Penicillin antipseudomonal

The pharmacology of penicillins differs markedly from compound to compound but has been well reviewed (57). The majority of derivatives, including penicillin G and the antipseudomonal penicillins, ate unstable in gastric acid and ate not available orally. The isoxazolyl penicillins ate relatively acid stable but not consistendy well absorbed by the oral route. Nafcillin and oxacillin ate poody absorbed orally cloxacillin, dicloxacillin, and ducloxacillin ate more teUable. Penicillin V, ampicillin, and patticulady amoxicillin ate relatively well absorbed orally. Esters of ampicillin such as bacampicillin, pivampicillin, and talampicillin improve the level of oral absorption of ampicillin to that achieved by amoxicillin. Absorption can be diminished by food after oral adruinistration, however, and peak blood levels, usually achieved after 1 to 2 h, ate somewhat delayed after ingestion of food. [Pg.83]

Cirrhosis Peritoneal Cefotaxime Regimen based on organism isolated 1. Add clindamycin or metronidazole if anaerobes are suspected 2. Other third-generation cephalosporins, extended-spectrum penicillins, aztreonam, and imipenem as alternatives 3. Aminoglycoside with antipseudomonal penicillin... [Pg.1135]

Urinary tract Third-generation cephalosporin (ceftriaxone) OR Fluoroquinolone (levofloxacin or ciprofloxacin) Antipseudomonal penicillin OR Antipseudomonal cephalosporin OR Antipseudomonal carbapenem plus aminoglycoside... [Pg.1191]

Newer antimicrobials have not demonstrated superiority in the prevention of SSI and should be reserved for treatment only. Carbapenems, antipseudomonal penicillins, and third-or fourth-generation cephalosporins are not appropriate antibiotics for surgical prophylaxis. Overuse of these antibiotics may contribute to collateral damage and the development of bacterial resistance. [Pg.1234]

Mezlocillin, piperacillin, and ticarcillin are parenteral antibiotics formulated as sodium salts, so prescribers must consider the sodium content of these antibiotics when administering them to patients with congestive heart failure. During their distribution phase, antipseudomonal penicillins achieve orfly low concentrations in the cerebrospinal fluid. Consequently, antipseudomonal penicillins are not among the drugs of first choice for meningitis therapy. [Pg.530]

The antipseudomonal penicillins undergo renal elimination (Table 45.1). Piperacillin and ticarcillin have minimal hepatic metabolism. In contrast, mezlocillin has significant hepatic metabolism and requires dose adjustment in patients with hepatic insufficiency. [Pg.530]

The antipseudomonal penicillins have comparable spectra of activity against many gram-positive and gram-negative pathogens, including most anaerobes. Mezlocillin, piperacillin, and ticarcillin have similar clinical outcomes in patients with known or suspected P. aeruginosa infections. Antipseudomonal penicillins are used to treat pneumonias associated with cystic fibrosis or mechanical ventilation. [Pg.530]

Carbenicillin indanyl sodium is an antipseudomonal penicillin formulated for oral administration. The drug achieves negligible carbenicillin concentrations in the urine of patients with renal failure. Consequently, carbenicillin is not appropriate for patients with renal failure. In patients with normal renal function, however, carbenicillin indanyl sodium is used to treat urinary tract infections caused by P. aeruginosa, Proteus spp., and Escherichia coli. [Pg.530]

Extended-Spectrum Penicillins (Ampicillin and the Antipseudomonal Penicillins)... [Pg.984]

Enterobacter, Citrobacter, Serratia TMP-SMZ,1 quinolone,3 carbapenem6 Antipseudomonal penicillin,7 aminoglycoside,5 cefepime... [Pg.1100]

Pseudomonas aeruginosa Antipseudomonal penicillin aminoglycoside5 Antipseudomonal penicillin quinolone,3 cefepime, ceftazidime, antipseudomonal carbapenem6 or aztreonam aminoglycoside5... [Pg.1101]

Septicemia with granulocytopenia Any Antipseudomonal penicillin + aminoglycoside ceftazidime cefepime imipenem or meropenem consider addition of systemic antifungal therapy if fever persists beyond 5 days of empiric therapy ... [Pg.1104]

The pharmacology of penicillins differs markedly from compound to compound. The majority of derivatives, including penicillin (j and the antipseudomonal penicillins, are unstable in gastric acid and are not available orally. The isoxazolyl penicillins are relatively acid-stable but... [Pg.126]

Enterobacter, citrobacter, serratia TMP-SMZ, quinolone, imipenem Antipseudomonal penicillin,4 aminoglycoside5, cefepime... [Pg.1171]

Pseudomonas aeruginosa Antipseudomonal penicillin + aminoglycoside5 Antipseudomonal penicillin + quinolone cefepime, ceftazidime, imipenem, or aztreonam aminoglycoside... [Pg.1171]

Typical therapeutic applications of ampicillin (A) and the antipseudomonal penicillins (B). [Pg.312]

Platelet dysfunction This side effect, which involves decreased agglutination, is observed with the antipseudomonal penicillins (carbenicillin and ticarcillin) and, to some extent, with penicillin G. It is generally a concern when treating patients predisposed to hemorrhage or those receiving anticoagulants. [Pg.314]

Treatment includes tobramycin, gentamicin, or amikacin alone or in combination with an antipseudomonal penicillin, such as piperadilin or ticarciliin. [Pg.326]

Occurs with all beta-lactams probably more often with penicillins G and V, antipseudomonal penicillins, cefaclor, cefadroxil, cefalexin,... [Pg.488]

Beta-lactamase sensitive penicillins Broad-spectrum penicillins Beta-lactamase resistant penicillins Antipseudomonal penicillins... [Pg.2757]

Aerobic gram-negative bacilli cefotaxime, ceftazidime, or aminoglycoside plus an antipseudomonal penicillin... [Pg.2063]

Pseudomonas aeruginosa aminoglycoside plus antipseudomonal penicillin or ceftazidime... [Pg.2063]

At least four different types of empirical parenteral antibiotic regimens are in use (1) monotherapy with an antipseudomonal cephalosporin (cefepime or ceftazidime) or antipseudomonal car-bapenem (imipenem-cilastatin or meropenem), (2) combination therapy with an aminoglycoside plus an antipseudomonal penicillin (piperacillin-tazobactam or ticarciUin-clavulate), an antipseudomonal cephalosporin, or an antipseudomonal carbapenem, (3) vancomycin plus an antipseudomonal cephalosporin or antipseudomonal carbapenem, with or without an aminoglycoside, and (4) a fluoroquinolone (ciprofloxacin or levofloxacin) in combination with an... [Pg.2198]

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