Dosing
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-lactamase inhibitor combinations are problematic with some gram-negative rods, depending on the strain and the type of beta-lactamase. Clavulanate can be antagonistic for ticarcillin (PubMed) and other beta-lactam antibiotics (PubMed). This is less of a problem with tazobactam, maybe occurring 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, Intraabdominal infections, Neutropenic fever, Osteomyelitis, Pneumonia, Sepsis, Sinusitis, surgical prophylaxis, UTI.
Don't use for
Class
Penicillin.
Last update 11/30/19