carindacillin

Action and Spectrum

Actions and spectrum: 

• Actions: carindacillin acts by inhibiting bacterial cell wall synthesis, leading to the disruption of the bacterial cell wall structure. This inhibition weakens the cell wall and eventually causes the bacteria to lyse (burst), leading to their death. The primary target of carindacillin’s action is the enzyme transpeptidase, also known as penicillin-binding protein (PBP), which is involved in the cross-linking of peptidoglycan chains in the bacterial cell wall. 
• Spectrum: carindacillin has a broader spectrum of activity compared to some other penicillin derivatives due to its resistance to certain beta-lactamase enzymes produced by bacteria. Beta-lactamases are enzymes that can break down and inactivate penicillins, limiting their effectiveness against certain bacteria. carindacillin is specifically effective against gram-negative bacteria that produce beta-lactamases, allowing it to retain its antibacterial activity against these strains. This broader spectrum includes some gram-negative organisms that are resistant to other penicillin antibiotics. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Nausea 

vomiting  

Diarrhea 

abdominal discomfort 

skin rashes 

Itching 

Headache 

Dizziness 

Joint pain 

Hives 

anaphylaxis 

Stevens johnson syndrome 

Fever 

Muscle pain 

Swelling 

Hepatotoxicity 

eosinophila 

pseudomembranous colitis 

Leukopenia 

thrombocytopenia 

Black Box Warning

Black Box Warning: 

There were no specific black box warnings associated with carindacillin. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity to Penicillins: Individuals who have a known hypersensitivity or allergic reaction to penicillins, including carindacillin, should avoid its use. Allergic reactions to penicillins can range from mild skin rashes to severe anaphylactic reactions. 
• Hypersensitivity to Beta-Lactam Antibiotics: Some people may have cross-reactivity between different beta-lactam antibiotics (such as penicillins and cephalosporins).  
• History of Severe Allergic Reactions: Individuals with a history of severe or life-threatening allergic reactions (anaphylaxis) to any medication should exercise caution and consult a healthcare provider before using carindacillin. 
• Colitis: carindacillin, like other antibiotics, can disrupt the normal balance of gut bacteria and potentially lead to a condition called antibiotic-associated colitis or pseudomembranous colitis. Individuals with a history of colitis should use carindacillin with caution and under the guidance of a healthcare provider. 
• Renal Impairment: carindacillin is primarily excreted through the kidneys. Individuals with significant renal impairment or kidney disease may require dose adjustments or alternative treatments. 
• Gastrointestinal Disorders: Individuals with a history of gastrointestinal disorders, particularly those related to antibiotic use, should use carindacillin with caution and under medical supervision. 

Caution: 

• Cross-Reactivity: Some individuals may have cross-reactivity between different beta-lactam antibiotics, such as penicillins and cephalosporins. Caution is advised in individuals with a history of severe allergic reactions to beta-lactam antibiotics. 
• Renal Impairment: carindacillin is primarily eliminated through the kidneys. Individuals with impaired renal function or kidney disease may require dose adjustments or close monitoring while using this medication. 
• Liver Dysfunction: Individuals with severe liver impairment may need dose adjustments or alternative treatments when using carindacillin. 
• Gastrointestinal Distress: Antibiotics, including carindacillin, can sometimes cause gastrointestinal disturbances like diarrhea, nausea, vomiting, and abdominal pain.  
• Superinfection: Prolonged or improper use of antibiotics can lead to the development of bacterial or fungal overgrowth, known as superinfection. If new infections or changes in existing symptoms occur during treatment, it is important to consult a healthcare provider. 
• Seizure Disorders: Some antibiotics, including penicillins, have been associated with a potential risk of seizures in individuals with a history of seizure disorders. Caution should be exercised in such cases. 
• Drug Interactions: carindacillin can interact with other medications, potentially affecting their efficacy or increasing the risk of side effects. 

Comorbidities: 

• Allergies or Hypersensitivity Reactions: Individuals with a history of allergies, especially to penicillins or other beta-lactam antibiotics, may be at higher risk of allergic reactions when using carindacillin. Cross-reactivity with other beta-lactam antibiotics (such as cephalosporins) may also be a concern. 
• Gastrointestinal Disorders: Individuals with gastrointestinal conditions, such as inflammatory bowel disease, may experience gastrointestinal disturbances while using carindacillin. 
• Superinfection Risk: Long-term or inappropriate use of antibiotics like carindacillin can lead to the development of superinfections caused by antibiotic-resistant bacteria or fungi. 
• Seizure Disorders: Certain antibiotics, including some penicillins, may have an increased risk of seizures. 
• Immunocompromised Conditions: Individuals with compromised immune systems may be more susceptible to infections and less responsive to treatment. Close monitoring and potential adjustments in treatment may be necessary. 
• Pregnancy and Lactation: The safety of carindacillin during pregnancy and lactation may need to be carefully evaluated, and its use should be discussed with a healthcare provider. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category: B 

Lactation: excreted into human milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• 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:

carindacillin is an antibiotic medication that belongs to the class of drugs known as penicillins. It is a derivative of ampicillin and is used to treat bacterial infections. carindacillin exerts its antibacterial effects by inhibiting the bacterial cell wall synthesis. It does so by interfering with the enzymes involved in the cross-linking of peptidoglycan chains, a crucial component of the bacterial cell wall. By disrupting cell wall formation, carindacillin weakens the structural integrity of bacterial cells, leading to cell lysis and death.  

Pharmacodynamics: 

• Time-Dependent Bactericidal Activity: carindacillin’s bactericidal activity is considered time-dependent. This means that the drug’s effectiveness is related to the amount of time its concentration remains above the minimum inhibitory concentration (MIC) required to inhibit bacterial growth. Maintaining a consistent and sufficient concentration of carindacillin in the bloodstream over time is crucial for optimal bactericidal effects. 
• Post-Antibiotic Effect: carindacillin is associated with a post-antibiotic effect, which means that its bactericidal activity continues even after the drug concentration drops below the MIC. This effect contributes to the drug’s ability to suppress bacterial growth for a period even after the drug has been eliminated from the body. 
• Spectrum of Activity: carindacillin has a broader spectrum of activity compared to some other penicillins due to its resistance to certain beta-lactamase enzymes produced by bacteria. This broader spectrum includes some gram-negative bacteria that are normally resistant to other penicillins. 
• Synergy with Aminoglycosides: In some cases, carindacillin’s antibacterial activity can be increased when used in combination with aminoglycoside antibiotics. This combination therapy can lead to a synergistic effect, resulting in improved bacterial killing. 
• Bacterial Resistance: Like all antibiotics, bacterial resistance to carindacillin can develop over time. Bacteria can develop various mechanisms to counteract the drug’s effects, such as producing beta-lactamase enzymes that degrade the antibiotic. Monitoring bacterial susceptibility and adjusting treatment strategies accordingly are essential to combat resistance.

Pharmacokinetics: 

Absorption 

carindacillin is typically administered orally. It is well-absorbed from the gastrointestinal tract after oral ingestion. The absorption rate and extent may be influenced by factors such as the presence of food in the stomach and the formulation of the medication. 

Distribution 

carindacillin is distributed throughout the body’s tissues and fluids, including blood, interstitial fluid, and extracellular spaces. The drug can cross the blood-brain barrier, allowing it to reach the central nervous system. It is important to note that the distribution of carindacillin within different body compartments can influence its effectiveness against various infections. 

Metabolism 

carindacillin undergoes minimal metabolism in the body. It is primarily eliminated through renal excretion in its unchanged form. Since the drug is excreted by the kidneys, dose adjustments may be necessary in individuals with impaired renal function to prevent drug accumulation. 

Elimination and excretion 

The primary route of excretion for carindacillin is through the kidneys. The unchanged drug is eliminated in the urine. 

Adminstartion

Administration: 

• Dosage: The dosage of carindacillin will be determined by your healthcare provider based on the specific infection being treated, your medical condition, age, weight, and other factors. It’s important to take the prescribed dosage as directed and not to alter the dose without consulting your healthcare provider. 
• Timing: carindacillin is usually taken on an empty stomach, before 1 hour or 2 hours after meals. However, the specific instructions may vary depending on the formulation of the medication. Follow your healthcare provider’s guidance regarding the timing of doses. 
• Tablets or Capsules: If carindacillin is available in tablet or capsule form, swallow the medication whole with a full glass of water.  
• Suspension: If carindacillin is available in suspension (liquid) form, use the provided measuring device to accurately measure the prescribed dose. Shake the suspension well before each use. 
• Complete the Course: It is important to complete the full course of carindacillin treatment, even if you start feeling better before the medication is finished. Stopping the medication prematurely could allow the infection to recur or lead to the development of antibiotic-resistant bacteria. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: carindacillin 

Pronounced: (ka-rin-duh-SIL-in)  

Why do we use carindacillin? 

• Respiratory Infections: carindacillin may be prescribed to treat respiratory tract infections like bronchitis, pneumonia, and sinusitis, caused by susceptible bacteria. 
• Urinary Tract Infections (UTIs): It is used in the treatment of UTIs caused by bacteria that are susceptible to the antibiotic. 
• Skin and Soft Tissue Infections: carindacillin may be effective in treating soft tissue and skin infections like cellulitis or wound infections. 
• Intra-Abdominal Infections: Some types of intra-abdominal infections, such as peritonitis, may be treated with carindacillin, especially if the causative bacteria are susceptible. 
• Bone and Joint Infections: carindacillin might be used as part of the treatment regimen for certain bone & joint infections caused by susceptible bacteria. 
• Bacterial Septicemia: carindacillin may be used in the treatment of bacterial septicemia, a serious bloodstream infection. 
• Gynecological Infections: In some cases, carindacillin could be used to treat gynecological infections caused by susceptible bacteria.