Dosage
The common dosage is 2g intravenously every 12 hours. There are good theoretical reasons for giving Temocillin as a continuous intravenous infusion in severe disease: a single loading dose of 2g is given intravenously followed by a 4g infusion over 24 hours. Temocillin for intravenous injection is diluted in 20ml of sterile water; it is diluted in less than 2.7ml of sterile water when being prepared for intramuscular injection; the continuous infusion is diluted in 48ml of sterile water for ease of administration (1ml per half hour). To reduce pain, the intramuscular injection may be made up using sterile 1% lignocaine instead of sterile water.
Temocillin may be given to patients with impaired renal function. No adjustment needs to be made to the dose in mild to moderate renal impairment (creatinine clearance greater than 30ml/min). The manufacturer does not recommend using reduced doses, instead they recommend increasing the duration between doses. In severe renal impairment when it is 10 to 30, the dose is 1g in 24 hours; when less than 10, the dose is 1g every 48 hours. Temocillin is cleared by haemodialysis, which means that in dialysis patients, the dose should be given after dialysis.
There is no licensed oral preparation of temocillin.
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