Antibiotic, Antifungal, Antiviral Drugs

Vials of ticarcillin disodium and clavulanate potassium labeled as containing a combined potency of 3.1 g of the drugs are reconstituted by adding approximately 13 mL of sterile water for injection or sodium chloride injection to provide a solution containing approximately 200 mg of ticarcillin per mL and 6.7 mg of clavulanic acid per mL. The vial should be shaken until the drug is dissolved.

Ticarcillin disodium and clavulanate potassium is used for the treatment of lower respiratory tract infections, skin and skin structure infections, complicated and uncomplicated urinary tract infections, bone and joint infections, septicemia, intra-abdominal infections (e.g., peritonitis), and gynecologic infections (e.g., endometritis), caused by susceptible organisms.

The drug also has been used for the treatment of anaerobic or mixed aerobic-anaerobic bacterial infections or for empiric anti-infective therapy in febrile granulocytopenic patients. For specific information on the uses of ticarcillin, seeUses in the Extended-Spectrum Penicillins General Statement 8:12.16.16. For information on the uses of ticarcillin in a fixed-ratio combination with clavulanic acid. Ticarcillin disodium is administered by slow IV injection or infusion or by deep IM injection.

Piperacillin sodium and tazobactam sodium is used parenterally for the treatment of moderate to severe infections caused by, or suspected of being caused by, susceptible b-lactamase-producing bacteria when piperacillin alone would be ineffective.

Dosage of piperacillin sodium and tazobactam sodium is expressed in terms of the total of the piperacillin and tazobactam content of the fixed combination. Potency of both piperacillin sodium and tazobactam sodium are expressed in terms of the bases of the drugs.

Oral carbenicillin indanyl sodium has been used with some success for short-term therapy or long-term suppressive therapy in the treatment of acute or chronic infections of the upper and lower urinary tract or for asymptomatic bacteriuria caused by susceptible strains of enterococci, Enterobacter, Escherichia coli, Morganella morganii, Proteus mirabilis, P. vulgaris, P. rettgeri, or Pseudomonas aeruginosa. However, most clinicians state that the drug is not a drug of choice for these infections. Some clinicians suggest that uncomplicated urinary tract infections should be treated with co-trimoxazole, fluoroquinolones, oral cephalosporins, nitrofurantoin, or fosfomycin; complicated urinary tract infections generally require parenteral therapy.

Amikacin, gentamicin, kanamycin, or tobramycin is used IM or IV in the short-term treatment of serious infections such as septicemia (including neonatal sepsis), bone and joint infections, skin and soft tissue infections (including those resulting from burns), respiratory tract infections, and postoperative and intra-abdominal infections (including peritonitis) caused by susceptible strains of gram-negative bacteria.

Oral carbenicillin indanyl sodium is used only for the treatment of acute or chronic infections of the upper and lower urinary tract, asymptomatic bacteriuria, or prostatitis caused by susceptible organisms.

Oxacillin shares the uses of other parenteral penicillinase-resistant penicillins (e.g., nafcillin) and generally is used only in the treatment of infections caused by, or suspected of being caused by, susceptible penicillinase-producing staphylococci. For specific information on the uses of oxacillin, see Uses in the Penicillinase-Resistant Penicillins General Statement 8:12.16.12. Oxacillin sodium is administered by IM injection or slow IV injection or infusion. Although oxacillin has been administered orally, an oral preparation of the drug is no longer commercially available in the US.