Ticarcillin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Susceptible infections 200-300 mg/kg/day in divided doses 4 or 6 hrly. Complicated UTI 150-200 mg/kg/day in divided doses 4 or 6 hrly. IV/IM Uncomplicated UTI 1 g 6 hrly.
Dosage Details
Intravenous
Severe Gram-negative infections, Skin infections, Septicaemia, Peritonitis, Bone and joint infections
Adult: 200-300 mg/kg daily by infusion in divided doses every 4 or 6 hr.
Child: 200-300 mg/kg by infusion in divided doses every 4 or 6 hr.

Parenteral
Complicated urinary tract infections
Adult: 150-200 mg/kg daily by IV infusion in divided doses every 4 or 6 hr.
Child: 150-200 mg/kg daily by IV infusion in divided doses every 4 or 6 hr.

Parenteral
Uncomplicated urinary tract infections
Adult: 1 g IM/slow IV Inj every 6 hr.
Child: 50-100 mg/kg in divided doses every 6-8 hr. Do not inject >2 g into each IM site.
Renal Impairment
Intravenous:
Peritoneal dialysis patients: 3 g every 12 hr; haemodialysis patients: 2 g every 12 hr plus an additional dose of 3 g after each dialysis session.
CrClDosage
<10Initial IV loading dose of 3 g, followed by 2 g every 12 hr (or 1 g IM every 6 hr).
<10> with hepatic impairmentInitial IV loading dose of 3 g, followed by 2 g IV every 24 hr or 1 g IM every 12 hr.
10-30Initial IV loading dose of 3 g, followed by 2 g every 8 hr.
30-60Initial IV loading dose of 3 g, followed by 2 g every 4 hr.
Parenteral:
Complicated urinary tract infections: Peritoneal dialysis patients: 3 g every 12 hr; haemodialysis patients: 2 g every 12 hr plus an additional dose of 3 g after each dialysis session.
CrClDosage
<10Initial IV loading dose of 3 g, followed by 2 g every 12 hr (or 1 g IM every 6 hr).
<10 with hepatic impairmentInitial IV loading dose of 3 g, followed by 2 g IV every 24 hr or 1 g IM every 12 hr.
10-30Initial IV loading dose of 3 g, followed by 2 g every 8 hr.
30-60Initial IV loading dose of 3 g, followed by 2 g every 4 hr.
Incompatibility
Incompatible with aminoglycosides.
Contraindications
Hypersensitivity to penicillins.
Special Precautions
Restricted sodium diet. Very high doses in poor renal function (risk of neurotoxicity) or heart failure. Avoid contact, skin sensitisation may occur. Monitor electrolyte concentrations, renal, hepatic and haematological status during prolonged and high dose therapy. Jarisch-Herxheimer reaction may be seen in spirochete infections particularly syphilis; avoid intrathecal route.
Adverse Reactions
Pain at the inj site and phlebitis; electrolyte disturbances (hypokalaemia or hypernatraemia); dose-dependent coagulation defect; purpura and haemorrhage; hypersensitivity reactions; haemolytic anaemia; interstitial nephritis; neutropenia; CNS toxicity including convulsions; diarrhoea; pseudomembranous colitis. Haemorrhagic cystitis especially in cystic fibrosis patients.
Potentially Fatal: Anaphylaxis.
IM/IV/Parenteral: B
Drug Interactions
Probenecid decreases clearance of ticarcillin. Increased bleeding risk with warfarin, acenocoumarol. Possible increase in ciclosporin, methotrexate levels with concurrent use. Possible contraceptive failure with combined oral contraceptives.
Lab Interference
May interfere with diagnostic tests for urinary glucose using copper sulfate, direct Coombs' test, and test for urinary or serum proteins. May interfere with diagnostic tests that use bacteria.
Action
Description: Ticarcillin is bactericidal through inhibition of the final cross-linking stage of peptidoglycan production by binding and inactivating transpeptidases thus inhibiting bacterial cell wall synthesis. It is active against gram-positive bacteria, gram-negative cocci, Pseudomonas aeruginosa, spirochetes, actinomycetes and has an extended spectrum of gram-negative bacteria compared to benzylpenicillin.
Pharmacokinetics:
Absorption: Not absorbed from GI tract. Peak plasma concentrations: 0.5-1 hr (IM).
Distribution: Widely distibuted. Protein-binding: 50%. Plasma half-life: 70 min; 50 min (patients with cystic fibrosis).
Metabolism: Limited metabolism.
Excretion: 90% excreted unchanged in urine.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Ticarcillin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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