M86.49 | Chronic osteomyelitis with draining sinus, multiple sites |
| M86.5 | Other chronic hematogenous osteomyelitis |
| M86.50 | Other chronic hematogenous osteomyelitis, unspecified site |
| M86.51 | Other chronic hematogenous osteomyelitis, shoulder |
| M86.511 | Other chronic hematogenous osteomyelitis, right shoulder |
| M86.512 | Other chronic hematogenous osteomyelitis, left shoulder |
| M86.519 | Other chronic hematogenous osteomyelitis, unspecified shoulder |
| M86.52 | Other chronic hematogenous osteomyelitis, humerus |
| M86.521 | Other chronic hematogenous osteomyelitis, right humerus |
| M86.522 | Other chronic hematogenous osteomyelitis, left humerus |
| M86.529 | Other chronic hematogenous osteomyelitis, unspecified humerus |
| M86.53 | Other chronic hematogenous osteomyelitis, radius and ulna |
| M86.531 | Other chronic hematogenous osteomyelitis, right radius and ulna |
| M86.532 | Other chronic hematogenous osteomyelitis, left radius and ulna |
| M86.539 | Other chronic hematogenous osteomyelitis, unspecified radius and ulna |
| M86.54 | Other chronic hematogenous osteomyelitis, hand |
| M86.541 | Other chronic hematogenous osteomyelitis, right hand |
| M86.542 | Other chronic hematogenous osteomyelitis, left hand |
| M86.549 | Other chronic hematogenous osteomyelitis, unspecified hand |
| M86.55 | Other chronic hematogenous osteomyelitis, femur |
| M86.551 | Other chronic hematogenous osteomyelitis, right femur |
| M86.552 | Other chronic hematogenous osteomyelitis, left femur |
| M86.559 | Other chronic hematogenous osteomyelitis, unspecified femur |
| M86.56 | Other chronic hematogenous osteomyelitis, tibia and fibula |
| M86.561 | Other chronic hematogenous osteomyelitis, right tibia and fibula |
| M86.562 | Other chronic hematogenous osteomyelitis, left tibia and fibula |
| M86.569 | Other chronic hematogenous osteomyelitis, unspecified tibia and fibula |
| M86.57 | Other chronic hematogenous osteomyelitis, ankle and foot |
| M86.571 | Other chronic hematogenous osteomyelitis, right ankle and foot |
| M86.572 | Other chronic hematogenous osteomyelitis, left ankle and foot |
| M86.579 | Other chronic hematogenous osteomyelitis, unspecified ankle and foot |
| M86.58 | Other chronic hematogenous osteomyelitis, other site |
| M86.59 | Other chronic hematogenous osteomyelitis, multiple sites |
| M86.6 | Other chronic osteomyelitis |
| M86.60 | Other chronic osteomyelitis, unspecified site |
| M86.61 | Other chronic osteomyelitis, shoulder |
| M86.611 | Other chronic osteomyelitis, right shoulder |
| M86.612 | Other chronic osteomyelitis, left shoulder |
| M86.619 | Other chronic osteomyelitis, unspecified shoulder |
| M86.62 | Other chronic osteomyelitis, humerus |
| M86.621 | Other chronic osteomyelitis, right humerus |
| M86.622 | Other chronic osteomyelitis, left humerus |
| M86.629 | Other chronic osteomyelitis, unspecified humerus |
| M86.63 | Other chronic osteomyelitis, radius and ulna |
| M86.631 | Other chronic osteomyelitis, right radius and ulna |
| M86.632 | Other chronic osteomyelitis, left radius and ulna |
| M86.639 | Other chronic osteomyelitis, unspecified radius and ulna |
| M86.64 | Other chronic osteomyelitis, hand |
| M86.641 | Other chronic osteomyelitis, right hand |
| M86.642 | Other chronic osteomyelitis, left hand |
| M86.649 | Other chronic osteomyelitis, unspecified hand |
| M86.65 | Other chronic osteomyelitis, thigh |
| M86.651 | Other chronic osteomyelitis, right thigh |
| M86.652 | Other chronic osteomyelitis, left thigh |
| M86.659 | Other chronic osteomyelitis, unspecified thigh |
| M86.66 | Other chronic osteomyelitis, tibia and fibula |
| M86.661 | Other chronic osteomyelitis, right tibia and fibula |
| M86.662 | Other chronic osteomyelitis, left tibia and fibula |
| M86.669 | Other chronic osteomyelitis, unspecified tibia and fibula |
| M86.67 | Other chronic osteomyelitis, ankle and foot |
| M86.671 | Other chronic osteomyelitis, right ankle and foot |
| M86.672 | Other chronic osteomyelitis, left ankle and foot |
| M86.679 | Other chronic osteomyelitis, unspecified ankle and foot |
| M86.68 | Other chronic osteomyelitis, other site |
| M86.69 | Other chronic osteomyelitis, multiple sites |
| M86.8 | Other osteomyelitis |
| M86.8x | Other osteomyelitis |
| M86.8x0 | Other osteomyelitis, multiple sites |
| M86.8x1 | Other osteomyelitis, shoulder |
| M86.8x2 | Other osteomyelitis, upper arm |
| M86.8x3 | Other osteomyelitis, forearm |
| M86.8x4 | Other osteomyelitis, hand |
| M86.8x5 | Other osteomyelitis, thigh |
| M86.8x6 | Other osteomyelitis, lower leg |
| M86.8x7 | Other osteomyelitis, ankle and foot |
| M86.8x8 | Other osteomyelitis, other site |
| M86.8x9 | Other osteomyelitis, unspecified sites |
| M86.9 | Osteomyelitis, unspecified |
| Diabetic foot infection | |
| E08.621 | Diabetes mellitus due to underlying condition with foot ulcer |
| E09.621 | Drug or chemical induced diabetes mellitus with foot ulcer |
| E10.621 | Type 1 diabetes mellitus with foot ulcer |
| E11.621 | Type 2 diabetes mellitus with foot ulcer |
| E13.621 | Other specified diabetes mellitus with foot ulcer |
| Enterobacter pneumonia | |
| J15.6 | Pneumonia due to other gram-negative bacteria |
| Escherichia coli pneumonia | |
| J15.5 | Pneumonia due to escherichia coli |
| Female genital tract infection | |
| N70 | Salpingitis and oophoritis |
| N70.0 | Acute salpingitis and oophoritis |
| N70.01 | Acute salpingitis |
| N70.02 | Acute oophoritis |
| N70.03 | Acute salpingitis and oophoritis |
| N70.1 | Chronic salpingitis and oophoritis |
| N70.11 | Chronic salpingitis |
| N70.12 | Chronic oophoritis |
| N70.13 | Chronic salpingitis and oophoritis |
| N70.9 | Salpingitis and oophoritis, unspecified |
| N70.91 | Salpingitis, unspecified |
| N70.92 | Oophoritis, unspecified |
| N70.93 | Salpingitis and oophoritis, unspecified |
| N71 | Inflammatory disease of uterus, except cervix |
| N71.0 | Acute inflammatory disease of uterus |
| N71.1 | Chronic inflammatory disease of uterus |
| N71.9 | Inflammatory disease of uterus, unspecified |
| N72 | Inflammatory disease of cervix uteri |
| N73.8 | Other specified female pelvic inflammatory diseases |
| N73.9 | Female pelvic inflammatory disease, unspecified |
| N74 | Female pelvic inflammatory disorders in diseases classified elsewhere |
| N75.0 | Cyst of bartholin's gland |
| N75.1 | Abscess of bartholin's gland |
| N76 | Other inflammation of vagina and vulva |
| N76.0 | Acute vaginitis |
| N76.1 | Subacute and chronic vaginitis |
| N76.2 | Acute vulvitis |
| N76.3 | Subacute and chronic vulvitis |
| N76.4 | Abscess of vulva |
| N76.5 | Ulceration of vagina |
| N76.6 | Ulceration of vulva |
| N76.8 | Other specified inflammation of vagina and vulva |
| N76.81 | Mucositis (ulcerative) of vagina and vulva |
| N76.89 | Other specified inflammation of vagina and vulva |
| Gram-negative aerobic bacillary pneumonia | |
| A02.22 | Salmonella pneumonia |
| J15.0 | Pneumonia due to klebsiella pneumoniae |
| J15.5 | Pneumonia due to escherichia coli |
| J15.6 | Pneumonia due to other gram-negative bacteria |
| P23.4 | Congenital pneumonia due to escherichia coli |
| Haemophilus influenzae pneumonia | |
| J14 | Pneumonia due to hemophilus influenzae |
| Infectious disease of abdomen | |
| A51.1 | Primary anal syphilis |
| K35 | Acute appendicitis |
| K35.2 | Acute appendicitis with generalized peritonitis |
| K35.20 | Acute appendicitis with generalized peritonitis, without abscess |
| K35.200 | Acute appendicitis with generalized peritonitis, without perforation or abscess |
| K35.201 | Acute appendicitis with generalized peritonitis, with perforation, without abscess |
| K35.209 | Acute appendicitis with generalized peritonitis, without abscess, unspecified as to perforation |
| K35.21 | Acute appendicitis with generalized peritonitis, with abscess |
| K35.210 | Acute appendicitis with generalized peritonitis, without perforation, with abscess |
| K35.211 | Acute appendicitis with generalized peritonitis, with perforation and abscess |
| K35.219 | Acute appendicitis with generalized peritonitis, with abscess, unspecified as to perforation |
| K35.3 | Acute appendicitis with localized peritonitis |
| K35.30 | Acute appendicitis with localized peritonitis, without perforation or gangrene |
| K35.31 | Acute appendicitis with localized peritonitis and gangrene, without perforation |
| K35.32 | Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess |
| K35.33 | Acute appendicitis with perforation, localized peritonitis, and gangrene, with abscess |
| K35.8 | Other and unspecified acute appendicitis |
| K35.80 | Unspecified acute appendicitis |
| K35.89 | Other acute appendicitis |
| K35.890 | Other acute appendicitis without perforation or gangrene |
| K35.891 | Other acute appendicitis without perforation, with gangrene |
| K65.0 | Generalized (acute) peritonitis |
| K65.2 | Spontaneous bacterial peritonitis |
| Infectious disorder of joint | |
| M00.9 | Pyogenic arthritis, unspecified |
| Inflammatory disease of female pelvic organs | |
| N70 | Salpingitis and oophoritis |
| N70.0 | Acute salpingitis and oophoritis |
| N70.01 | Acute salpingitis |
| N70.02 | Acute oophoritis |
| N70.03 | Acute salpingitis and oophoritis |
| N70.1 | Chronic salpingitis and oophoritis |
| N70.11 | Chronic salpingitis |
| N70.12 | Chronic oophoritis |
| N70.13 | Chronic salpingitis and oophoritis |
| N70.9 | Salpingitis and oophoritis, unspecified |
| N70.91 | Salpingitis, unspecified |
| N70.92 | Oophoritis, unspecified |
| N70.93 | Salpingitis and oophoritis, unspecified |
| N71 | Inflammatory disease of uterus, except cervix |
| N71.0 | Acute inflammatory disease of uterus |
| N71.1 | Chronic inflammatory disease of uterus |
| N71.9 | Inflammatory disease of uterus, unspecified |
| N72 | Inflammatory disease of cervix uteri |
| N73 | Other female pelvic inflammatory diseases |
| N73.0 | Acute parametritis and pelvic cellulitis |
| N73.1 | Chronic parametritis and pelvic cellulitis |
| N73.2 | Unspecified parametritis and pelvic cellulitis |
| N73.3 | Female acute pelvic peritonitis |
| N73.4 | Female chronic pelvic peritonitis |
| N73.5 | Female pelvic peritonitis, unspecified |
| N73.8 | Other specified female pelvic inflammatory diseases |
| N73.9 | Female pelvic inflammatory disease, unspecified |
| Intra-abdominal abscess | |
| D73.3 | Abscess of spleen |
| K35.21 | Acute appendicitis with generalized peritonitis, with abscess |
| K35.210 | Acute appendicitis with generalized peritonitis, without perforation, with abscess |
| K35.211 | Acute appendicitis with generalized peritonitis, with perforation and abscess |
| K35.219 | Acute appendicitis with generalized peritonitis, with abscess, unspecified as to perforation |
| K35.33 | Acute appendicitis with perforation, localized peritonitis, and gangrene, with abscess |
| K50.014 | Crohn's disease of small intestine with abscess |
| K50.114 | Crohn's disease of large intestine with abscess |
| K50.814 | Crohn's disease of both small and large intestine with abscess |
| K50.914 | Crohn's disease, unspecified, with abscess |
| K51.014 | Ulcerative (chronic) pancolitis with abscess |
| K51.214 | Ulcerative (chronic) proctitis with abscess |
| K51.314 | Ulcerative (chronic) rectosigmoiditis with abscess |
| K51.414 | Inflammatory polyps of colon with abscess |
| K51.514 | Left sided colitis with abscess |
| K51.814 | Other ulcerative colitis with abscess |
| K51.914 | Ulcerative colitis, unspecified with abscess |
| K57.0 | Diverticulitis of small intestine with perforation and abscess |
| K57.00 | Diverticulitis of small intestine with perforation and abscess without bleeding |
| K57.01 | Diverticulitis of small intestine with perforation and abscess with bleeding |
| K57.2 | Diverticulitis of large intestine with perforation and abscess |
| K57.20 | Diverticulitis of large intestine with perforation and abscess without bleeding |
| K57.21 | Diverticulitis of large intestine with perforation and abscess with bleeding |
| K57.4 | Diverticulitis of both small and large intestine with perforation and abscess |
| K57.40 | Diverticulitis of both small and large intestine with perforation and abscess without bleeding |
| K57.41 | Diverticulitis of both small and large intestine with perforation and abscess with bleeding |
| K57.8 | Diverticulitis of intestine, part unspecified, with perforation and abscess |
| K57.80 | Diverticulitis of intestine, part unspecified, with perforation and abscess without bleeding |
| K57.81 | Diverticulitis of intestine, part unspecified, with perforation and abscess with bleeding |
| K63.0 | Abscess of intestine |
| K65.1 | Peritoneal abscess |
| K68.1 | Retroperitoneal abscess |
| K68.11 | Postprocedural retroperitoneal abscess |
| K68.12 | Psoas muscle abscess |
| K68.19 | Other retroperitoneal abscess |
| K75.0 | Abscess of liver |
| N15.1 | Renal and perinephric abscess |
| N34.0 | Urethral abscess |
| N41.2 | Abscess of prostate |
| Klebsiella pneumonia | |
| J15.0 | Pneumonia due to klebsiella pneumoniae |
| Lower respiratory infection | |
| J15.9 | Unspecified bacterial pneumonia |
| J18.9 | Pneumonia, unspecified organism |
| J22 | Unspecified acute lower respiratory infection |
| Peritonitis | |
| K65 | Peritonitis |
| K65.0 | Generalized (acute) peritonitis |
| K65.2 | Spontaneous bacterial peritonitis |
| K65.9 | Peritonitis, unspecified |
| Skin and skin structure infection | |
| H05.01 | Cellulitis of orbit |
| H05.011 | Cellulitis of right orbit |
| H05.012 | Cellulitis of left orbit |
| H05.013 | Cellulitis of bilateral orbits |
| H05.019 | Cellulitis of unspecified orbit |
| H60.1 | Cellulitis of external ear |
| H60.10 | Cellulitis of external ear, unspecified ear |
| H60.11 | Cellulitis of right external ear |
| H60.12 | Cellulitis of left external ear |
| H60.13 | Cellulitis of external ear, bilateral |
| K12.2 | Cellulitis and abscess of mouth |
| L03 | Cellulitis and acute lymphangitis |
| L03.0 | Cellulitis and acute lymphangitis of finger and toe |
| L03.01 | Cellulitis of finger |
| L03.011 | Cellulitis of right finger |
| L03.012 | Cellulitis of left finger |
| L03.019 | Cellulitis of unspecified finger |
| L03.03 | Cellulitis of toe |
| L03.031 | Cellulitis of right toe |
| L03.032 | Cellulitis of left toe |
| L03.039 | Cellulitis of unspecified toe |
| L03.1 | Cellulitis and acute lymphangitis of other parts of limb |
| L03.11 | Cellulitis of other parts of limb |
| L03.111 | Cellulitis of right axilla |
| L03.112 | Cellulitis of left axilla |
| L03.113 | Cellulitis of right upper limb |
| L03.114 | Cellulitis of left upper limb |
| L03.115 | Cellulitis of right lower limb |
| L03.116 | Cellulitis of left lower limb |
| L03.119 | Cellulitis of unspecified part of limb |
| L03.2 | Cellulitis and acute lymphangitis of face and neck |
| L03.21 | Cellulitis and acute lymphangitis of face |
| L03.211 | Cellulitis of face |
| L03.22 | Cellulitis and acute lymphangitis of neck |
| L03.221 | Cellulitis of neck |
| L03.3 | Cellulitis and acute lymphangitis of trunk |
| L03.31 | Cellulitis of trunk |
| L03.311 | Cellulitis of abdominal wall |
| L03.312 | Cellulitis of back [any part except buttock] |
| L03.313 | Cellulitis of chest wall |
| L03.314 | Cellulitis of groin |
| L03.315 | Cellulitis of perineum |
| L03.316 | Cellulitis of umbilicus |
| L03.317 | Cellulitis of buttock |
| L03.319 | Cellulitis of trunk, unspecified |
| L03.8 | Cellulitis and acute lymphangitis of other sites |
| L03.81 | Cellulitis of other sites |
| L03.811 | Cellulitis of head [any part, except face] |
| L03.818 | Cellulitis of other sites |
| L03.9 | Cellulitis and acute lymphangitis, unspecified |
| L03.90 | Cellulitis, unspecified |
| L08.9 | Local infection of the skin and subcutaneous tissue, unspecified |
| N48.22 | Cellulitis of corpus cavernosum and penis |
Formulary Reference Tool