Drug Index

Ticarcillin/Clavulanate

 
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Mechanism :

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs), which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis.


Indication :

• Infections caused by beta-lactamase-producing isolates of S. aureus, Haemophilus influenzae, Klebsiella species, E. coli, Pseudomonas aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens.


Contraindications :

Hypersensitivity (history of a serious reaction [e.g., anaphylaxis, Stevens-Johnson syndrome]) to ticarcillin, clavulanate, or to other beta-lactams (e.g., penicillins, cephalosporins).


Dosing :

Infants ≥3 months, Children, and Adolescents: IV

<60 kg: 200 mg ticarcillin/kg/day in divided doses every 6 hours. Maximum: 12 g daily.

≥60 kg: 3 g every 6 hours.

In severe infections, give every 4 hours. Maximum: 18 g daily.

Cystic fibrosis (off-label use): IV: 400 mg ticarcillin/kg/day in divided doses every 6 hours.


Adverse Effect :

Rash, nausea, diarrhea, phlebitis at injection site, increased eosinophils, increased AST, increased ALT.


Interaction :

Aminoglycosides: Penicillins may decrease the serum concentration of Aminoglycosides.
Tetracyclines: May diminish the therapeutic effect of Penicillins.
Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
>303.2 g every 8 hours
10-301.6 g every 8 hours
<101.6 g every 12 hours

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HDDialysed. Dose as in GFR<10 mL/min
HDF/High fluxDialysed. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in GFR=10–30 mL/min or 2.4 g every 6–8 hours1
CVVHD/HDFDialysed. 3.2 g every 6 hours

Hepatic Dose :

There are no pediatric specific recommendations; based on experience in adult patients, dosing adjustment suggested with concomitant renal dysfunction.
08/03/2020 16:53:01 Ticarcillin/Clavulanate
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