Imipenem must be prescribed with which of the following to prevent kidney toxicity?

Imipenem is a broad-spectrum beta-lactam antibiotic effective against a wide range of bacteria, but it is also susceptible to enzymatic degradation by dehydropeptidase I, an enzyme located in the renal brush border. This degradation can lead to the production of nephrotoxic metabolites, which may cause kidney toxicity. To counteract this potential effect and to enhance the efficacy of imipenem, cilastatin is co-administered.

Cilastatin serves as a dehydropeptidase I inhibitor, preventing the breakdown of imipenem in the renal tubules, thereby allowing for increased levels of the antibiotic in the body without the associated risk of nephrotoxicity. The use of cilastatin not only maximizes imipenem's therapeutic effect but also mitigates the risk of adverse renal effects, making this combination essential in clinical practice.

While the other choices are also carbapenems, they do not have the same role as cilastatin in relation to imipenem's pharmacokinetics and safety profile. Thus, cilastatin is specifically indicated to protect the kidneys from toxicity associated with imipenem treatment.