Adult Dosing
Bacterial infections caused by susceptible bacteria
60 kgs
Gynecologic infections
> 60 kgs
- Moderate: 200 mg/kg/day IV divided q6 hrs; based on ticarcillin component
- Severe: 300 mg/kg/day IV divided q4 hrs; based on ticarcillin component
< 60 kgs
- 200-300 mg/kg/day IV divided q4-6 hrs; based on ticarcillin component
Pediatric Dosing
- Note: Safety and effectiveness in pediatric patients < 3months have not been established
Bacterial infections caused by susceptible bacteria
60 kgs
- Mild-Moderate: 3.1 g IV q6 hrs
- Severe: 3.1 g IV q4 hrs
< 60 kgs
- Mild-Moderate: 200 mg/kg/day IV divided q6 hrs, based on ticarcillin component
- Severe: 300 mg/kg/day IV divided q4 hrs, based on ticarcillin component
[Outline]
Renal Dose Adjustment (Based on CrCl)
- > 60 mL/min: Loading dose of 3.1 g IV followed 3.1 g IV q4 hrs
- 30-60 mL/min: Loading dose of 3.1 g IV followed 2 g IV q4 hrs
- 10-30 mL/min: Loading dose of 3.1 g IV followed 2 g IV q8 hrs
- < 10 mL/min with hepatic impairment: Loading dose of 3.1 g IV followed 2 g IV q24 hrs
- Hemodialysis: 2 g IV q12 hrs; give 3.1 g supplement after each dialysis
- Peritoneal dialysis: 3.1 g IV q12 hrs; give 3.1 g supplement after each dialysis
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- To reduce the development of drug-resistant bacteria and maintain the effectiveness of ticarcillin/clavulante, use only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria
- Perform susceptibility testing before initiating therapy
- Serious hypersensitivity (anaphylactic) reactions have been reported in patients on penicillin therapy; more likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens. Discontinue therapy if allergic reaction occurs. Inquire about history of sensitivity to penicillins, cephalosporins, or other allergens
- Treatment with epinephrine and other emergency measures may be required in serious acute hypersensitivity reactions
- Pseudomembranous colitis (C. difficile infection) which may range in severity from mild diarrhea to fatal colitis can appear during or after antibiotic treatment
- Bleeding manifestations have occurred in some patients receiving beta-lactam antibiotics. If bleeding manifestations occur, the drug should be discontinued and appropriate therapy instituted
- Prolonged use may result in fungal or bacterial superinfection
- Monitor CrCl at baseline, then periodically if on prolonged therapy
- Monitor CBC, potassium, liver function tests if prolonged therapy
Cautions: Use cautiously in
- Renal impairment
- Hemorrhage
- Penicillin-sensitive patients
- Sodium restriction
- Hypersensitivity to multiple allergens
- Hypokalemia
- Elderly patients
Pregnancy Category:B
Breastfeeding: Literature unavailable on use of ticarcillin and clavulanic acid during breastfeeding. Maternal doses of ticarcillin 15 g/day produce low levels in milk that are not expected to cause adverse effects in breastfed infants. Rare occasion of disruption of infant's GI flora have occurred with the use of penicillins, but these effects have not been adequately evaluated. Use of ticarcillin and clavulanic acid is acceptable during breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 16 December 2010). According to manufacturer's data, it is unknown whether this drug is excreted in human milk. As many drugs are excreted in human milk, caution should be exercised when administered to a nursing woman.
US Trade Name(s)
US Availability
Timentin (clavulanic acid/ticarcillin)
- PWDR for INJ: 3.1 g [0.1 g/3 g] vials
- PWDR for INJ: 31 g [1 g/30 g] vials
- INJ: 3.1 g [3 g/100 mL/0.1 g/mL]
Canadian Trade Name(s)
Canadian Availability
Timentin (clavulanic acid/ticarcillin)
- PWDR for INJ: 3.1 g [0.1 g/3 g] vials
- PWDR for INJ: 31 g [1 g/30 g] vials
- INJ: 3.1 g [3 g/100 mL/0.1 g/mL]
UK Trade Name(s)
UK Availability
Timentin (clavulanic acid/ticarcillin)
- PWDR for INJ:
- 0.8 g [0.05 g/0.750 g] vials
- 1.6 g [0.1 g/1.5 g] vials
- 3.2 g [0.2 g/3 g] vials
Australian Trade Name(s)
Australian Availability
Timentin (clavulanic acid/ticarcillin)
- PWDR for INJ: 3.1 g [0.1 g/3 g] vials
[Outline]