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temocillin (Temopen)
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
General
penicillin
Database Correlations
PUBCHEM correlations
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: 34756180
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00407-2/fulltext
- Wikipedia: Temocillin
https://en.wikipedia.org/wiki/Temocillin
- 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