# Exploring the Effectiveness of Imipenem/Relebactam in Patients with Antimicrobial-Resistant Hospital-Acquired Infections: Findings from Systematic Literature Reviews

**Authors:** Ryan K. Shields, Ignacio Martin-Loeches, Emre Yücel, Shalini Bagga, Vaneet Pal Kaur Khurana, Prashant Soni, Prateek Das, Carolyn Cameron

PMC · DOI: 10.3390/antibiotics15020170 · Antibiotics · 2026-02-05

## TL;DR

This study evaluates how well imipenem/relebactam treats antibiotic-resistant hospital infections, showing it works well even in high-risk patients.

## Contribution

The study provides new evidence on the efficacy of imipenem/relebactam in treating multidrug-resistant infections in vulnerable populations.

## Key findings

- Imipenem/relebactam showed reduced mortality compared to other treatments.
- It had comparable clinical and microbiological responses in treating infections.
- It performed well in patients with severe renal impairment.

## Abstract

Introduction: Infections attributed to multidrug-resistant organisms have resulted in a significant clinical burden, high mortality, and excessive costs. Identifying the most appropriate and efficacious treatments will aid in reducing these burdens. Imipenem/cilastatin + relebactam (I/R) is used against multidrug-resistant infections providing an alternative option which may support patients where traditional treatments are no longer effective. Objective: The objective was to evaluate the efficacy of I/R for complicated urinary tract infections, complicated intra-abdominal infections, hospital-acquired bacterial pneumonia, and ventilator-associated bacterial pneumonia, based on data aggregated from randomized controlled trials. Method: Two systematic literature reviews were conducted to include randomized controlled trials which aligned with the inclusion criteria reporting on the efficacy of I/R against placebo or other comparators such as piperacillin/tazobactam or colistin. The outcomes of interest were mortality, clinical response, and microbiological response. Results: The results found reduced mortality and comparable clinical and microbiological response with I/R versus its comparators. I/R displayed the largest favorable clinical and microbiological responses within high-risk populations, including those with severe renal impairment when compared with piperacillin/tazobactam. Conclusions: These findings support the efficacy of I/R for key Gram-negative infections, particularly within vulnerable patient populations. Despite the favorable outcomes reported, there is a need for further real-world evidence generation to support the efficacy of I/R to aid in standardizing treatment guidelines and reducing the clinical and economic burden associated with multidrug-resistant bacterial infections.

## Linked entities

- **Chemicals:** imipenem (PubChem CID 104838), relebactam (PubChem CID 44129647), piperacillin (PubChem CID 43672), tazobactam (PubChem CID 123630), colistin (PubChem CID 5311054)

## Full-text entities

- **Genes:** PIP (prolactin induced protein) [NCBI Gene 5304] {aka BRST-2, GCDFP-15, GCDFP15, GPIP4}, TAFAZZIN (tafazzin, phospholipid-lysophospholipid transacylase) [NCBI Gene 6901] {aka BTHS, CMD3A, EFE, EFE2, G4.5, LVNCX}, KCNIP1 (potassium voltage-gated channel interacting protein 1) [NCBI Gene 30820] {aka KCHIP1, VABP}, HABP2 (hyaluronan binding protein 2) [NCBI Gene 3026] {aka FSAP, HABP, HGFAL, NMTC5, PHBP, PHBSP}
- **Diseases:** Pyelonephritis (MESH:D011704), ARC (MESH:D006030), ventilator (MESH:D053717), acquired infections (MESH:D017714), Pneumonia (MESH:D011014), bacterial pneumonia (MESH:D018410), cancer (MESH:D009369), Intra-Abdominal Infection (MESH:D059413), CRE (MESH:D060467), critically ill (MESH:D016638), injury to (MESH:D014947), Respiratory Tract Infection (MESH:D012141), MDR (MESH:D018088), sepsis (MESH:D018805), RI (MESH:D007674), ME (MESH:D000072861), bacterial infection (MESH:D001424), Gram-negative infections (MESH:D016905), CRE infection (MESH:D007239), hospital-acquired pneumonia (MESH:D000077299), blood stream infections (MESH:D000086982), cUTI (MESH:D014552), toxicity (MESH:D064420), HAIs (MESH:D003428), P. aeruginosa (MESH:D011552), Catheter-Related Infections (MESH:D055499), deaths (MESH:D003643)
- **Chemicals:** Methicillin (MESH:D008712), meropenem (MESH:D000077731), Carbapenem (MESH:D015780), vancomycin (MESH:D014640), Relebactam (MESH:C568736), I/R (MESH:C000633884), C/T (MESH:C000594038), beta-lactam (MESH:D047090), MER/VAB (MESH:C000654127), Imipenem (MESH:D015378), piperacillin/tazobactam (MESH:D000077725), /R (MESH:D001120), vaborbactam (MESH:C000626994), -lactamases (-), Imipenem/cilastatin (MESH:D000077728), C/A (MESH:C000595613)
- **Species:** Streptococcus pneumoniae (species) [taxon 1313], Human immunodeficiency virus 1 (no rank) [taxon 11676], Enterobacterales (order) [taxon 91347], Pseudomonas aeruginosa (species) [taxon 287], Klebsiella pneumoniae (species) [taxon 573], Escherichia coli (E. coli, species) [taxon 562], Enterococcus faecium (species) [taxon 1352], Enterobacteriaceae (enterobacteria, family) [taxon 543], Acinetobacter baumannii (species) [taxon 470], Mycobacterium tuberculosis (species) [taxon 1773], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Staphylococcus aureus (species) [taxon 1280], Homo sapiens (human, species) [taxon 9606], Stenotrophomonas maltophilia (species) [taxon 40324], Human immunodeficiency virus (species) [taxon 12721]

## Full text

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## Figures

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## References

45 references — full list in the complete paper: https://tomesphere.com/paper/PMC12937441/full.md

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Source: https://tomesphere.com/paper/PMC12937441