Temocillin revived

David Livermore, Paul M. Tulkens

Research output: Contribution to journalEditorial

82 Citations (Scopus)

Abstract

Resistance in Gram-negative pathogens is an increasing concern, with carbapenems often appearing as the only acceptable treatment option in serious infections. Reviving older compounds that have fallen into disuse may help to alleviate this burden. Temocillin (6-α-methoxy-ticarcillin) is resistant to most if not all classical and extended-spectrum β-lactamases and to AmpC enzymes. It is also chemically stable, allowing administration by continuous infusion. Pharmacokinetic/pharmacodynamic analysis, aided by Monte-Carlo simulations, suggests a breakpoint of 8 mg/L for the registered maximum dosage of 4 g daily. Temocillin's weaknesses, explaining its limited previous use, are a lack of activity against Gram-positive organisms, anaerobes and Pseudomonas. In settings where these are unlikely or are covered by other agents, temocillin may be useful, potentially 'sparing' carbapenems and having little apparent potential to select for Clostridium difficile.

Original languageEnglish
Pages (from-to)243-245
Number of pages3
JournalJournal of Antimicrobial Chemotherapy
Volume63
Issue number2
DOIs
Publication statusPublished - 2009

Keywords

  • AmpC
  • ESBLs
  • α-methoxy penicillins

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