Tags: Ticarcillin

Infectious disorders

Infectious diseases comprise those illnesses that are caused by microorganisms or their products. Clinical manifestations of infection occur only when sufficient tissue injury has been inflicted directly by microbial products (e.g., endotoxins and exotoxins), or indirectly by host responses (e.g., cytokines and hydrolytic enzymes released by polymorphonuclear leukocytes). Despite the extraordinary recent advances that have occurred in therapeutics for infectious diseases, a number of basic principles should be followed to prescribe antimicrobials and vaccines is an optimal manner.

Antimicrobial therapy: general principles

A wide variety of antimicrobial agents is available to treat established infections caused by bacteria, fungi, viruses, or parasites. This section will cover the general principles of antimicrobial therapy and will also include illustrative clinical problems to emphasize proper decision-making in using antimicrobials.

Toxicity of Antimicrobial Therapy

The mechanisms associated with common adverse reactions to antimicrobials include dose-related toxicity that occurs in a certain fraction of patients when a critical plasma concentration or total dose is exceeded, and toxicity that is unpredictable and mediated through allergic or idiosyncratic mechanisms. For example, certain classes of drugs such as the aminoglycosides are associated with dose-related toxicity.

Management of the Febrile Neutropenic Patient

Consideration of treatment of the febrile neutropenic patient includes a brief summary of risk factors, organisms responsible for the disease, workup and management of a patient with respect to antimicrobial therapy, and immunoenhancement. Many clinical disease entities can cause a spectrum of immune suppression, and solid and hematologic tumors vary with respect to the degree of immune suppression they produce. Neutropenia is defined as an absolute neutrophil count that is less than 1000 cells/mm3. As the count falls below 1000 cells/mm3, the risk of infection increases.

Penicillins

Penicillin G is an acid that is combined with sodium, potassium, procaine, or benzathine to increase its stability or to regulate its absorption. The latter two are “long-acting” forms. Penicillin G is useful in the treatment of streptococcal infections due to S. pyogenes (group A), S. agalactiae (group B), S. pneumoniae, viridans streptococci, Corynebacterium diphtheria, N. meningitidis, many strains of N. gonorrhea, Treponema pallidum, and many anaerobic streptococci, such as peptococcus and peptostreptococcus.

Vancomycin Hydrochloride: Uses

IV vancomycin hydrochloride is used in the treatment of potentially life-threatening infections caused by susceptible organisms which cannot be treated with other effective, less toxic anti-infective agents. Vancomycin is used principally for the treatment of severe infections caused by gram-positive bacteria in patients who cannot receive or who have failed to respond to penicillins and cephalosporins or for the treatment of gram-positive bacterial infections that are resistant to b-lactams and other anti-infectives. Prevention of the emergence of drug resistance, its dissemination among pathogens, and the spread of such pathogens has become an increasingly important public health problem. Medical, pharmacy, and other staff and individuals responsible for drug-use policy and formulary decisions should review and restrict the use of certain anti-infectives, including vancomycin, and ensure that their use is appropriate.

Ticarcillin Disodium and Clavulanate Potassium

Adverse effects reported with ticarcillin disodium and clavulanate potassium are similar to those reported with ticarcillin alone. For information on adverse effects reported with ticarcillin and other extended-spectrum penicillins, see Cautions in the Extended-Spectrum Penicillins General Statement 8:12.16.16. Rash, pruritus, urticaria, and fever have been reported with ticarcillin disodium and clavulanate potassium.

Ticarcillin Disodium and Clavulanate Potassium: Dosage and Administration

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: Uses

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.

Ticarcillin Disodium

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.

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