Temocillin

How it works

It inhibits bacterial cell-wall synthesis by binding penicillin-binding proteins, and its stability to many beta-lactamases underlies its activity against resistant Enterobacterales.

Prescribing in practice

• It is contraindicated in patients with a history of immediate hypersensitivity to penicillins or other beta-lactams owing to the risk of cross-reactivity.
• It has no useful activity against Pseudomonas aeruginosa, anaerobes or Gram-positive organisms, so it is unsuitable as empirical monotherapy for mixed infections.
• Dose adjustment is required in renal impairment as it is largely eliminated unchanged by the kidneys.

Monitoring

Monitor renal function to guide dosing and review the full blood count during prolonged parenteral therapy.

Counselling the patient

• Tell your team about any previous penicillin allergy.
• It is given by injection or infusion, usually in hospital or via outpatient parenteral therapy.
• Report rash, diarrhoea or signs of infection at the drip site.

Evidence & guidelines

It is recommended in UK practice as a carbapenem-sparing option for susceptible Gram-negative infections, including those due to ESBL-producing organisms.