Clavulanate / Ticarcillin Dosage

Usual Adult Dose for Bacteremia

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Intraabdominal Infection

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Joint Infection

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Osteomyelitis

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Peritonitis

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Pneumonia

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Pyelonephritis

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Septicemia

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Bacterial Infection

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Urinary Tract Infection

3.1 g IV every 4 to 6 hours

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, Escherichia coli, Staphylococcus aureus, or Pseudomonas aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, Haemophilus influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, Enterobacter cloacae, Serratia marcescens, or S aureus
• Peritonitis due to E coli, K pneumoniae, or Bacteroides fragilis group

Usual Adult Dose for Endometritis

Moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

Use: For the treatment of endometritis due to susceptible beta-lactamase-producing isolates of Prevotella melaninogenicus, Enterobacter species (including E cloacae), E coli, Klebsiella pneumoniae, S aureus, or S epidermidis

Usual Adult Dose for Skin or Soft Tissue Infection

3.1 g IV every 4 to 6 hours

Use: For the treatment of skin and skin structure infections due to susceptible beta-lactamase-producing isolates of S aureus, Klebsiella species, or E coli

Infectious Diseases Society of America (IDSA) Recommendations:

• Incisional surgical site infection: 3.1 g IV every 6 hours

Comments:

• Recommended as a single-drug regimen for treatment of incisional surgical site infections after intestinal or genitourinary tract surgery
• Current guidelines should be consulted for additional information.

Usual Adult Dose for Skin and Structure Infection

3.1 g IV every 4 to 6 hours

Use: For the treatment of skin and skin structure infections due to susceptible beta-lactamase-producing isolates of S aureus, Klebsiella species, or E coli

Infectious Diseases Society of America (IDSA) Recommendations:

• Incisional surgical site infection: 3.1 g IV every 6 hours

Comments:

• Recommended as a single-drug regimen for treatment of incisional surgical site infections after intestinal or genitourinary tract surgery
• Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Bacteremia

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Intraabdominal Infection

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Joint Infection

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Osteomyelitis

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Peritonitis

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Pneumonia

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Pyelonephritis

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Septicemia

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Bacterial Infection

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Urinary Tract Infection

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Skin and Structure Infection

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Usual Pediatric Dose for Endometritis

3 months or older:
Less than 60 kg:

• Mild to moderate infections: 50 mg/kg (ticarcillin component) IV every 6 hours
• Severe infections: 50 mg/kg (ticarcillin component) IV every 4 hours

At least 60 kg:

• Mild to moderate infections: 3.1 g IV every 6 hours
• Severe infections: 3.1 g IV every 4 hours

Comments:

• An alternative agent with proven clinical efficacy should be used if meningitis suspected/verified; alternative agents also recommended for prophylaxis against CNS infections.

Uses: For the treatment of infections due to susceptible beta-lactamase-producing isolates of the designated bacteria:

• Septicemia (including bacteremia) due to Klebsiella species, E coli, S aureus, or P aeruginosa (or other Pseudomonas species)
• Lower respiratory infections due to S aureus, H influenzae, or Klebsiella species
• Bone and joint infections due to S aureus
• Skin and skin structure infections due to S aureus, Klebsiella species, or E coli
• Urinary tract infections (complicated and uncomplicated) due to E coli, Klebsiella species, P aeruginosa (or other Pseudomonas species), Citrobacter species, E cloacae, S marcescens, or S aureus
• Endometritis due to P melaninogenicus, Enterobacter species (including E cloacae), E coli, K pneumoniae, S aureus, or S epidermidis
• Peritonitis due to E coli, K pneumoniae, or B fragilis group

American Academy of Pediatrics (AAP) Recommendations:
Neonates:
7 days or younger: 75 mg/kg (ticarcillin component) IV every 12 hours
8 to 28 days: 75 mg/kg (ticarcillin component) IV every 8 hours

1 month or older:
Severe infections: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day (based on ticarcillin component)

Renal Dose Adjustments

Initial loading dose: 3.1 g IV once

Maintenance dose (based on ticarcillin component):

• CrCl greater than 60 mL/min: 3 g IV every 4 hours
• CrCl 30 to 60 mL/min: After loading dose, 2 g IV every 4 hours
• CrCl 10 to 30 mL/min: After loading dose, 2 g IV every 8 hours
• CrCl less than 10 mL/min: After loading dose, 2 g IV every 12 hours
• CrCl less than 10 mL/min and liver dysfunction: After loading dose, 2 g IV every 24 hours

Liver Dose Adjustments

Liver dysfunction and CrCl less than 10 mL/min:

• Initial loading dose: 3.1 g IV once
• Maintenance dose (based on ticarcillin component): After loading dose, 2 g IV every 24 hours

Dose Adjustments

Adults weighing less than 60 kg: 200 to 300 mg/kg/day (ticarcillin component) IV in divided doses every 4 to 6 hours

Precautions

Safety and efficacy have not been established in patients younger than 3 months.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis:

• Initial loading dose: 3.1 g IV once
• Maintenance dose (based on ticarcillin component): After loading dose, 2 g IV every 12 hours
• Supplemental dose: 3.1 g IV after each dialysis

Peritoneal dialysis: 3.1 g IV every 12 hours

Other Comments

3.1 g ticarcillin-clavulanate contains 3 g ticarcillin and 100 mg clavulanic acid

Administration advice:

• Administer via IV infusion over 30 minutes.
• May administer by direct infusion or through a Y-type IV infusion set; if using a Y-type IV infusion set, temporarily discontinue administration of any other solutions during infusion of this drug.
• Galaxy(R) Containers (PL 2040 Plastic): Do not use plastic containers in series connections.
• Duration of therapy depends on infection severity; in general, continue for at least 2 days after signs/symptoms of infection have disappeared. The usual duration of therapy is 10 to 14 days, but difficult and complicated infections may require more prolonged therapy.

Storage requirements:

• Galaxy(R) Containers: Store at or below -20C (-4F) and avoid unnecessary handling; thawed solution is stable for 24 hours at 22C (72F) or for 7 days at 4C (39F); do not refreeze.
• Vials (3.1 g) and Pharmacy Bulk Packages (31 g): Store at or below 25C (77F) before reconstitution; the manufacturer product information should be consulted regarding stability periods of reconstituted and/or further diluted solutions at room temperature (21C to 24C [70F to 75F]), under refrigeration (4C [40F]), or frozen (-18C [0F]); once thawed, do not refreeze.

Reconstitution/preparation techniques:

• Galaxy(R) Containers: Thaw frozen container at room temperature (22C [72F]) or in refrigerator (4C [39F]); do not force thaw by immersion in water baths or by microwave irradiation.
• Vials (3.1 g) and Pharmacy Bulk Packages (31 g): Reconstitution and further dilution needed (final concentration between 10 to 100 mg/mL); the manufacturer product information should be consulted.

IV compatibility:

• Compatible diluents and IV solutions: Sterile Water for Injection, USP; Sodium Chloride Injection 0.9%, USP; Dextrose Injection 5%, USP; Lactated Ringer's Injection, USP
• Incompatible: Sodium Bicarbonate
• Galaxy(R) Containers: Do not add supplementary medication.

General:

• To reduce the development of drug-resistant organisms and maintain effective therapy, this drug should be used only to treat or prevent infections proven or strongly suspected to be caused by susceptible bacteria.
• Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.
• Theoretical sodium content is about 4.51 mEq (103.6 mg) per gram of ticarcillin-clavulanate; at usual recommended doses, patients would receive about 56 to 84 mEq/day (1285 to 1927 mg/day) of sodium.

Monitoring:

• General: Serum potassium in patients with fluid and electrolyte imbalance and in patients receiving prolonged therapy

Patient advice:

• Avoid missing doses and complete the entire course of therapy.
• Consult physician at once if watery and bloody stools (with or without stomach cramps and fever) develop.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer