Its primary use is against Enterobacteriaceae, and in particular against strains producing extended-spectrum β-lactamase or AmpC β-lactamase.[5] Temocillin is also usually active against KPC-producing K. pneumoniae, and synergistic activity has been demonstrated when administered alongside fosfomycin.[6]
Dosage
The common dose is 2 g intravenously every 12 hours and the high dose, notably in critically ill patients, is 2g every 8 hours. Theoretical reasons exist for giving temocillin as a continuous intravenous infusion in severe disease[7][8] a single loading dose of 2 g is given intravenously followed by a 4-g or 6-g infusion over 24 hours. According to the SPC, chemical and physical in-use stability has been demonstrated for 24 hours at 25 °C for the following solvents: water for injection, physiological saline (0.9% sodium chloride), dextrose 5%, sodium chloride compound (Ringer's solution), Hartmann solution (sodium lactate compound + Ringer's lactate solution).
Temocillin for intravenous injection is diluted in 10 to 20 ml of sterile water; it is diluted in less than 2 ml of sterile water when being prepared for intramuscular injection; the continuous infusion is diluted in 48 ml of sterile water for ease of administration (2 ml per hour). To reduce pain, the intramuscular injection may be made up using sterile 1% lignocaine instead of sterile water.[citation needed]
Temocillin may be given to patients with impaired renal function after the dose has been adapted:
Creatinine clearance (mL/min)
Dosage per administration
Interval between administrations
More than 60
2 g
12 h
60 to 30
1 g
12 h
30 to 10
1 g
24 h
In case of intermittent high-flux hemodialysis: 1 g (I.V. injection) per 24 h of inter-dialytic session, preferably at the end of the hemodialysis (1 g q24 h, 2 g q48 h, 3 g q72 h).
In case of continuous peritoneal dialysis in ambulatory patients: 1 g every 24 hours.
No oral preparation of temocillin is licensed.
Adverse effects
The undesirable effects of temocillin are those of any β-lactam antibiotic. In particular, it has been associated with angioedema and anaphylaxis in penicillin-allergic patients. Animal studies have not shown any induction of Clostridioides difficile infection.[9] As with any other penicillin, convulsions can occur if very high doses are given.[citation needed]
^Chanal M, Sirot J, Cluzel M, Joly B, Glanddier Y (June 1983). "[In vitro study of the bacteriostatic and bactericidal activity of temocillin (BRL 17421)]". Pathologie-Biologie (in French). 31 (6): 467–470. PMID6348653.
