Selected clinical features of available β-lactam-β-lactamase inhibitor combinations

β-Lactam-β-lactamase inhibitor compositionTrade name; manufacturerRoute of administration, formulations, and dosing intervalsat1/2, h (% protein bound)Mean peak serum levels (μg/ml)Approved clinical indicationsProven clinical efficacy for susceptible causative organism(s):
Piperacillin-tazobactamZosyn; Wyethi.v., 2.0 g/0.25 g q6h, 3.0 g/0.375 g q6h, 4.0 g/0.5 g q6hPiperacillin and tazobactam, 0.7-1.2 (30)1 h after 3.375-g dose: piperacillin, 106; tazobactam 10.7Appendicitis E. coli, Bacteroides spp.
Skin and soft tissue infections, including diabetic foot infections S. aureus
Postpartum endometritis or pelvic inflammatory disease E. coli
Community-acquired pneumonia H. influenzae
Hospital-acquired, ventilator-acquired pneumonia S. aureus, A. baumannii, H. influenzae, K. pneumoniae, P. aeruginosab
Ampicillin-sulbactamUnasyn; Pfizeri.v./i.m., 1.0 g/0.5 g q6h, 2.0 g/1.0 g q6hAmpicillin, 1.0 (28); sulbactam, 1.0 (38)After 15-min infusion of 1-g/0.5-g dose: ampicillin, 40-71; sulbactam, 21-40Skin and skin structure infections S. aureus, E. coli, Klebsiella spp., P. mirabilis, B. fragilis, Enterobacter spp., A. calcoaceticus
Intra-abdominal infections E. coli, Klebsiella spp., Bacteroides spp., Enterobacter spp.
Gynecological infections E. coli, Bacteroides spp.
Amoxicillin-clavulanateAugmentin; GlaxoSmithKlinePediatric oral suspension, 600 mg/42.9 mg/5 ml q12hcAmoxicillin, 1.3 (18); clavulanate, 1.0 (25)1 h after 250-mg/ 62.5-mg dose: amoxicillin, 6.9; clavulanate, 1.6Otitis media S. pneumoniae, H. influenzae, Moraxella catarrhalis
Chewable tablet and oral suspension, 125 mg/31.25 mg q8h, 200 mg/28.5 mg q12h, 250 mg/62.5 mg q8h, 400 mg/57.0 mg q12hCommunity-acquired pneumonia or acute bacterial sinusitis H. influenzae, M. catarrhalis, H. parainfluenzae, K. pneumoniae, methicillin-susceptible S. aureus, S. pneumoniae
Tablet, 250 mg/125 mg q8h, 500 mg/125 mg q8-12h, 875 mg/125 mg q12hSinusitis H. influenzae, M. catarrhalis
Extended-release tablet, 1,000 mg/62.5 mg q12hSkin and skin structure infections S. aureus, E. coli, Klebsiella spp.
Urinary tract infections E. coli, Klebsiella spp., Enterobacter spp.
Ticarcillin-clavulanateTimentin; GlaxoSmithKlinei.v., 3.0 g/0.1 g q4-6hTicaracillin, 1.1 (45); clavulanate, 1.1 (25)1 h after 3.1-g dose: ticarcillin, 131; clavulanate, 1.8Septicemia Klebsiella spp., E. coli, S. aureus, P. aeruginosa
Lower respiratory tract infections S. aureus, H. influenzae, Klebsiella spp.
Bone and joint infections S. aureus
Skin and skin structure infections S. aureus, Klebsiella spp., E. coli
Urinary tract infections E. coli, Klebsiella spp., P. aeruginosa, Citrobacter spp., Enterobacter cloacae, Serratia marcescens, S. aureus
Gynecologic infections Prevotella melaninogenicus, Enterobacter spp., E. coli, K. pneumoniae, S. aureus, S. epidermidis
Intra-abdominal infections E. coli, K. pneumoniae, B. fragilis
  • a i.v., intravenous; i.m., intramuscular; q6h, every 6 h.

  • b When treated with piperacillin-tazobactam, hospital-acquired and ventilator-acquired pneumonia caused by P. aeruginosa should be administered with an aminoglycoside.

  • c The dose of amoxicillin-clavulanate in the pedatric oral suspension is 45 mg/kg q12h based on information available in the material supplied by the manufacturer.