Ver el código de «Ticarcillin/Clavulanate»

'''Brand Discontinued in U.S
'''

==General==
*Type: [[Is PenicillinType::Anti-Pseudomonal]] [[Is DrugClass::Penicillin]]
*Dosage Forms:
*Common Trade Names: Timentin

==Adult Dosing==
'''Ticarcillin/clavulanate: each 3.1g dose contains 3g ticarcillin and 0.1g clavulanate (dosages written by ticarcillin component)'''

===General===
*<60 kg 
**200-300mg ticarcillin/kg/day IV divided q4-6 hours 
**First Dose:  
**Max: 18 g/day
*≥60 kg
**3.1 g every 4-6 hours 
**First Dose: 
**Max: 18 g/day

==Pediatric Dosing==
'''Ticarcillin/clavulanate: each 3.1g dose contains 3g ticarcillin and 0.1g clavulanate (dosages written by ticarcillin component)'''
===General (≥3 Months)===
*'''<60 kg'''
**200-300mg ticarcillin/kg/day IV divided q4-6 hours 
**First Dose: 50mg tiacarcillin/kg IV x 1
**Max: 18g/day
*'''≥60 kg'''
**3.1 g q4-6 hours
**Max: 18g/day

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy]]: B
*Lactation: Use caution
*Renal Dosing
Considerations for hemodialysis/peritoneal dialysis and CRRT patients NOT included below
**Adult
Loading dose: IV: 3.1 g one dose, followed by maintenance dose based on creatinine clearance:

CrCl 30-60 mL/minute: 2 g of ticarcillin component every 4 hours 

CrCl 10-30 mL/minute: 2 g of ticarcillin component every 8 hours 

CrCl <10 mL/minute: 2 g of ticarcillin component every 12 hours 

CrCl <10 mL/minute with concomitant hepatic dysfunction: 2 g of ticarcillin component every 24 hours

**Pediatric
No dosing adjustments in manufacturer's label, clinical recommendations include:

GFR >30 mL/minute/1.73 m2: No adjustment required.

GFR 10-29 mL/minute/1.73 m2: 50 to 75 mg ticarcillin/kg every 8 hours

GFR <10 mL/minute/1.73 m2 (without concomitant hepatic failure): 50 to 75 mg ticarcillin/kg every 12 hours

GFR <10 mL/minute/1.73 m2 (with concomitant hepatic failure): 50 to 75 mg ticarcillin/kg every 24 hours

*Hepatic Dosing
**Adult
With concomitant renal dysfunction (Clcr <10 mL/minute): 2 g of ticarcillin component every 24 hours.
**Pediatric
No specific pediatric recommendations, adjust if concomitant renal dysfunction

==Contraindications==
*Allergy to class/drug

==Adverse Reactions==
===Serious===

===Common===

==Pharmacology==
*Half-life: Ticarcillin: 1.1 hours; Clavulanic acid: 1.1 hours
*Metabolism: 
*Excretion: 
*Mechanism of Action:

==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||I
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||I
|-
| ||[[Enterococcus faecium]]||I
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||X2
|-
| Gram Negatives||[[N. gonorrhoeae]]||X2
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||'''S'''
|-
| ||[[Enterobacter]] sp, AmpC pos||'''S'''
|-
| ||[[Serratia]] sp||'''S'''
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||'''S'''
|-
| ||[[Citrobacter diversus]]||'''S'''
|-
| ||[[Citrobacter sp.]]||'''S'''
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||I
|-
| ||[[Pseudomonas aeruginosa]]||'''[[Has Antipseudomonal::S]]'''
|-
| ||[[Burkholderia cepacia]]||X1
|-
| ||[[Stenotrophomonas maltophilia]]||'''S'''
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||'''S'''
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}

===Key===
{{Template:Antibacterial Spectra Key}}

==See Also==
*[[Antibiotics (Main)]]

==References==
<references/>
[[Category:Pharmacology]]
Dowell JA, Korth-Bradley J, Milisci M, et al, "Evaluating Possible Pharmacokinetic Interactions Between Tobramycin, Piperacillin, and a Combination of Piperacillin and Tazobactam in Patients With Various Degrees of Renal Impairment," J Clin Pharmacol, 2001, 41:979-86 PMID: 11549103