Infectious Disease Compendium

Ticarcillin/Clavulanate (Timentin®)

Dosing

CrCl Formula

CrCl > 80: 3.1 g iv q 4 - 6 h.

CrCl 80-50: 3.1 g iv q 4 - 6 h.

CrCl 50-10: 2-3.1 g iv q 6 - 8 h.

CrCl < 10: 2 g iv q 12 h.

Hemodialysis: 3.1 g after dialysis.

Peritoneal dialysis: 3.1 g iv q 12 h.

Important side effects

Anaphylaxis, coagulation abnormalities; bleeding time and platelet aggregation, convulsions, hypersensitivity reactions, hypokalemia, rash, thrombophlebitis.

Important drug interactions

Rants and Screeds

I am proud to say that in 15 years I have yet to find a reason to give this antibiotic. E-mail me if you have found an indication.

Pearls

Beta-lactamse inhibitor combinations are problematic with some gram negative rods, depending on the strain and the type of beta-lactamase. Clavulanate can be antagotistic for ticarcillin (PubMed) and other beta lactam antibiotics (PubMed). This is less of a problem with tazobactam, maybe occuring 1% of the time (PubMed).

Treatment of choice

Nothing.

Use for

Got me. Costs too much, too much resistance, better alternatives. I have used Ticarcillin/clavulanate as a marker that the prescriber knows little if anything about the rational use of antibiotics. I believe that it is both 100% sensitive and specific. It has indications for Arthritis, Cellulitis, Cystic fibrosis, Diverticulosis/itis, Empyema, Endometritis, eye infections, gynecologic infections, Intra abdominal infections, Neutropenic fever, Osteomyelitis, Pneumonia, Sepsis, Sinusitis, surgical prophylaxis, UTI.

Don't use for

Class

Penicillin.