Ticarcillin Disodium

Antibiotic Penicillin (Extended-spectrum, Carboxypenicillin)

Dosage & Administration Guidelines

Species Route Dose Frequency Duration & Clinical Notes
Dog IV 33-50 mg/kg q6-8h Duration: 7-14 days or as clinically indicated
Notes: Administer slowly over 30 minutes. For severe infections, use higher end of dose range.
Cat IV 33-50 mg/kg q6-8h Duration: 7-14 days or as clinically indicated
Notes: Administer slowly over 30 minutes. Monitor renal function.
Horse IV 44-88 mg/kg q6h Duration: 5-10 days or as clinically indicated
Notes: Administer slowly over 30 minutes. For severe infections, use higher end of dose range.
Cattle IV or IM 33-50 mg/kg q6-8h Duration: 3-7 days or as clinically indicated
Notes: IV administration preferred. IM injection may cause pain and tissue irritation.
Small Ruminants (Sheep, Goats) IV or IM 33-50 mg/kg q6-8h Duration: 3-7 days or as clinically indicated
Notes: Extra-label use. IV preferred.
Rabbit IV or IM 50 mg/kg q8-12h Duration: 7-14 days or as clinically indicated
Notes: Extra-label use. Use cautiously in rabbits due to potential GI disturbances.

Clinical Indications & Species Uses

General Indications
  • Treatment of infections caused by susceptible Gram-negative bacteria, especially Pseudomonas aeruginosa
  • Septicemia
  • Pneumonia
  • Urinary tract infections
  • Skin and soft tissue infections
  • Bone and joint infections
Dog (Canine)
  • Treatment of infections caused by susceptible Gram-negative bacteria, especially Pseudomonas aeruginosa
  • Septicemia
  • Pneumonia
  • Urinary tract infections
  • Skin and soft tissue infections
  • Bone and joint infections
  • Intra-abdominal infections (in combination with other agents)
Cat (Feline)
  • Treatment of infections caused by susceptible Gram-negative bacteria, especially Pseudomonas aeruginosa
  • Septicemia
  • Pneumonia
  • Urinary tract infections
  • Skin and soft tissue infections
Horse (Equine)
  • Treatment of Gram-negative infections, particularly Pseudomonas aeruginosa
  • Septicemia
  • Pneumonia
  • Metritis
  • Wound infections
  • Post-operative infections
Cattle (Bovine)
  • Treatment of bovine respiratory disease complex (BRD) when caused by susceptible organisms
  • Septicemia
  • Metritis
  • Foot rot
  • Wound infections
Small Ruminants (Sheep / Goat)
  • Treatment of susceptible Gram-negative infections, including pneumonia and septicemia (extra-label use)
Rabbit & Small Mammals
  • Treatment of susceptible Gram-negative infections, especially Pseudomonas aeruginosa (extra-label use)

Pharmacology & Mechanism of Action

Drug Class: Antibiotic | Pharmacological Group: Penicillin (Extended-spectrum, Carboxypenicillin)

Mechanism of Action: Ticarcillin is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), thereby disrupting peptidoglycan cross-linking. This leads to cell lysis and death, primarily in actively dividing bacteria. It is bactericidal and has an extended spectrum compared to natural penicillins, including activity against many Gram-negative organisms, particularly Pseudomonas aeruginosa, and some anaerobes.

Pharmacodynamics: Ticarcillin exhibits time-dependent killing; its efficacy is best correlated with the time that plasma concentrations exceed the minimum inhibitory concentration (MIC) of the pathogen. It is generally more active against Pseudomonas aeruginosa than carbenicillin, but less active than piperacillin. It is susceptible to beta-lactamases, and is often combined with clavulanate to overcome resistance.

⚑ Pharmacokinetics Summary

Absorption: Ticarcillin is poorly absorbed after oral administration; therefore, it is administered parenterally (IV or IM). After IM injection, absorption is rapid but incomplete, with peak plasma concentrations achieved within 1-2 hours.
Distribution: Ticarcillin is widely distributed into body tissues and fluids, including pleural, peritoneal, and synovial fluids. It penetrates the blood-brain barrier poorly unless the meninges are inflamed. It crosses the placenta and is distributed into milk.
Metabolism: Ticarcillin undergoes minimal hepatic metabolism; the majority of the drug is excreted unchanged by the kidneys.
Excretion: Ticarcillin is primarily eliminated by renal tubular secretion and glomerular filtration. In animals with normal renal function, approximately 60-90% of the dose is excreted unchanged in the urine within 6-12 hours. Biliary excretion is minor.
Half-Life: Dog: 0.8-1.2 hours; Horse: 1.0-1.5 hours; Cattle: 1.5-2.0 hours; Cat: 1.0-1.5 hours (approximate).
Bioavailability: Oral bioavailability is negligible; therefore, it is administered parenterally. IM bioavailability is approximately 80-90%.
Protein Binding: Approximately 45-65% bound to plasma proteins in most species.

Available Formulations & Strengths

Injectable Solution (powder for reconstitution) 1 g, 3 g, 6 g vials (IV or IM)
Combination with Clavulanate (Timentin) 3 g ticarcillin + 0.1 g clavulanate per vial (IV)

Contraindications & Clinical Warnings

Contraindications:
  • Known hypersensitivity to penicillins or cephalosporins
  • Severe renal impairment (dose adjustment required)
  • Concurrent use with bacteriostatic antibiotics (e.g., tetracyclines, chloramphenicol) may antagonize bactericidal effect
Warnings & Clinical Precautions:
  • Use with caution in animals with renal impairment; adjust dose or extend dosing interval.
  • Use with caution in animals with a history of allergic reactions to beta-lactams.
  • Prolonged use may result in overgrowth of non-susceptible organisms (e.g., Candida, Clostridium difficile).
  • In horses, monitor for diarrhea and signs of colitis.
  • In ruminants, IM injection may cause tissue irritation; IV administration preferred.
  • Extra-label use in food animals requires veterinary oversight and extended withdrawal times.

Adverse Effects & Reactions

Common:

  • Pain at injection site
  • Phlebitis (with IV administration)
  • Gastrointestinal disturbances (nausea, diarrhea)

Serious / Severe:

  • Anaphylaxis
  • Acute interstitial nephritis
  • Neurotoxicity (seizures) at high doses, especially in renal impairment
  • Clostridial enterocolitis in horses

Rare:

  • Bleeding disorders (due to platelet dysfunction)
  • Electrolyte imbalances (hypernatremia, hypokalemia) with high doses
  • Hepatotoxicity

Key Drug Interactions

Interacting Drug / Class Clinical Effect & Mechanism Severity
Aminoglycosides (e.g., gentamicin, amikacin) Synergistic antibacterial effect; however, both drugs are nephrotoxic and ototoxic, so monitor renal function. Moderate
Probenecid Decreases renal tubular secretion of ticarcillin, increasing plasma concentrations and risk of toxicity. Moderate
Methotrexate Ticarcillin may reduce renal clearance of methotrexate, increasing its toxicity. High
Oral contraceptives (in humans, but relevant in research) May reduce efficacy of oral contraceptives; not directly applicable in veterinary medicine. Mild
Bacteriostatic antibiotics (e.g., tetracyclines, chloramphenicol) May antagonize the bactericidal effect of ticarcillin; avoid concurrent use. Moderate

Overdose & Toxicity Management

Signs of Toxicity:

  • Neurological signs including seizures
  • Encephalopathy
  • Electrolyte imbalances (hypernatremia, hypokalemia)
  • Gastrointestinal disturbances
  • Nephrotoxicity

Emergency Treatment Protocol: Treatment is primarily supportive. Discontinue the drug, provide fluid therapy to enhance renal excretion, and manage seizures with anticonvulsants (e.g., diazepam). In severe cases, hemodialysis may be considered. There is no specific antidote.

Food Animal Withdrawal Times

πŸ₯© Meat: 18 daysπŸ₯› Milk: 3 days

Withdrawal times are for cattle and are based on label recommendations for ticarcillin. For extra-label use in other food animals, consult a veterinarian and follow FARAD guidelines. Extended withdrawal times may be required.

Storage, Handling & Regulatory Information

Storage Temperature: Store powder at controlled room temperature (20-25Β°C). Reconstituted solution is stable for 24 hours at room temperature or 72 hours under refrigeration (2-8Β°C).

Handling & Special Conditions: Do not freeze. Discard unused portions after the stability period.

Dispensing Status: Prescription Required (Rx Only)

Approval Status: Approved for use in dogs, cats, and horses (as Timentin). Not approved for food animals in the US, but may be used extra-label.

Extra-Label (Off-Label) Use: In the US, extra-label use of ticarcillin in food animals is permitted under AMDUCA, provided there is a valid veterinarian-client-patient relationship, and withdrawal times are extended as per FARAD recommendations. Not approved for use in all species; use in minor species is extra-label.

Clinical Pearls & Practice Notes

πŸ’‘ Clinical Insights: Ticarcillin is a broad-spectrum penicillin with enhanced activity against Pseudomonas aeruginosa. It is often combined with clavulanate (Timentin) to overcome beta-lactamase resistance. Due to its short half-life, frequent dosing is required. It is primarily used in hospital settings for severe infections. In veterinary medicine, it is commonly used in dogs, cats, and horses for Gram-negative infections, especially those involving Pseudomonas. In food animals, its use is extra-label and requires careful consideration of withdrawal times. Monitoring renal function is important, especially in critically ill animals. Ticarcillin should be administered slowly IV to avoid adverse effects. It is not absorbed orally, so parenteral administration is mandatory.

References & Literature

  • πŸ“š Plumb's Veterinary Drug Handbook
  • πŸ“š Papich Veterinary Pharmacology and Therapeutics
  • πŸ“š Compendium of Veterinary Products (CVP)