Ticarcillin / Clavulanate
Ticarcillin disodium and clavulanate potassium
Also known as: Timentin · Claventin · BRL-2288 · ticarcillinum natricum · BRL-14151K · kalii clavulanas · Ticarcillin/Clavulanic acid · Ticarcillin potassium clavulanate
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Sepsis | 40-50 mg/kg | IV | q6-8h | — | 🌎 NA |
| Susceptible infections | 15-50 mg/kg | IV, IM or SC | q6-8h | — | 🌎 NA |
| Pseudomonas sepsis/bacteremia | 20-50 mg/kg | IV | q6-8h | — | 🌎 NA |
| Adjunctive treatment of Pseudomonas otitis | 0.5 mL in each ear | topical | twice daily | — | 🌎 NA |
| Serious systemic infections | 15-25 mg/kg followed by CRI at 7.5-15 mg/kg/h | IV | CRI | As directed | 🌍 EU |
| Pseudomonas otitis (adjunct) | 0.25-0.5 ml of a 100 mg/ml injectable ticarcillin solution | topical | q8h | As directed | 🌍 EU |
- Sepsis: Dosed on the basis of ticarcillin content
- Susceptible infections: Dosed on the basis of ticarcillin content
- Pseudomonas sepsis/bacteremia: Dosed on the basis of ticarcillin content
- Adjunctive treatment of Pseudomonas otitis: Using the ticarcillin/clavulanic acid product (Timentin). Dilute according to manufacturer's directions, draw into 2 mL aliquots and freeze. Thaw and use each aliquot.
- Serious systemic infections: Initial bolus followed by continuous rate infusion
- Pseudomonas otitis (adjunct): Instil into the affected ear
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Sepsis | 40-50 mg/kg | IV | q6-8h | — | 🌎 NA |
| Pseudomonas sepsis/bacteremia | 40 mg/kg | IV | q6h | — | 🌎 NA |
| Resistant Pseudomonas infections | 50 mg/kg | IV or IM | 4 times daily | — | 🌎 NA |
| Susceptible infections | 15-50 mg/kg | IV, IM or SC | q6-8h | — | 🌎 NA |
| Serious systemic infections | 15-25 mg/kg followed by CRI at 7.5-15 mg/kg/h | IV | CRI | As directed | 🌍 EU |
| Pseudomonas otitis (adjunct) | 0.25-0.5 ml of a 100 mg/ml injectable ticarcillin solution | topical | q8h | As directed | 🌍 EU |
- Sepsis: Dosed on the basis of ticarcillin content
- Pseudomonas sepsis/bacteremia: Dosed on the basis of ticarcillin content
- Resistant Pseudomonas infections: May need more frequent dosing or constant rate infusion for resistant infections
- Susceptible infections: Dosed on the basis of ticarcillin content
- Serious systemic infections: Initial bolus followed by continuous rate infusion
- Pseudomonas otitis (adjunct): Instil into the affected ear
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Susceptible infections | 50 mg/kg | IV | q6h | — | 🌎 NA |
| Neonatal septicemia (Foals) | 40-60 mg/kg | IV or IM | q8h | — | 🌎 NA |
| Susceptible infections (Foals) | 50 mg/kg | IV or IM | q6-8h | — | 🌎 NA |
| Intrauterine infusion | 3-6 grams with a minimum of 200 mL of saline | Intrauterine | every 4-6 h | — | 🌎 NA |
- Susceptible infections: Dosed on the basis of ticarcillin content
- Neonatal septicemia (Foals): Dosed on the basis of ticarcillin content
- Susceptible infections (Foals): Dosed on the basis of ticarcillin content
- Intrauterine infusion: Mares need to be treated frequently in order to maintain drug concentrations above MIC.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Ticarcillin/clavulanate (Timentin®) is a powerful, injectable extended-spectrum penicillin (anti-pseudomonal penicillin) combined with a beta-lactamase inhibitor.
- Expanded Spectrum: The addition of clavulanate protects ticarcillin from enzymatic degradation, extending its efficacy against beta-lactamase-producing strains of E. coli, Pasteurella spp., Staphylococcus spp., Klebsiella, and Proteus.
- Clinical Pearl: It is particularly valued in veterinary medicine for its efficacy against Pseudomonas aeruginosa and is often reserved for severe, hospital-acquired infections, sepsis, or bacteremia.
- Alternative Uses: While primarily a systemic hospital drug, it is frequently compounded into an otic preparation for the adjunctive treatment of stubborn Pseudomonas ear infections in dogs.
Mechanism of action
Ticarcillin is a bactericidal beta-lactam antibiotic:
- Binds to specific Penicillin-Binding Proteins (PBPs) (such as transpeptidases and carboxypeptidases) located inside the bacterial cytoplasmic membrane.
- Inhibits bacterial cell wall mucopeptide synthesis → creates an osmotically unstable spheroplast → leads to cell lysis and death.
Clavulanate Potassium is a "suicide inhibitor":
- Competitively and irreversibly binds to beta-lactamase enzymes (including types II, III, IV, V, and staphylococcal penicillinases).
- Prevents these enzymes from hydrolyzing the beta-lactam ring of ticarcillin, thereby restoring and expanding its antimicrobial spectrum.
- Note: Type I beta-lactamases (often associated with E. coli, Enterobacter, and Pseudomonas) are generally not inhibited by clavulanic acid.
Safety & warnings
Contraindications
- Documented hypersensitivity to penicillins or other beta-lactam antibiotics
- Known hypersensitivity to penicillins or other beta-lactam antibiotics
Adverse effects
- Hypersensitivity reactions (allergic reactions)
- Platelet dysfunction and bleeding (especially at high doses or with renal impairment)
- CNS effects including headache, giddiness, hallucinations, and seizures (at high doses)
- Pain at intramuscular (IM) injection sites
- Phlebitis or local vein irritation (IV administration)
- Antibiotic-associated diarrhea or colitis
- Nausea
- Diarrhoea
- Skin rashes
Precautions
Dosage adjustments should be made in patients with significantly impaired renal function. Patients receiving very high dosages or those with renal impairment are more prone to developing platelet function abnormalities (bleeding) or CNS toxicity. IV administration should be given slowly (over at least 30 minutes) using dilute concentrations to avoid vein irritation.
Drug interactions
In vitro synergy against certain bacteria; however, penicillins can chemically inactivate aminoglycosides in vitro and in vivo (especially in renal failure or at massive doses). Do not mix in the same syringe or IV line.
Reduces renal tubular secretion of ticarcillin, maintaining higher systemic levels for a longer duration (does not affect clavulanate elimination).
Increased risk of bleeding due to potential ticarcillin-induced platelet dysfunction; use with caution.
Increased risk of bleeding due to potential ticarcillin-induced platelet dysfunction; use with caution.
Mutual inactivation if mixed in the same syringe. However, there is significant synergism in vivo against Pseudomonas when administered separately.
Monitoring
- Clinical efficacy (resolution of clinical signs, WBC count, fever)
- Renal function (in patients with pre-existing impairment)
- Signs of bleeding or CNS abnormalities (if on high doses)
- Clinical signs of infection resolution
- Renal function (in prolonged use)
- Signs of hypersensitivity or adverse gastrointestinal effects
Pharmacokinetics
Half-life
Absorption
Ticarcillin is not appreciably absorbed after oral administration. When given IM to humans, peak levels occur in 30-60 minutes. Bioavailability in horses after IM administration is approximately 65%.
Distribution
Distributes into pleural fluid, interstitial fluid, bile, sputum, and bone. CSF levels are low (6% of serum) with normal meninges, but increase (39%) with inflammation. Volume of distribution (Vd) is 0.34 L/kg in dogs and 0.22-0.25 L/kg in horses. Crosses the placenta and is found in small quantities in milk.
Metabolism
In humans, 10-15% of ticarcillin is hydrolyzed to inactive compounds. Clavulanic acid is extensively metabolized in dogs primarily to 1-amino-4-hydroxybutan-2-one.
Elimination
Ticarcillin is eliminated primarily by the kidneys via tubular secretion and glomerular filtration. Clavulanic acid is excreted unchanged in urine (34-52% in dogs), feces (25-27%), and respired air (16-33%).
Overdose
A single inadvertent overdose is unlikely to cause significant morbidity. However, very high dosages of parenteral penicillins (especially in patients with underlying renal disease) have induced CNS effects (hallucinations, headaches, seizures) and alterations in platelet function leading to bleeding.
Available products
Formulations
- Powder for injection
- Premixed frozen injection
- Injectable: 3 g ticarcillin and 200 mg clavulanic acid powder for reconstitution
Human-labeled
- Ticarcillin Disodium Powder for Injection and Clavulanate Potassium: 3 grams ticarcillin and 0.1 gram clavulanic acid in 3.1 gram vials, piggyback bottles, ADD-Vantage vials, 100 mL premixed frozen Galaxy plastic containers, and 31 gram pharmacy bulk packages (Timentin®)
- Ticarcillin Powder for Injection and Clavulanate Potassium: 3 grams ticarcillin and 0.1 gram clavulanic acid/100 mL (Timentin®)
- Timentin 3.2 g (3 g ticarcillin / 200 mg clavulanic acid) powder for injection
Regulatory status
Human authorized product used under the prescribing cascade for serious infections.
Human authorized product used under the prescribing cascade.
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store unused vials at room temperature (below 24°C/75°F). Darkening of powder/solution indicates degradation of clavulanate. Reconstituted solutions (200 mg/mL) are stable for 6 hours at room temperature and 72 hours refrigerated. Diluted IV solutions (10-100 mg/mL) vary in stability; thawed solutions must be used within 8 hours and not refrozen.
Client information
Note: This medication is primarily used as an injectable drug in a hospital setting for severe, life-threatening infections.
- Compounded Ear Drops: If your veterinarian has prescribed this as a compounded ear drop for stubborn Pseudomonas infections, keep the aliquots (syringes/vials) frozen until needed. Thaw individual doses just before use as directed.
- Side Effects: Watch for signs of an allergic reaction (facial swelling, hives, difficulty breathing) or severe diarrhea, and contact your veterinarian immediately if these occur.
- Bleeding Risk: Rarely, this drug can affect blood clotting. Report any unusual bruising or bleeding.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.