Ticarcillin/Clavulanate
Brand Discontinued in U.S
General
- Type: Anti-Pseudomonal Penicillin
- Dosage Forms:
- Common Trade Names: Timentin
Adult Dosing
Ticarcillin/clavulanate: each 3.1g dose contains 3g ticarcillin and 0.1g clavulanate (dosages written by ticarcillin component)
General
- <60 kg
- 200-300mg ticarcillin/kg/day IV divided q4-6 hours
- First Dose:
- Max: 18 g/day
- ≥60 kg
- 3.1 g every 4-6 hours
- First Dose:
- Max: 18 g/day
Pediatric Dosing
Ticarcillin/clavulanate: each 3.1g dose contains 3g ticarcillin and 0.1g clavulanate (dosages written by ticarcillin component)
General (≥3 Months)
- <60 kg
- 200-300mg ticarcillin/kg/day IV divided q4-6 hours
- First Dose: 50mg tiacarcillin/kg IV x 1
- Max: 18g/day
- ≥60 kg
- 3.1 g q4-6 hours
- Max: 18g/day
Special Populations
- Pregnancy: B
- Lactation: Use caution
- Renal Dosing
Considerations for hemodialysis/peritoneal dialysis and CRRT patients NOT included below
- Adult
Loading dose: IV: 3.1 g one dose, followed by maintenance dose based on creatinine clearance:
CrCl 30-60 mL/minute: 2 g of ticarcillin component every 4 hours
CrCl 10-30 mL/minute: 2 g of ticarcillin component every 8 hours
CrCl <10 mL/minute: 2 g of ticarcillin component every 12 hours
CrCl <10 mL/minute with concomitant hepatic dysfunction: 2 g of ticarcillin component every 24 hours
- Pediatric
No dosing adjustments in manufacturer's label, clinical recommendations include:
GFR >30 mL/minute/1.73 m2: No adjustment required.
GFR 10-29 mL/minute/1.73 m2: 50 to 75 mg ticarcillin/kg every 8 hours
GFR <10 mL/minute/1.73 m2 (without concomitant hepatic failure): 50 to 75 mg ticarcillin/kg every 12 hours
GFR <10 mL/minute/1.73 m2 (with concomitant hepatic failure): 50 to 75 mg ticarcillin/kg every 24 hours
- Hepatic Dosing
- Adult
With concomitant renal dysfunction (Clcr <10 mL/minute): 2 g of ticarcillin component every 24 hours.
- Pediatric
No specific pediatric recommendations, adjust if concomitant renal dysfunction
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life: Ticarcillin: 1.1 hours; Clavulanic acid: 1.1 hours
- Metabolism:
- Excretion:
- Mechanism of Action:
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- Sanford Guide to Antimicrobial Therapy 2014
Dowell JA, Korth-Bradley J, Milisci M, et al, "Evaluating Possible Pharmacokinetic Interactions Between Tobramycin, Piperacillin, and a Combination of Piperacillin and Tazobactam in Patients With Various Degrees of Renal Impairment," J Clin Pharmacol, 2001, 41:979-86 PMID: 11549103