Drug effective in pseudomonas infection is
The special feature of this penicillin congener is its activity against Pseudomonas aeruginosa and indole positive proteus which are not inhibited by PnG or aminopenicillins. It is less active against
a. Salmonella, E. coli and Enterobacter, while Klebsiella and Gram positive cocci are unaffected by it. Pseudomonas strains less sensitive to carbenicillin have developed in some areas, especially when inadequate doses have been used.
b. Carbenicillin is neither penicillinase-resistant nor acid resistant. It is inactive orally and is excreted rapidly in urine (Ph 1 hr). It is used as sodium salt in a dose of 1–2 g IM or 1–5 g IV every 4–6 hours. At the higher doses, enough sodium may be administered to cause fluid retention and CHF in patients with borderline renal or cardiac function.
c. High doses have also caused bleeding by interfering with platelet function. This appears to result from perturbation of agonist receptors on platelet surface.
d. The indications for carbenicillin are—serious infections caused by Pseudomonas or Proteus, e.g., bums, urinary tract infection, septicemia; but piperacillin is now preferred. It may be used together with gentamicin, but the two should not be mixed in the same syringe.
- It is more potent than carbenicillin against Pseudomonas, but other properties are similar to it.
- This antipseudomonal penicillin is about 8 times more active than carbenicillin. It has good activity against Klebsiella and is used mainly in neutropenic immunocompromised patients having serious Gram-negative infections, and in bums. Elimination Ph is 1 hr.
- Concurrent use of gentamicin or tobramycin is advised.
Antimicrobial agents active against