Search
carbenicillin; carindacillin (Geocillin)
Tradename: Geocillin. 4th generation penicillin. (carbenicillin indanyl sodium)
Indications:
- treatment of bacterial infections due to susceptible organisms
a) treatment of upper & lower urinary tract infections
b) asymptomatic bacteriuria
c) prostatitis
Contraindications:
-> severe renal impairment (creatinine clearance < 10 mL/min)
Dosage:
1) urinary tract infection: 382-764 mg PO QID for 10 days or longer
2) prostatitis 764 mg QID for 2-4 weeks or longer
3) children:
a) 30-50 mg/kg/day divided QID
b) maximum 2-3 g/day
4) take with water; tablet have bitter taste
Tabs: 382 mg. (23 mg of Na+/tab) Dose adjustment in renal failure:
creatinine clearance dosage
10-50 mL/min dose every 12-24 hours
< 10 mL/min avoid use
Pharmacokinetics:
1) oral absorption: 30-40%
2) distribution
a) crosses placenta
b) small amounts appear in breast milk
c) distributes into the bile
d) low concentrations in CSF
3) protein binding 50%
4) 1/2 life 1-1.5 hours (adults), prolonged in patients with renal insufficiency
5) time to peak concentration: 0.5-2 hours
6) 80-85% excreted unchanged in the urine
7) serum concentrations insufficient for treatment of systemic infections
8) moderately dializable (20-50%)
Antimicrobial activity:
- Pseudomonas aeruginosa [4]
- Providencia
- Morganella morganii
- Escherichia coli
- Proteus
- Enterococcus
- Enterobacter [4]
Adverse effects:
1) common (> 10%)
- diarrhea
2) less common (1-10%)
- nausea/vomiting, taste disturbance, flatulence, glossitis
3) uncommon (< 1%)
- headache, skin rash, urticaria, anemia, thrombocytopenia, leukopenia, neutropenia, eosinophilia, hyperthermia, itchy eyes, vaginitis, hypokalemia, hematuria, thrombophlebitis
Drug interactions:
- give at least 1 hour prior to aminoglycosides
Laboratory:
1) specimen:
a) serum, plasma (heparin, EDTA)
b) stable in solution for 15 days at 5 degrees C
2) methods: MB, HPLC
Test interactions:
1) false positive urine protein
2) serum protein
3) false positive urine glucose (clinitest)
Interactions
drug interactions
General
4th generation penicillin (extended-spectrum)
Properties
MISC-INFO: elimination route KIDNEY
1/2life 1.1 HOURS
protein-binding 50%
elimination by hemodialysis +/-
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed.,
W.B. Saunders, 1995
- Deprecated Reference