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clen

Imentin is combined preparation ticarcillin sodium -polusinteticheskogo karboksipenitsillina broad spectrum antibacterial activity and potassium clavulanate produced by many clen bacteria. The action of  can lead to destruction of some antibacterial agents even before their exposure to pathogens. Potassium clavulanate destroy this protective mechanism by blocking the action of enzymes, making the bacteria susceptible to ticarcillin. Potassium clavulanate has no antibacterial activity, but its combination with ticarcillin in a preparation Timentin provides a broad-spectrum antibiotic that is insensitive .

Timentin bactericidal effect in vitro against a broad spectrum of microorganisms.

Gram-negative bacteria:

 

  • Acinetobacter species
  • Moraxella catarrhalis
  • Citrobacter species, including C. freundii, C. and S. diversus amalonaticus
  • Enterobacter species (despite the fact that many strains of Enterobacter species are resistant in vitro, clinical efficacy ticarcillin with clavulanic acid in urinary tract infections has been demonstrated)
  • Escherichia coli
  • Haemophilus influenzae
  • Klebsiella species, including K. pneumoniae
  • Morganella morganii
  • Neisseria gonorrhoeae
  • Neisseria meningitidis #
  • Proteus mirabilis
  • Proteus vulgaris clen
  • Providencia rettgeri
  • Providencia stuartii
  • Pseudomonas aeruginosa
  • Pseudomonas including P. maltophilia
  • Salmonella species
  • Serratia species, including S, marcescens

 

Gram-positive bacteria:

 

  • Staphylococcus aureus
  • Staphylococcus epidermidis (coagulase-negative)
  • Staphylococcus saprophyticus
  • Streptococcus agalactiae # (group B)
  • Streptococcus bovis #
  • Enterococcus faecalis #
  • Streptococcus pneumoniae # (Dipplococcus pneumoniae)
  • Streptococcus pyogenes # (group A beta-hemolytic)
  • Viridans group streptococci

 

Anaerobic bacteria:

 

  • Bacteroides species, including the B. fragilis group (B. fragilis, B. vulgatus, B. thetaiotaomicron, B. ovatus, B. distasonis), and non-B. fragilis (beta melanogennye)
  • Clostridium species including C. perfringens, C. difficile, C. sporogenes, C. and S. ramosum bifermentans #
  • Eubacterium species clen
  • Fusobacterium species including F. nucleatum and F. necrophorum #
  • Peptococcus species #
  • Peptostreptococcus species #
  • Veillonella species

 

# Sign marked sensitive to ticarcillin strains not producing beta-lactamase.

Pharmacokinetics
The mean value of the area under the curve, “concentration-time” for ticarcillin is 485 ug / ml / 3.1 hours after administration, and 3.2 g of respective values of clavulanic acid up to 8.2 mcg / mL / hr and 15.6 g / ml / h. Following intravenous infusion at a dose of ticarcillin 3.1 g and 3.2 g for 30 minutes, the maximal plasma concentration achieved immediately after infusion, and 330 constitute ug / ml for both doses. Thus pharmacokinetic parameters of clavulanic acid is 8 ug / ml (3.1 grams of ticarcillin) and 16 ug / ml (3.2 grams of ticarcillin).

Distribution
ticarcillin distributed in organs and tissues when administered parenterally. It has been shown ticarcillin penetration into the bile, pleural fluid, cerebrospinal fluid. Half-life is inversely proportional to the blood plasma creatinine clearance. Plasma protein binding is 50% for ticarcillin and 25% for clavulanic acid.

Excretion
average half-life of blood serum determined in healthy volunteers for ticarcillin and clavulanic acid is 68 minutes and 64 minutes respectively. Approximately 60-70% of ticarcillin and 35-45% of clavulanic acid is excreted unchanged by the kidneys during the first hours after administration of a single dose of the drug (in healthy volunteers with normal renal function). Two hours after the intravenous infusion of 3.2 g ticarcillin drug concentration in urine is greater than 1500 micrograms / ml and clavulanic acid concentration exceeds 70 g / ml. After 4-6 hours after administration at a dose of 3.2 g of the urinary concentration of 2 ug / ml.

Patients with impaired renal function
ticarcillin can be displayed by dialysis, and the elimination rate is dependent on the type of dialysis.

Indications
Timentin indicated for the treatment of infections caused by pathogens with established or suspected sensitivity, such as:

 

  • Infections of bone and connective tissue caused by beta-lactamase producing strains of Staphylococcus aureus
  • Gynecological infections, including endometritis induced beta-lactamase producing strains of Bacteroides melaninogenicus #, species Enterobacter (including E. cloacae #), Escherichia coli, Klebsiella pneumoniae #, Staphylococcus aureus and Staphylococcus epidermidis
  • Intraabdominal infections, including peritonitis caused by beta-lactamase producing strains of Escherichia coli, Klebsiella pneumoniae and Bacteroides fragilis #
  • Lower respiratory tract infections caused by beta-lactamase producing strains of Staphylococcus aureus, Haemophilus influenzae # and Klebsiella species #
  • Septicemia including bacteremia caused by beta-lactamase producing strains of Klebsiella species #, E. coli #, Staphylococcus aureus #, Pseudomonas aeruginosa # (and other Pseudomonas species #)
  • Infections of the skin and subcutaneous tissue caused by beta-lactamase producing strains of Staphylococcus aureus, Klebsiella species # and E. coli #
  • Urinary tract infections (complicated and uncomplicated) caused by beta-lactamase-producing strains of E. coli, Klebsiella species, Pseudomonas aeruginosa # (and other Pseudomonas species #), Citrobacter species #, Enterobacter cloacae #, Serratia marcescens # and Staphylococcus aureus #

 

The efficacy against microorganisms clen marked with #, was shown for less than 10 infections in each nosological group.

Contraindications
: Hypersensitivity to beta-lactam antibiotics (including penicillins and cephalosporins) .Preparat contraindicated in premature babies with impaired renal function.

Precautions
Very rarely reported of hypokalemia during treatment with the drug. Therefore, caution should be exercised when administered to patients with an imbalance of electrolytes and fluids. It recommended periodic monitoring of potassium serum levels in patients receiving long-term medication. In some patients, the treatment timentin observed a moderate increase in alanine aminotransferase and aspartate. In this regard, patients with severe hepatic impairment Timentin function should be used with caution.

pregnancy and lactation Pregnancy Studies in animals have teratogenic effects of the drug were found. There are limited data on its use during pregnancy. The decision on the appointment of the drug during pregnancy should be taken with extreme caution. In this regard, the appointment of timentin pregnant women physician should carefully weigh the potential benefits and potential risks associated with the use of this drug.

Lactation
Timentin can be given during lactation, but taking into account that trace amounts of the drug passes into breast milk, it is necessary to take into account the risk of sensitization in the newborn.

Dosing and Administration
Timentin administered intravenously:. Jet slowly (over 3-4 minutes) or drip (for 20-30 minutes)
intervals between infusions should be at least 4 hours.
Treatment should continue for 48-72 hours after the disappearance clinical symptoms.

SIDE EFFECTS Reactions giperchuvstvitelyyusti Skin rash, itching, hives, anaphylactic reactions. Very rare – bullous reactions (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis). When clen all reactions giperchuvstvitelyyusti timentin use should be discontinued.