Neonatal Drug Therapy Manual

Ticarcillin/Clavulanic Acid

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Antibiotic with B-Lactamase Inhibitor
Original Date: 
February 2010
  • Treatment of lower respiratory tract infections due to Stenotrophomonas maltophilia when Septra cannot be used
  • IV intermittent infusion: over 30 - 60 minutes

- Dosages recommendations are based on ticarcillin component:

  • < 2 kg:
    • 0 - 7 days: 150 mg/kg/day divided Q12h
    • > 7 days: 225 mg/kg/day divided Q8h
  •   > 2 kg:
    • 0 - 7 days: 225 mg/kg/day divided Q8h
    • > 7 days: 300 mg/kg/day divided Q6h


Dosage adjustment required in renal and/or hepatic failure. Refer to available references or clinical pharmacist for dosage adjustment.

Side Effects: 
  • Endocrine and metabolic: hypernatremia, hypokalemia
  • GI: diarrhea, nausea, vomiting
  • Hematologic: leukopenia, decreased hemoglobin, inhibition of platelet aggregation, neutropenia, haemolytic anemia, thrombocytopenia
  • Hepatic: elevated ALT, AST, bilirubin
  • Local: thrombophlebitis, pain, swelling
  • Renal: elevated BUN, serum creatinine
Parameters to Monitor: 
  • Serum electrolytes
  • Periodic renal, hepatic and hematologic function tests
Reconstitution and Stability: 

IV intermittent infusion:

  • Ticarcillin/Clavulanate potassium 3.1 g
    • Add 13 mL SWFI. Take 15 mL (3.1 g) and add to 45 mL D5W
    • Final concentration: 50 mg/mL (of ticarcillin)

- Solutions Compatible: D5W, 0.9% NaCl

- Y-site Compatible: heparin, insulin, morphine, TPN, KCl

Incompatible: vancomycin, sodium bicarbonate

  • Separate administration from aminoglycoside (gentamicin, tobramycin) by at least 30 - 60 minutes

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