Intraperitoneal penetration of ticarcillin/clavulanic acid (Timentin)

Area of Science:

• Pharmacology
• Surgical Antibiotic Prophylaxis

Background:

• Effective antibiotic prophylaxis is crucial in abdominal surgery to prevent surgical site infections.
• Understanding the pharmacokinetic profile of antibiotics in peritoneal fluid is essential for optimizing dosing strategies.

Purpose of the Study:

• To evaluate the penetration and distribution of ticarcillin and clavulanic acid into peritoneal fluid after intravenous administration in patients undergoing elective abdominal surgery.
• To compare serum and peritoneal fluid levels of ticarcillin and clavulanic acid over time.

Main Methods:

• Thirty-eight patients received a single intravenous dose of ticarcillin (3.0 g) plus clavulanic acid (0.2 g) prior to surgery.
• Peritoneal fluid and serum samples were collected at varying times for drug level analysis using sterile assay discs.
• Pharmacokinetic parameters, including drug concentrations and half-lives, were determined for both serum and peritoneal fluid.

Main Results:

• Both ticarcillin and clavulanic acid demonstrated rapid penetration into peritoneal fluid.
• Mean peritoneal fluid levels were approximately 70% of serum levels for ticarcillin and 67% for clavulanic acid.
• Drug levels in peritoneal fluid declined in parallel with serum levels, with a half-life of approximately 1 hour for both agents. The ratio of ticarcillin-clavulanic acid in serum and peritoneal fluid remained consistent over time.

Conclusions:

• Intravenous ticarcillin plus clavulanic acid achieves rapid and significant concentrations in peritoneal fluid following elective abdominal surgery.
• The pharmacokinetic profile suggests that standard dosing regimens provide adequate peritoneal antibiotic coverage.
• These findings support the use of ticarcillin and clavulanic acid for surgical prophylaxis in abdominal procedures.