ticarcillin/clavulanate

Action and Spectrum

Actions and spectrum: 

ticarcillin/clavulanate is a combination of ticarcillin, a broad-spectrum penicillin antibiotic, and clavulanate, a beta-lactamase inhibitor. It has a broad spectrum of activity against Gram-negative and Gram-positive bacteria, including Pseudomonas aeruginosa and Enterobacteriaceae. It is often used to treat infections of the respiratory tract, urinary tract, skin, and intra-abdominal infections.

Drug Interaction

Adverse Reaction

Frequency defined

1-10%

Nausea

Phlebitis

Increased AST

Rash

Diarrhea

Increased eosinophils

Increased ALT

Post marketing Reports

CNS: giddiness, convulsive seizures, Headache, or neuromuscular hyperirritability

Lymphatic and Hemic systems: leukopenia, eosinophilia, prolonged prothrombin time and reduction of hematocrit or hemoglobin, Thrombocytopenia, neutropenia and bleeding time

Renal: elevation of BUN or serum creatinine, decreased serum potassium, Hemorrhagic cystitis, hypernatremia, and uric acid

Hypersensitivity reactions: pruritus, arthralgia, drug fever, chest discomfort, bullous reactions, Skin rash, urticaria, myalgia, chills, anaphylactic reactions.

Gastrointestinal: stomatitis, nausea, diarrhea, pseudomembranous colitis, flatulence, vomiting, epigastric pain

liver function tests: increased ALT, AST, serum alkaline phosphatase, serum bilirubin, cholestatic jaundice

Local reactions: burning, thrombophlebitis, Pain, swelling

Black Box Warning

Black Box Warning:

ticarcillin/clavulanate does not have any black box warnings associated with it.

Contraindication / Caution

Contraindication/Caution:

Contraindication:

ticarcillin/clavulanate is contraindicated in patients with a history of severe hypersensitivity reactions to any penicillin, cephalosporin, or beta-lactamase inhibitor. It should also be avoided in patients with a history of cholestatic jaundice or hepatic dysfunction associated with ticarcillin/clavulanate use. Additionally, it is contraindicated in patients with a history of allergic reactions to other beta-lactam antibiotics or any component of the formulation.

Caution:

Hypersensitivity: Patients with a history of hypersensitivity to ticarcillin, clavulanate, or any other penicillin antibiotics should not take ticarcillin/clavulanate.

Gastrointestinal disease: Patients with a history of gastrointestinal disease, particularly colitis, should use ticarcillin/clavulanate with caution.

Hepatic impairment: ticarcillin/clavulanate should be used with caution in patients with severe hepatic impairment.

Renal impairment: The drug should be used with caution in patients with renal impairment or those who are receiving concurrent nephrotoxic drugs.

Coagulation disorders: Patients with coagulation disorders should use the drug with caution, as it may increase the risk of bleeding.

Pregnancy and breast-feeding: ticarcillin/clavulanate should be used during pregnancy or breastfeeding only if clearly needed and after consulting with a healthcare provider.

Comorbidities:

ticarcillin/clavulanate is a combination of two antibiotics and is used to treat a wide range of bacterial infections. The use of antibiotics, including ticarcillin/clavulanate, can lead to the development of antibiotic-resistant bacterial infections, which can be difficult to treat. Therefore, it should be used under caution when prescribing and using ticarcillin/clavulanate, especially in patients with a history of antibiotic use, recurrent infections, or underlying conditions that may increase the risk of resistance development, such as cystic fibrosis or immunodeficiency disorders. Additionally, caution is advised when prescribing ticarcillin/clavulanate to elderly patients or those with impaired kidney or liver function.

Pregnancy / Lactation

Pregnancy consideration:

Pregnancy category: B

Lactation: It is not known whether ticarcillin/clavulanate is excreted in human milk

Pregnancy category:

Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester.

Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women.

Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women.

Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women.

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

Pharmacology

Pharmacology:

ticarcillin/clavulanate is a combination of ticarcillin, extended-spectrum penicillin, and clavulanic acid, a β-lactamase inhibitor. The combination extends the spectrum of ticarcillin to include β-lactamase-producing strains of bacteria. ticarcillin inhibits bacterial cell wall synthesis by binding to and inhibiting penicillin-binding proteins, resulting in bacterial cell death. Clavulanic acid inhibits β-lactamase enzymes, which are produced by many bacteria and inactivate ticarcillin, thereby increasing the effectiveness of the antibiotic. ticarcillin/clavulanate has activity against a broad range of Gram-positive and Gram-negative bacteria.

Pharmacodynamics:

ticarcillin/clavulanate is a combination of extended-spectrum penicillin (ticarcillin) and a beta-lactamase inhibitor (clavulanate). The clavulanate component helps protect ticarcillin from being degraded by beta-lactamase enzymes produced by some bacteria, extending the spectrum of activity. The combination exhibits bactericidal activity against a broad range of gram-positive and gram-negative bacteria, including anaerobes. ticarcillin/clavulanate is active against many strains of bacteria resistant to other antibiotics.

Pharmacokinetics:

Absorption

ticarcillin/clavulanate is administered intravenously. Therefore, it does not undergo oral absorption.

Distribution

ticarcillin/clavulanate is distributed throughout the body tissues, including the lungs, liver, bile, bone, and genital tract. ticarcillin is highly bound to plasma proteins, while clavulanate has moderate plasma protein binding.

Metabolism

ticarcillin/clavulanate is not significantly metabolized in the body.

Elimination and excretion

ticarcillin/clavulanate is primarily eliminated by the kidneys through glomerular filtration and tubular secretion. ticarcillin has a half-life of approximately 1 hour, while clavulanate has a half-life of approximately 1.3 hours.

Adminstartion

Administration:

ticarcillin/clavulanate is available in oral tablets and as an intravenous (IV) injection. The dose and route of administration depend on the type and severity of the infection being treated, as well as the patient’s age, weight, and renal function. The tablets should be taken with food to improve absorption. The IV injection is typically given over 30-60 minutes.

Patient Information Leaflet

Patient information leaflet

Generic Name: ticarcillin/clavulanate

Pronounced: tie-kar-sil-in / kluh-vyoo-luh-neyt.

Why do we use ticarcillin/clavulanate?

ticarcillin/clavulanate is an antibiotic medication that is used to treat a wide range of bacterial infections. It is typically used in the treatment of infections of the respiratory tract, urinary tract, skin, and soft tissues. It is also used to treat bone and joint infections, intra-abdominal infections, and infections caused by susceptible bacteria in immunocompromised patients. ticarcillin/clavulanate is commonly used in hospitals and is typically administered by injection or infusion.