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Ticarcillin
Pham P and Bartlett JG
03-17-2008
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Available formulation in Zambia: IV: 3gm vial. Availability varies.
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Pseudomonas pneumonia: Ticarcillin 3 gm q4h plus gentamicin.
Zambia Information Author: Paul A. Pham, Pharm. D.
- Gynecologic infections (endomyometritis)
- Intra-abdominal infections
- Lower respiratory infections
- Septicemia
- Skin and skin structure infections
- Urinary tract infections
- Bone and joint infections
brand
name
| generic
| Mfg
| brand
forms
| cost*
|
| Ticar | Ticarcillin | Abbott | IV
vial
20g | $82.50 |
*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP).
AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's
information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
3Gm IV q4-6h (up to 24 Gm/day). Use 3Gm IV q4h for serious infections.
GFR >60ml/min: standard dose 3Gm IV q4-6h (up to 24Gm per day). Pulmonary, pseudomonal, and serious infections: 3Gm IV q4h.
30-60ml/min: 2gm q4h . If <30ml/min: 2gm q8h.
2Gm q12h
2Gm q12h plus 3Gm post-dialysis
3 Gm q12h
CVVH: 2 Gm q6-8h. CVVHD: 3 Gm q6h.
- Hypersensitivity reactions
- Rash
- GI intolerance
- Phlebitis at infusion sites
- Jarisch-Herxheimer reaction (with syphilis or other spirochetal infections)
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C. difficile colitis
- LFTs elevations with rare cases of hepatitis
- Drug fever
- Coombs' test positive w/ hemolytic anemia
- Interstitial nephritis
- Leukopenia and thrombocytopenia
- Abnormal platelet aggregation with bleeding diathesis (especially in renal failure)
- CNS: seizures and twitching (with high doses in patients with renal failure)
- Hepatitis
- Anaphylaxis
- Tetracyclines: in vitro antagonism when co-administered. Bactericidal effect of penicillins may be diminished in vivo. Management recommendation: avoid concurrent administration. In two studies involving a total of 79 patients with pneumococcal meningitis treated with either penicillin plus tetracyclines or penicillin monotherapy resulted in a higher mortality rate (79-85%) in the combination therapy compared to penicillin monotherapy (30-33%) [Arch Intern Med 1951:88:489, Ann Intern Med 1961; 55:545]. However there was not a difference in mortality between penicillin monotherapy and penicillin plus tetracycline in the treatment of pneumococcal pneumonia [Arch Intern Med 1953; 91:197].
- Probenecid may prolong ticarcillin. May be result in significant accumulation in renal failure.
Anti-pseudomonal penicillin. Contains 4.75 Meq of sodium per gram of ticarcillin. Reduced enterococcal activity compared to piperacillin. Reduced activity vs. S. pneumoniae. Hydrolized by plasmid-mediated beta-lactamases.
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