Antipseudomonals
The extended-spectrum penicillins can be categorized into two classes:
carboxypenicillins and ureidopenicillins. The major antimicrobial agent in the
carboxypenicillin class is ticarcillin and in the ureidopenicillin class is
piperacillin. These agents have similar spectra of activity as ampicillin.
Ampicillin has activity against most streptococci, enterococci,
nonbeta-lactamase-producing species of Haemophilus influenzae, and gram-
negative enteric pathogens, such as Escherichia coli. Ticarcillin and
piperacillin have extended activity against many gram-negative organisms,
including Proteus, Enterobacter, and Pseudomonas sp.
Ticarcillin and piperacillin rarely are indicated in community-acquired
infections; they are used frequently in combination with other antimicrobial
agents for empiric therapy of nosocomial pneumonia, bacteremia, and urinary
tract infections. The gram-positive
coverage of these two agents can be improved for methicillin-susceptible
Staphylococcus aureus by the addition of a beta-lactamase inhibitor (ticarcillin-clavulanic
acid or piperacillin-tazobactam). However, the beta-lactamase inhibitor might
not improve the gram-negative coverage, such as for Pseudomonas.
References:
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