The Hip: Preservation, Replacement and Revision

Carbenicillin/Geocillin/Geopen/Pyopen


- See:
      - AnitPseudo
      - Penicillin Family

- Useful for infections caused by Pseudomonas and Proteus;
- There are small differences in the pattern of activity of these agents against gram-negative organisms.  Ticarcillin is two to four times more active than carbenicillin against P. aeruginosa
- more active against gram positive organisms;
- Adult: 4-8 gm q4hr Injection/PO;
- When used alone note appearance of resistent gram negative bacteria;
- For uncomplicated UTI: 500mg tab PO q6h or 1-2 gm IM/IV q6h;
- Serious UTI: 200mg/kg/day by continuous infusion;
- For serious infections outside the urinary tract: 300-500 mg/kg/day in divided doses or by continuous infusion;
- w/ osteomyelitis
  Dose IV     time p admin.  Mean Ser conc (ug/ml)    Mean Bone conc (ug/gm)
  5gm/4hr         90 min          204                      24.5
- Dosing Regimens for Patients with Renal Insufficiency: (Dose for70kg Adult
    {gm/dosing interval in hours}):CrCl:>80:3/4-6; CrCl:50-79:3/4-6; CrCl:30-49::3/6-8;; CrCl:10-29::3/8-12;;
- Note high sodium content (4.7mEq Na/gm) or parental Carbenicillin, may produce fluid overload;
- Good diffusion from blood into CSFonly with inflammation, but insufficient for Pseudomonas; Ratio of CSF to Blood Level (%): Normal Meninges: 15; Inflammed Meninges: 20;
- Will interact with aminoglycosides, Oral Anticoagulants, Oral contra



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, November 30, 2012 2:43 pm