Brand Name(s) in US
Timentin
Description
Temocillin disodium is a broad-spectrum, β-lactamase resistant, injectable penicillin.
High serum levels and a five hour half-life allow once or twice-daily dosing.
Originator
Beecham (United Kingdom)
Uses
Ticarcillin is a carboxypenicillin belonging to the beta-lactam class of antibiotics. Ticarcillin is an injectable antibiotic used in the treatment of infections caused by gram-negative bacteria, particularly Pseudomonas aeruginosa.
Uses
Ticarcillin (SB) is a significant penicillin antibiotic that incorporates the thiophene ring system.
Definition
ChEBI: A penicillin compound having a 6beta-[(2R)-2-carboxy-2-thiophen-3-ylacetyl]amino side-group.
Antimicrobial activity
Because it is hydrolyzed less rapidly than ampicillin, non-β-
lactamase-producing strains of N. gonorrhoeae, ampicillin-susceptible
H. influenzae and some Enterobacteriaceae are susceptible.
Most aerobic and anaerobic Gram-positive bacteria are susceptible,
with the exception of E. faecalis and β-lactamase-producing
Staph. aureus. Anaerobic Gram-negative bacteria including B. fragilis
are usually susceptible. Bactericidal synergy with aminoglycosides
is demonstrable against Ps. aeruginosa and enterobacteria.
Acquired resistance
Ticarcillin is generally cross-resistant with carbenicillin.
It is somewhat stable to hydrolysis by AmpC-mediated β-lactamases of Gram-negative bacilli, but can be hydrolyzed
by most other chromosomally and plasmid-mediated enzymes
unless protected by a β-lactamase inhibitor.
Pharmacokinetics
Oral absorption: Negligible
C
max 1 g intramuscular: 35 mg/L after 1 h
Plasma half-life: 1.3 h
Volume of distribution: 0.21 L/kg
Plasma protein binding: 50–60%
Absorption and distribution
It is not orally absorbed. On parenteral co-administration
with gentamicin, the plasma concentration of ticarcillin is
unaffected, but the concentration of gentamicin is lowered. It
enters the serous fluids, providing concentrations up to 60%
of those of the plasma. It does not cross the normal meninges
but levels of up to 50% of those of the plasma can be found
in meningitis.
Metabolism and excretion
Up to 15% is excreted as penicilloic acid, a higher percentage
than for carbenicillin (up to 5%). Some is excreted in
the bile, producing levels 2–3 times those in the plasma, but
the main route of excretion is through the kidneys (80%),
principally as unchanged drug, appearing in the urine in the
first 6 h. It is more rapidly eliminated in children with cystic
fibrosis.
Clinical Use
Serious infection, including septicemia, respiratory tract infections,
genitourinary tract infections and skin and soft-tissue infections caused
by susceptible bacteria
Side effects
As with all penicillins, hypersensitivity reactions may occur,
but are less frequent and severe than those associated with
benzylpenicillin. Rashes and eosinophilia occur; reversible
abnormalities of liver function can develop. Since large doses
of the drug have to be used, convulsions can occur, as with
other penicillins, and being a disodium salt, electrolyte disturbances
can result from the sodium load and from loss of
potassium.
Synthesis
Ticarcillin, [2S-(2|á,5|á,6|?)]-3,3-dimethyl-7-oxo-6-[2-carboxy-2-(3-thienyl)
acetamido]-4-thia-1-azabicyclo[3.2.0]-heptan-2-carboxylic acid (32.1.1.34), is synthesized by direct acylation of 6-APA in the presence of sodium hydroxide, but with
3-thienylmalonic acid chloride (32.1.1.33), which gives ticarcillin.
