Temocillin
General Information
A penicillin antibiotic. Do NOT use if patient is allergic to penicillin.
Restricted formulary antimicrobial: For details see OUH netFormulary
AWaRe antibiotic classification: 'Watch'. Use as per guidelines.
Standard dose
2g IV BD
For bacteraemia with susceptible organism or in critically unwell patients: the dose can be increased to 2g IV TDS.
Obesity
Dosing for penicillins should be at the upper end of recommended ranges, particularly for morbidly obese patient with severe infections, considering patient’s renal function.
Renal and hepatic impairment
Renal impairment
Note: Accumulation of sodium from injection can occur in patients with renal failure.
|
Creatinine clearance (mL/min) |
Where the usual dose would be 2g BD temocillin |
Where the usual dose would be 2g TDS temocillin |
|
More than 60 |
No adjustment |
No adjustment |
|
40-60 |
No adjustment |
2g BD |
|
20-40 |
2g STAT then 1g BD |
|
|
less than 20 |
2g STAT then 1g OD |
|
Note: dose ranges use creatinine clearance, rather than eGFR.
Hepatic impairment
No dose adjustment required in hepatic impairment.
Notable Interactions
Methotrexate: Temocillin can reduce excretion of methotrexate (increased risk of toxicity).
Vitamin K antagonists: Appropriate monitoring should be undertaken. It would be prudent to monitor coagulation status within 3 days of starting or stopping a penicillin.
This is not a complete list. Please see the BNF, Summary of Product Characteristics or speak to a pharmacist.
Pregnancy and breastfeeding
Pregnancy
Discuss with pharmacy
Breastfeeding
Caution. Discuss with pharmacy. Very little published evidence: trace amounts in milk.
Additional information
- 2g of temocillin contains approximately 10mmol of sodium. Accumulation of sodium from injection can occur with high doses and in patients with renal failure.
- Monitor potassium. Risk of hypokalaemia in patients with low potassium reserves and those who are receiving cytotoxic therapy or diuretics.
References
- EUMEDICA SA. Negaban 1 g, powder for solution for injection/infusion summary of product characteristics: Electronic Medicines Compendium [Internet]. Revision date: 26/1/18. Accessed January 2024. Available from: https://www.medicines.org.uk/emc/product/466
- Joint Formulary Committee. British National Formulary (BNF). Accessed january 2024 Available from: https://www.medicinescomplete.com
- The Renal Drug Database. Temocillin [Internet]. Last update 4/7/2023 Accessed january 2024. Available from: https://renaldrugdatabase.com/monographs/temocillin
- UK Teratology Information Service. Use of penicillins in pregnancy [Internet]. 2019 [cited 2023 Oct 12]. Available from: https://uktis.org/monographs/use-of-penicillins-in-pregnancy/
- Specialist Pharmacy Service. Temocillin – Lactation Safety Information [Internet]. Last update November 2020. Accessed january 2024. Available from: https://www.sps.nhs.uk/medicines/temocillin/
- UK Medicines Information. How should antibiotics be doses in obesity – last updated 2017 Mar 1. Accessed via: https://www.gloshospitals.nhs.uk/media/documents/Obese_Dosing_2016_update.pdf [Accessed january 2024].