Ticarcillin and Clavulanate Potassium

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Czech Republic: Timentin; France: Claventin; Greece: Timentin; Poland: Timentin; Romania: Timentin; UK: Timentin.

North America

Canada: Timentin; USA: Timentin.

Latin America

Brazil: Timentin; Mexico: Timentin.

Drug combinations

Chemistry

Ticarcillin Monosodium: C~15~H~15~N~2~NaO~6~S~2~ H~2~O. Mw: 424.42. (1) 4-Thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid, 6-[(carboxy-3-thienylacetyl)amino]-3,3-dimethyl-7-oxo, monosodium salt, [2S-[2α,5α,6β(S*)]]-, monohydrate; (2)(R)-N-[(2S,5R,6R)-2-Carboxy-3,4-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]hept-6-yl]-3-thiophenemalonamic acid monosodium salt. CAS-74682-62-5 [anhydrous].

Clavulanate Potassium: C~8~H~8~KNO~5~. Mw: 237.25. (1) 4-Oxa-1-azabicyclo[3.2.0]heptane-2-carboxylic acid, 3-(2-hydroxyethylidene)-7-oxo-, monopotassium salt, [2R-(2α,3Z,5α)]-; (2) Potassium (Z)-(2R,5R)-3-(2-hydroxyethylidene)-7-oxo-4-oxa-1-azabicyclo[3.2.0]heptane-2-carboxylate. CAS-61177-45-5 (1986).

Pharmacologic Category

Extended-spectrum Penicillins.

Mechanism of action

Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins. This in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Therapeutic use

Treatment of lower respiratory tract, urinary tract, skin and skin structures, bone and joint, gynecologic (endometritis) and intra-abdominal (peritonitis) infections, and septicemia caused by susceptible organisms. Clavulanate expands activity of ticarcillin to include β-lactamase-producing strains of S. aureus, H. influenzae, Bacteroides species, and some other Gram-negative bacilli.

Pregnancy and lactiation implications

Ticarcillin and clavulanate cross placenta. Human experience with penicillins during pregnancy has shown no evidence of adverse effects to fetus. Ticarcillin/clavulanate is approved for treatment of postpartum gynecologic infections, including endometritis, caused by susceptible organisms. Enters breast milk (use caution in lactation).

Unlabeled use

Contraindications

Hypersensitivity to ticarcillin, clavulanate, any penicillin, or any component of the formulation.

Warnings and precautions

Serious and occasionally severe or fatal hypersensitivity (anaphylactoid) reactions reported in patients on penicillin therapy, especially with history of β-lactam hypersensitivity, history of sensitivity to multiple allergens, or previous IgE-mediated reactions (e.g. anaphylaxis, angioedema, urticaria). Use with caution in asthmatic patients. Bleeding disorders observed (particularly in renal impairment). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in heart failure (due to high sodium load), in renal impairment, and in history of seizure disorder (high levels, particularly in presence of renal impairment, may increase risk of seizures).

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