Carbenicillin Indanyl Sodium
Pronouncation: (car-BEN-ih-SILL-in IN-duh-nil SO-dee-uhm)Class: Extended-spectrum penicillin
Trade Names:
Geocillin
- Tablets 382 mg carbenicillin (118 mg indanyl sodium ester)
Pharmacology
Feedback for Carbenicillin Indanyl Sodium
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Inhibits mucopeptide synthesis in bacterial cell wall.
Pharmacokinetics
Absorption
Rapidly absorbed. T max is 1 h. C max is about 6.5 mcg/mL.
Distribution
50% protein bound.
Metabolism
Rapidly converted to carbenicillin by hydrolysis of the ester linkage.
Elimination
About 30% is excreted in the urine unchanged within 12 h.
Indications and Usage
Treatment of acute and chronic infections of the upper and lower urinary tract, prostatitis, and asymptomatic bacteriuria caused by susceptible microorganisms.
Contraindications
Hypersensitivity to penicillins.
Dosage and Administration
AdultsPO 382 to 764 mg 4 times daily.
General Advice
- Do not use in patient with severe renal function impairment (Ccr less than 10 mL/min) because therapeutic urine levels of carbenicillin will not be achieved.
- Administer without regard to meals but administer with food if GI upset occurs.
Storage/Stability
No data.
Drug Interactions
Contraceptives, oralMay reduce efficacy of oral contraceptives. Use nonhormonal form of contraception during carbenicillin therapy.
ProbenecidMay increase and prolong carbenicillin blood levels.
TetracyclinesMay impair bactericidal effects of carbenicillin.
Adverse Reactions
CNS
Headache.
Dermatologic
Hypersensitivity reactions including pruritus, rash, and urticaria.
EENT
Itchy eyes.
GI
Abdominal cramps; anorexia; bad taste; diarrhea; dry mouth; flatulence; furry tongue; glossitis; loose stools; nausea; rectal bleeding; unspecified epigastric distress; vomiting.
Genitourinary
Vaginitis.
Hematologic
Anemia; eosinophilia; leukopenia; neutropenia; thrombocytopenia.
Lab Tests
Mild AST elevations.
Miscellaneous
Hyperthermia.
Precautions
MonitorRenal/Hepatic/Hematopoietic functionEnsure renal, hepatic, and hematopoietic function are periodically assessed during prolonged therapy. Inform health care provider if abnormalities noted. SensitivityReview results of culture and sensitivity testing as appropriate. Ensure carbenicillin is discontinued and another antimicrobial agent is started if sensitivity tests indicate that the organism is resistant to carbenicillin. Side effectsMonitor patient for DERM, GI, general body side effects, and signs of superinfection. Report to health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping. Therapy responseMonitor patient's response to therapy. Notify health care provider if infection does not appear to be improving or is worsening. |
Pregnancy
Category B .
Lactation
Excreted in breast milk.
Children
Safety and efficacy not established.
Renal Function
Use drug cautiously; dosage adjustment may be required.
Superinfection
May result in bacterial or fungal overgrowth of nonsusceptible organisms.
Prophylactic use
Is unlikely to provide benefit and may increase risk of development of drug-resistant bacteria.
Patient Information
- Review dosing schedule and prescribed length of therapy with patient or caregiver. Advise patient or caregiver that dose and duration of therapy are dependent on the site and cause of infection and response to treatment.
- Reinforce to patient or caregiver the need to take exactly as prescribed and to complete the entire course of therapy, even if symptoms of infection have disappeared. Caution patient or caregiver that skipping doses or not completing the full course of therapy may allow the infection to worsen and increase the possibility that the bacteria will become resistant to the antibiotic and may cause infections that will not be treatable in the future.
- Instruct patient to take each dose without regard to meals but to take with food if stomach upset occurs.
- Instruct patient to notify health care provider if infection does not appear to be improving or is worsening.
- Advise patient or caregiver to notify health care provider if severe diarrhea or diarrhea lasting 2 or 3 days occurs.
- Warn patient that diarrhea containing blood or pus may be a sign of a serious disorder and to seek medical care if noted and not treat at home.
- Advise patient or caregiver to report signs of superinfection to health care provider: black “furry” tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge.
- Advise patient, family, or caregiver to discontinue therapy and contact health care provider immediately if skin rash, hives, itching, or shortness of breath occur.
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Prostatitis, Bladder Infection
