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.

Further information

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

Medical Disclaimer