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What real-world harms show up with imipenem/cilastatin?

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Among 2,574 FAERS reports, imipenem/cilastatin AEs clustered in older men, often within 3 days, with strong signals for delirium, disorganised speech, and some unlabeled events such as cerebral atrophy.

Source

Real-world pharmacovigilance investigation of imipenem/cilastatin: signal detection using the FDA Adverse Event Reporting System (FAERS) database

Jia P, Zhou Y, Gao Y, et al. · Frontiers in pharmacology · 2025

doi.org/10.3389/fphar.2025.1524159Read the full paper ↗8 citationscc by

Study at a glance

Design
Other — FAERS disproportionality analysis of imipenem/cilastatin as primary suspect, 2004 Q1–2023 Q4 (ROR, PRR, BCPNN, EBGM)
N
N=2574 · 2,574 AE reports (6,605 AEs) with IMI/CIL as primary suspect
Population
Spontaneous FAERS reports worldwide in which imipenem/cilastatin was the primary suspect drug
Outcome
Adverse-event signals by MedDRA SOC/PT, including onset time and previously unlabeled events

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Pulled FAERS cases with IMI/CIL as primary suspect (2004–2023) and ran ROR, PRR, BCPNN, and EBGM disproportionality analyses classified by MedDRA.

What they found

2,574 reports / 6,605 AEs; 57.89% male; 58.94% aged >60. Most AEs within 3 days. Signals spanned 24 SOCs. Unlabeled PTs included cerebral atrophy, toxic encephalopathy, language disorder, disorganised speech, dysphoria, and delirium (n=263, ROR 72.31).

The limits

What it doesn't show

Spontaneous reports cannot measure true incidence or prove causation; missing data, stimulated reporting, and no denominator limit risk estimates.

Key terms

Imipenem/cilastatin (IMI/CIL)
Carbapenem antibiotic plus renal dehydropeptidase inhibitor.
FAERS
FDA Adverse Event Reporting System of spontaneous safety reports.
Primary suspect (PS)
Reporter-designated drug most likely responsible for the AE.
ROR
Reporting odds ratio used to detect disproportionate AE signals.
MedDRA PT/SOC
Preferred terms nested in system organ classes for coding AEs.
Disproportionality analysis
Signal detection comparing how often an AE is reported with a drug vs others.

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FAERS PS reports numbered about:

Common questions

How many PS reports?

2,574 reports (6,605 AEs) from 2004–2023.

Who was over-represented?

Men (57.89%) and people >60 years (58.94%).

When did AEs occur?

Most within 3 days of starting the drug.

New signals?

Examples include cerebral atrophy, delirium, and disorganised speech.

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