temocillin (Temopen)
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Introduction
Used in UK, France, Belgium, Luxenberg, Iran.
Designated orphan drug by FDA to treat Burkholderia cepacia lung infection in patients with cystic fibrosis[3]
Indications
- treatment of multiple drug-resistant, Gram-negative bacteria
- especially extended spectrum beta-lcatamase producing Enterobacteriaceae
- urinary tract infection including pyelonephritis
Contraindications
- not active against Gram-positive bacteria or bacteria with altered penicillin-binding proteins
Dosage
- 2 g IV every 8-12 hours
Dosage adjustment in renal failure
Table
| eGFR* | dosage |
|---|---|
| 60 mL/min | 2 grams every 12 hours |
| 30-60 mL/min | 1 gram every 12 hours |
| 10-30 mL/min | 1 gram every 24 hours |
eGFR*: estimated glomerular filtration rate
Antimicrobial activity
- Moraxella catarrhalis
- Brucella abortus
- Burkholderia cepacia
- Citrobacter species
- Escherichia coli
- Haemophilus influenzae
- Klebsiella pneumoniae
- Pasteurella multocida
- Proteus mirabilis
- Salmonella typhimurium
- Yersinia enterocolitica
- active against some Enterobacter species, Morganella morganii, Serratia species
- no activity against Acinetobacter species or Pseudomonas aeruginosa
Adverse effects
- common adverse events were diarrhea & abdominal pain
- angioedema & anaphylaxis in penicillin-allergic patients
- convulsions at very high doses[2]
Mechanism of action
- beta latamase-resistant penicillin
- less disturbance of the intestinal microbiota than cefotaxime, with significantly lower Enterobacterales
- low C difficile colitis risk vs cephalosporins & carbapenems
More general terms
References
- ↑ Alexander W 'Forgotten Antibiotic' Temocillin Disturbs Intestinal Microbiota Less Than Cefotaxime in Febrile UTIs Medscape. November 02, 2021 https://www.medscape.com/viewarticle/962055
Edlund C, Ternhag A, Skoog Stahlgren G et al The clinical and microbiological efficacy of temocillin versus cefotaxime in adults with febrile urinary tract infection, and its effects on the intestinal microbiota: a randomised multicentre clinical trial in Sweden. Lancet Infect Dis. 2021 Oct 28:S1473-3099(21)00407-2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34756180 https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00407-2/fulltext - ↑ 2.0 2.1 Wikipedia: Temocillin https://en.wikipedia.org/wiki/Temocillin
- ↑ 3.0 3.1 Balakrishnan I, Koumaki V, Tsakris A Temocillin: Is this the right momentum for its global use? Future Medicine. 2019. Jan 15. https://www.futuremedicine.com/doi/10.2217/fmb-2018-0316