carbenicillin

Action and Spectrum

Actions and spectrum: 

carbenicillin is an extended spectrum pencillin. It acts by interfering with last step of bacterial cell wall synthesis by carrying acylation reaction of C-terminal domain of the pencillin sensitive- transpeptidase enzyme. Being a member of beta-lactum antibiotics, it inhibits bacterial growth by interacting with pencillin-binding proteins thereby inhibiting the synthesis of peptidoglycan wall.  

It is an extended spectrum antibiotic that is known to act effectively against both gram positive and gram-ve bacteria. It is known for high efficacy as antipseudomonal and antiproteal drug. Due to its higher levels in urine, carbenicillin is used in the treatment of upper and lower tract urinary infections against vulnerable strains of Proteus vulgaris, Escherichia coli, Proteus mirabilis, Pseudomonas species and Enterobacter species etc. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Headaches 

Hypersensitivity reactions such as fever, rashes, allergic reactions may occur. 

Irritation of vagina followed by vaginal discharge may occur 

Nausea, vomiting, pain in the stomach, diarrhea, flatulence, and bad taste are a few common side effects of carbenicillin. 

Black Box Warning

Black Box Warning: 

Not Specified

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

Carbenicillin is a penicillin-class antibiotic, and individuals who have a known intolerance or allergy to penicillins or beta-lactam antibiotics should not take it. An allergic reaction might be severe and even fatal.  

Patients having a history of severe gastrointestinal difficulties, particularly antibiotic-associated colitis or pseudomembranous colitis, should avoid carbenicillin, as it may aggravate these disorders.  

As carbenicillin is mostly eliminated through the kidneys and can build in patients with impaired renal function, people with severe liver or kidney impairment may require dose changes or other antibiotics.  

Caution:  

Carbenicillin can influence blood clotting factors, so individuals with a history of blood problems or taking blood clotting drugs should use carbenicillin with caution and under constant medical supervision.  

Previous seizures: Because carbenicillin has been linked to reducing seizure thresholds, patients with a history of seizures or epilepsy should be thoroughly monitored if carbenicillin is administered.  

methotrexate concomitant use: Combining methotrexate and carbenicillin may raise the risk of methotrexate toxicity. In such circumstances, dose modifications and monitoring may be required. 

Pregnancy / Lactation

Pregnancy consideration:  

US FDA pregnancy category: B 

Lactation:  

Limited studies suggest that carbenicillin is produced in low levels in milk and hence safe to be administered  

Pregnancy category: 

Category A: Studies that were well-controlled and met expectations revealed no risk to the foetus `in either the first or second trimester. 

Category B: There were a lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

Free carbenicillin is the pharmacologically active part of the salt. carbenicillin applies its antibacterial action by obstruction with cell wall union of susceptible microscopic organisms.   

Pharmacodynamics: 

carbenicillin is an antibiotic drug belongs to the subclass semisynthetic penicillins. However, carbenicillin gives significant in vitro action against different both gram (+ve and -ve) microorganisms, the main part of its profile is in its antiproteal and antipseudomonal action. Because of the increased concentrations in urine, carbenicillin has exhibited clinical viability in urinary diseases because of vulnerable kinds of: Escherichia coli, Proteus vulgaris, Proteus mirabilis, Pseudomonas species, Morganella morganii, Enterobacter species, Providencia rettgeri, and Enterococci (S. faecalis).  

Pharmacokinetics:  

Absorption 

It is rapidly absorbed in the small intestine in oral administration. 30-40% of oral bioavailability can be observed.  

Distribution 

Study data not specified 

Metabolism 

Minimal rate of metabolism is attained 

Elimination and excretion 

It is orally inactive and excreted rapidly in urine. 

Half life:  

1 hour 

Adminstartion

Administration: 

It can be administered orally as tablets. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: carbenicillin  

Why do we use carbenicillin? 

carbenicillin is a semisynthetic antibiotic used in the treatment of bacterial infections and UTI’s. Tell the doctor if you are allergic to penicllins, cephalosporins such as cefclor, ceftin etc.