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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/15 22:08:42」(JST)

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Ticarcillin is a carboxypenicillin. It is almost invariably^{[citation needed]} sold and used in combination with clavulanate as Timentin. Because it is a penicillin, it also falls within the larger class of beta-lactam antibiotics. Its main clinical use is as an injectable antibiotic for the treatment of Gram-negative bacteria, particularly Pseudomonas aeruginosa. It is also one of the few antibiotics capable of treating Stenotrophomonas maltophilia infections.

It is provided as a white or pale-yellow powder. It is highly soluble in water, but should be dissolved only immediately before use to prevent degradation.

Mechanism of action

Ticarcillin's antibiotic properties arise from its ability to prevent cross-linking of peptidoglycan during cell wall synthesis, when the bacteria try to divide, causing cell death.

Ticarcillin, like penicillin, contains a β-lactam ring that can be cleaved by beta-lactamases, resulting in inactivation of the antibiotic. Those bacteria that can express β-lactamases are, therefore, resistant to β-lactam antibiotics. Due, at least in part, to the common β-lactam ring, ticarcillin can cause reactions in patients allergic to penicillin. Ticarcillin is also often paired with a β-lactamase inhibitor such as clavulanic acid (co-ticarclav).

Other uses

In molecular biology, ticarcillin is used to as an alternative to ampicillin to test the uptake of marker genes into bacteria. It prevents the appearance of satellite colonies that occur when ampicillin breaks down in the medium. It is also used in plant molecular biology to kill Agrobacterium, which is used to deliver genes to plant cells.

Dosing and posology

Ticarcillin is not absorbed orally, so must be given by intravenous or intramuscular injection.

Trade names and preparations

Ticarcillin: Ticar was formerly marketed by Beecham, then SmithKline Beecham until 1999, when it merged with Glaxo to form GlaxoSmithKline; it is no longer available in the UK. US distribution ceased in 2004. Ticar was replaced by Timentin.
Ticarcillin/clavulanate: Timentin, in Australia, the UK, and the US, was marketed by Beecham, then GlaxoSmithKline.

Synthesis

Carbenicillin is used in the clinic primarily because of its low toxicity and its utility in treating urinary tract infections due to suceptible Pseudomonas species. Its low potency, low oral activity, and suceptibility to bacterial beta-lactamases make it vulnerable to replacement by agents without these deficits. One contender in this race is ticaricillin. It's origin depended on the well-known fact that a divalent sulfur is roughly equialent to a vinyl group (cf methiopropamine, sufentanil, pizotyline etc).

Ticarcillin synthesis: GEORGE BRAIN EDWARD, CHARLES NAYLER JOHN HERBERT; BE 646991 (1964 to Beecham).

One synthesis began by making the monobenzyl ester of 3-Thienylmalonic acid, converting this to the acid chloride with SOCl2, and condensing it with 6-Aminopenicillanic acid (6-APA). Hydrogenolysis (Pd/C) completed the synthesis of ticarcillin.

UpToDate Contents

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1. ペニシリン penicillins
2. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock
3. β-ラクタマーゼ阻害剤、カルバペネム系、およびモノバクタム系抗菌薬の併用 combination beta lactamase inhibitors carbapenems and monobactams
4. 成人における重症敗血症および敗血症性ショックの評価およびマネージメント evaluation and management of severe sepsis and septic shock in adults
5. 化膿性（敗血症性）血栓性静脈炎 suppurative septic thrombophlebitis

English Journal

High level of resistance to Aztreonam and Ticarcillin in Pseudomonas aeruginosa isolated from soil of different crops in Brazil.

Pitondo-Silva A1, Martins VV1, Fernandes AF1, Stehling EG2.Author information 1Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Ribeirão Preto, Brazil.2Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Ribeirão Preto, Brazil. Electronic address: elianags@usp.br.AbstractPseudomonas aeruginosa can be found in water, soil, plants and, human and animal fecal samples. It is an important nosocomial pathogenic agent characterized by an intrinsic resistance to multiple antimicrobial agents and the ability to develop high-level (acquired) multidrug resistance through some mechanisms, among them, by the acquisition of plasmids and integrons, which are mobile genetic elements. In this study, 40 isolates from Brazilian soil were analyzed for antibiotic resistance, presence of integrons and plasmidial profile. The results demonstrated that the vast majority of the isolates have shown resistance for aztreonam (92.5%, n=37) and ticarcillin (85%, n=34), four isolates presented plasmids and eight isolates possess the class 1 integron. These results demonstrated that environmental isolates of P. aeruginosa possess surprising antibiotic resistance profile to aztreonam and ticarcillin, two antimicrobial agents for clinical treatment of cystic fibrosis patients and other infections occurred by P. aeruginosa.
The Science of the total environment.Sci Total Environ.2013 Dec 22;473-474C:155-158. doi: 10.1016/j.scitotenv.2013.12.021. [Epub ahead of print]
Pseudomonas aeruginosa can be found in water, soil, plants and, human and animal fecal samples. It is an important nosocomial pathogenic agent characterized by an intrinsic resistance to multiple antimicrobial agents and the ability to develop high-level (acquired) multidrug resistance through some
PMID 24369293

Stability and compatibility of antimicrobial lock solutions.

Bookstaver PB, Rokas KE, Norris LB, Edwards JM, Sherertz RJ.Author information P. Brandon Bookstaver, Pharm. D., BCPS (AQ-ID), AAHIVP, is Associate Professor and Vice Chair, Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy (SCCP), University of South Carolina Campus, Columbia. Kristina E. E. Rokas, Pharm.D., is Postgraduate Year 2 Infectious Diseases Resident, Department of Pharmacy, Wake Forest Baptist Health, Winston-Salem, NC. LeAnn B. Norris, Pharm.D., BCPS, BCOP, is Assistant Professor, Department of Pharmacy Practice and Outcomes Sciences; and Julie M. Edwards is a Pharm.D. candidate, SCCP, University of South Carolina Campus. Robert J. Sherertz, M.D., is Professor Emeritus, School of Medicine, Wake Forest University, Winston-Salem.AbstractPURPOSE: Published stability and compatibility data on a growing array of solutions used for antimicrobial lock therapy (ALT) are reviewed.
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.Am J Health Syst Pharm.2013 Dec 15;70(24):2185-98. doi: 10.2146/ajhp120119.
PURPOSE: Published stability and compatibility data on a growing array of solutions used for antimicrobial lock therapy (ALT) are reviewed.SUMMARY: ALT involves the instillation of a highly concentrated antimicrobial, often in combination with an anticoagulant, into a central venous catheter (CVC) l
PMID 24296841

Is Chryseobacterium indologenes a shunt-lover bacterium? A case report and review of the literature.

Ozcan N, Dal T, Tekin A, Kelekci S, Can S, Ezin O, Kandemir I, Gul K.Author information Dicle University Medical Faculty, Department of Medical Microbiology; Dicle University Medical Faculty, Department of Pediatrics, Diyarbak?r, Turkey.AbstractChryseobacterium indologenes is a non-fermentative Gram-negative bacillus formerly belonging to the Flavobacterium genus. It is widely found in water and soil, also on wet surfaces of the hospital environment. It rarely causes infections and is usually associated with altered immune status or indwelling devices. We present a case of ventriculoperitoneal shunt infection caused by C. indologenes in a premature pediatric patient. A six-month-old male infant with congenital hydrocephalus and ventriculoperitoneal shunt was admitted with complaints of irritability, high fever and projectile vomiting. He was diagnosed as suffering from meningitis based on the clinical symptoms and laboratory findings of cerebrospinal fluid. The ventriculoperitoneal shunt was externalized and cerebrospinal fluid samples were sent for bacterial cultures. The isolated bacterium was identified as C. indologenes by conventional methods and the BD Phoenix 100 (Becton Dickinson, MD, USA) fully automated microbiology system. Antimicrobial susceptibility testing was performed by the microdilution method and Kirby-Bauer's disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines. The isolate was found susceptible to ciprofloxacin, levofloxacin, cefoperazone and trimethoprim-sulfamethoxazole, while it was resistant to amikacin, aztreonam, cefepime, ceftazidime, gentamicin, imipenem and ticarcillin-clavulanic acid. The treatment was started with trimethoprim-sulfamethoxazole and cefoperazone-sulbactam The ventriculoperitoneal shunt was then removed. The patient was fully healed after two weeks and discharged. Central nervous system infection is a rare form of C. indologenes infections. The case presented herein may make a useful contribution to the existing literature.
Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive.Infez Med.2013 Dec 1;21(4):312-6.
Chryseobacterium indologenes is a non-fermentative Gram-negative bacillus formerly belonging to the Flavobacterium genus. It is widely found in water and soil, also on wet surfaces of the hospital environment. It rarely causes infections and is usually associated with altered immune status or indwel
PMID 24335463

Japanese Journal

Antibiotic Resistance and Extended-Spectrum β-Lactamases in Isolated Bacteria from Seawater of Algiers Beaches (Algeria)

ALOUACHE SOUHILA,KADA MOHAMED,MESSAI YAMINA [他],ESTEPA VANESA,TORRES CARMEN,BAKOUR RABAH
Microbes and environments 27(1), 80-86, 2012-03-01
… The most significant resistance rates were observed for amoxicillin and ticarcillin, whereas they were relatively low for ceftazidime, cefotaxime and imipenem. … ticarcillin, 19.6% and 47.7%), and for 2 sites relatively preserved from anthropogenic influence, resistance rates were lowest (amoxicillin, 1.5% and 16%; … ticarcillin, 0.8% and 2.6%). …
NAID 10030122942

Aeromonas hydrophila subsp. dhakensis Isolated from Feces, Water and Fish in Mediterranean Spain

Esteve Consuelo,Alcaide Elena,Blasco María Dolores
Microbes and Environments 27(4), 367-373, 2012
… They were all resistant to ticarcillin, amoxicillin-clavuranic acid, cefoxitin, and imipenem, regardless of its source. …
NAID 130001877548

In vitro flowering and viable seed setting of transgenic lettuce cultures

Franklin G.,Oliveira A. L.,Dias [他]
Plant biotechnology 28(1), 63-68, 2011-03-25
… Transgenic calluses and shoot buds were induced on MS medium augmented with 0.1 mg l－1 benzyladenine (BA), 0.1 mg l－1 α-naphtaleneacetic acid (NAA), 100 mg l－1 kanamycin and 500 mg l－1 timentin (ticarcillin clavulanate). …
NAID 10028258605

Related Pictures

★リンクテーブル★

リンク元	「抗菌薬」「チカルシリン」
拡張検索	「ticarcillin sodium/potassium clavulanate mixture」「ticarcillin sodium」

「抗菌薬」

Ticarcillin
Systematic (IUPAC) name
	(2S,5R,6R)-6-{[(2R)-2-carboxy-2-(3-thienyl)acetyl]amino}-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid
Clinical data
AHFS/Drugs.com	monograph
MedlinePlus	a685037
Pregnancy; category	AU: B2; US: B (No risk in non-human studies);
Legal status	℞ (Prescription only);
Routes of; administration	Intravenous
Pharmacokinetic data
Protein binding	45%
Biological half-life	1.1 hours
Excretion	Renal
Identifiers
CAS Registry Number	34787-01-4
ATC code	J01CA13 J01CR03
PubChem	CID: 36921
DrugBank	DB01607
ChemSpider	33876
UNII	F93UJX4SWT
KEGG	D08593
ChEBI	CHEBI:9587
ChEMBL	CHEMBL1449
Chemical data
Formula	C15H16N2O6S2
Molecular mass	384.429 g/mol
	SMILES O=C(O)[C@@H]2N3C(=O)[C@@H](NC(=O)[C@@H](c1ccsc1)C(=O)O)[C@H]3SC2(C)C ;
	InChI InChI=1S/C15H16N2O6S2/c1-15(2)9(14(22)23)17-11(19)8(12(17)25-15)16-10(18)7(13(20)21)6-3-4-24-5-6/h3-5,7-9,12H,1-2H3,(H,16,18)(H,20,21)(H,22,23)/t7-,8-,9+,12-/m1/s1 ; Key:OHKOGUYZJXTSFX-KZFFXBSXSA-N ;
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　　[★]

英: antibacterial drug, antibacterial
関: 抗生剤、薬理学、抗菌薬一覧、抗細菌薬

first aid step 1 2006 p.165

定義

細菌/微生物に静菌作用、殺菌作用を示す物質。結果として、人において病原性を除去する目的で使用される。
このうち、微生物によって産生される物質を抗生物質と呼ぶ

作用機序による分類

細胞壁合成阻害：βラクタム系抗菌薬(ペニシリン系抗菌薬、セフェム系抗菌薬、モノバクタム系抗菌薬、カルバペネム系抗菌薬)
核酸合成阻害　：ニューキノロン系抗菌薬、メトロニダゾール
タンパク質合成阻害

30S：アミノグリコシド系抗菌薬、テトラサイクリン系抗菌薬
50S：マクロライド系抗菌薬、クリンダマイシン、クロラムフェニコール、ストレプトグラミン系抗菌薬、オキソゾリニドン系抗菌薬(リゾネリド)

代謝拮抗：サルファ剤(サルファメソキサゾール、トリメトプリム)

first aid step 1 2006 p.165

	Mechanism of action	Drugs
1	Block cell wall synthesis by inhibition of peptidoglycan cross-linking	penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
2	Block peptidoglycan synthesis	bacitracin, vancomycin, cycloserine
3	Disrupt bacterial/fungal cell membranes	polymyxins
4	Disrupt fungal cell membranes	amphotericin B, nystatin, fluconazole/azoles
5	Block nucleotide synthesis	sulfonamides, trimethoprim
6	Block DNA topoisomerases	quinolones
7	Block mRNA synthesis	rifampin
8	Block protein synthesis at 50S ribosomal subunit	chloramphenicol, erythromycin/macrolides, lincomycin, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid
9	Block protein synthesis at 30S ribosomal subunit	aminoglycosides, tetracyclines, spectinomycin 　ATuSi　→　あつし

薬物動態

濃度依存性：アミノグリコシド系抗菌薬、ニューロキノロン系抗菌薬
時間依存性：βラクタム系抗菌薬

治療期間

小児

尾内一信 ; 第 39 回日本小児感染症学会教育講演 2 小児感染症の抗菌薬療法 -耐性菌時代の適正使用-

感染臓器・臨床診断	原因菌	投与期間（抗菌薬）
髄膜炎	インフルエンザ菌	7-10日
	肺炎球菌	10-14日
	髄膜炎菌	7-10日
	GBS，腸内細菌，リステリア	21日
中耳炎	＜2 歳	10日
中耳炎	2 歳≦	5-7日
咽頭炎	A 群連鎖球菌	10日(ペニシリン系薬)
咽頭炎	A 群連鎖球菌	5日(セフェム系薬)
肺炎	肺炎球菌，インフルエンザ菌	解熱後3-4日
	黄色ブドウ球菌	3-4週間
	マイコプラズマ，クラミジア	10-21日
腎臓、膀胱炎、腎盂腎炎	大腸菌，プロテウス，腸球菌	3日
腎臓、膀胱炎、腎盂腎炎	大腸菌，プロテウス，腸球菌	14日
骨髄炎	黄色ブドウ球菌	21日
骨髄炎	連鎖球菌，インフルエンザ菌	14日

主要な感染症の抗菌薬投与期間

感染レジマニュ p.27

骨	骨髄炎		4-6週
耳鼻咽喉	中耳炎		5-7日
	副鼻腔炎		5-14日
	A群溶連菌咽頭炎		10日
肺	肺炎	肺炎球菌	7-10日 or 解熱後3日間
		インフルエンザ菌	10-14日
		マイコプラズマ	14日(7-10日)
		レジオネラ	21日
	肺化膿症		28-42日
心臓	感染性心内膜炎	α連鎖球菌	2-4週
		黄色ブドウ球菌	4-6週
消化管	腸炎	赤痢菌	3日
		チフス	14日(5-7日)
		パラチフス
	腹膜炎	特発性	5日
		二次性	10-14日
胆肝膵	肝膿瘍	細菌性	4-8週
		アメーバ性	10日
尿路	膀胱炎		3日
	急性腎盂腎炎		14日(7-10日)
	急性腎盂腎炎・再発		6週
	慢性前立腺炎		1-3ヶ月
髄腔	髄膜炎	インフルエンザ菌	7-10日
		髄膜炎菌
		肺炎球菌	10-14日
		リステリア	21日
敗血症	敗血症	コアグラーゼ陰性ブドウ球菌	5-7日
		黄色ブドウ球菌	28日(14日)
		グラム陰性桿菌	14日(7-14日)
		カンジダ	血液培養陰性化後, 14日