Which medications in the drug class Penicillins are used in the treatment of Peritonitis and Abdominal Sepsis?

Updated: Jul 23, 2019
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

Penicillins

The penicillins are bactericidal antibiotics that work against sensitive organisms at adequate concentrations and inhibit the biosynthesis of cell wall mucopeptide.

Piperacillin and Tazobactam sodium (Zosyn)

Piperacillin is a semisynthetic extended-spectrum penicillin that inhibits bacterial cell wall synthesis by binding to specific penicillin-binding proteins; it is the most effective of the antipseudomonal penicillins.

Tazobactam increases piperacillin activity against S aureus, Klebsiella, Enterobacter, and Serratia species; the greatest increase is in activity against B fragilis. However, it does not increase anti–P aeruginosa activity.

Amoxicillin and clavulanate (Augmentin)

Amoxicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins; clavulanate inhibits beta-lactamase producing bacteria. This combination is a good alternative antibiotic for patients allergic or intolerant to the macrolide class. Usually, it is well tolerated, and provides good coverage for most infectious agents. It is not effective against Mycoplasma and Legionella species. The half-life of the oral dosage form is 1-1.3 hours. It has good tissue penetration but does not enter cerebrospinal fluid.

Ticarcillin and clavulanate potassium (Ticar)

This combination of an antipseudomonal penicillin with a beta-lactamase inhibitor provides coverage against most gram-positive and gram-negative organisms, as well as most anaerobes. It inhibits biosynthesis of cell wall mucopeptide and is effective during the stage of active growth.

Ampicillin (Omnipen, Marcillin)

Ampicillin interferes with bacterial cell wall synthesis during active multiplication, causing bactericidal activity against susceptible organisms. Dose adjustments may be necessary in renal failure. Rash should be evaluated carefully to differentiate nonallergic ampicillin rash from hypersensitivity reaction.


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