Azlocillin

Intravenous
Infections due to Pseudomonas aeruginosa, Peritonitis, Respiratory tract infections, Septicaemia, Urinary tract infections

Dose reduction may be required if patient also has severe hepatic impairment.

CrCl	Dosage
<30	Increase dosing interval to 12 hr.

Dose reduction may be required if patient also has severe renal impairment.

Incompatible with aminoglycosides, ciprofloxacin, metronidazole and tetracyclines.

Hypersensitivity to penicillins.

Restricted sodium diet. Very high doses in poor renal function (risk of neurotoxicity) or heart failure. Avoid contact, skin sensitization may occur. Monitor serum potassium concentration, renal and haematological status. Spirochete infections particularly syphilis; suprainfection with penicillin-resistant organisms with prolonged use; avoid intrathecal route.

Pain at the inj site and phlebitis; electrolyte disturbances; dose-dependent coagulation defect; purpura and haemorrhage; hypersensitivity reactions including uticaria; fever; joint pains; rashes; angioedema; serum sickness-like reactions; haemolytic anemia; interstitial nephritis; neutropenia; thrombocytopenia; CNS toxicity including convulsions; diarrhoea; antibiotic-associated colitis.
Potentially Fatal: Anaphylaxis.

Probenecid prolongs T_1/2 of azlocillin. Bacteriostatic drugs eg chloramphenicol, tetracyclines; other antibacterials; anticoagulants.

May interfere with diagnostic tests for urinary glucose using copper sulfate, direct Coomb's test, and test for urinary or serum proteins. May interfere with diagnostic tests that use bacteria.

Description: Antimicrobial action is similar to piperacillin and includes activity against a wide range of gram-negative organisms including Klebsiella pneumoniae. Activity in vitro against Enterobacteriaceae is generally <that of mezlocillin or piperacillin but has comparable activity to piperacillin against Pseudomonas aeruginosa.
Pharmacokinetics:
Absorption: Not absorbed significantly in the GI tract.
Distribution: Protein binding: 20-46%. Widely distributed and crosses the placenta.
Metabolism: Metabolised to a limited extent.
Excretion: About 50-70% of a dose is excreted unchanged in the urine within 24 hr. Also excreted in the bile. Plasma half-life: About 1 hr. Removed by haemodialysis.

Penicillins