Gram-positive: Streptococcus spp., Enterococcus, Listeria monocytogenes
Gram-negative: H. influenzae, E. coli, Proteus mirabilis, Salmonella spp., Shigella spp.
Exerts bactericidal activity via inhibition of bacterial cell wall synthesis by binding one or more of the penicillin binding proteins (PBPs). Exerts bacterial autolytic effect by inhibition of certain PBPs related to the activation of a bacterial autolytic process.
Penicillins produce time-dependent killing
Distribution: Total protein binding: 30 to 40%;
Distribution sites: aqueous humor, bile, bone, CSF, lungs, urine
Volume of distribution: 14 L
Excretion: Renal excretion: 60 to 75%; elimination half-life: 1.53 hours
Hematologic: anemia, thrombocytopenia, neutropenia, agranulocytosis
Renal: nephrotoxicity, interstitial nephritis
Hepatic: transient increases in transaminases
Other: Jarisch-Herxheimer Reaction (fever, chills, sweating, tachycardia, hyperventilation, flushing, and myalgia)
Gram-negative infections: 2 to 5 grams every 8 hours IV
Serious infections: 225 to 300 mg/kg/day IV in 4 to 6 divided doses (usual IV doses 3g q4h or 4g q6h) (up to 18 g/day)
Renal failure: CrCl 30 to 50 mL/min: increase dosing interval to every 4 to 6 hours
CrCl between 10 to 30 mL/min: 2 g IV q8h
CrCl < 10 mL/min: 3 g IV q12h
Hepatic failure: No dosing changes recommended at this time.
Contraindications: Anaphylaxis to azlocillin or other penicillins
Ciprofloxacin – decreased clearance of ciprofloxacin
Live Typhoid Vaccine - decreased immunological response to the typhoid vaccine
Probenecid - increased azlocillin levels
Category B:No evidence of risk in humans but studies inadequate.
Therapeutic: Culture and sensitivities, signs and symptoms of infection
Toxic: Periodic CBC, urinalysis, BUN, SCr, AST and ALT, diarrhea, skin rash
Azlin (Miles -United States)
Securopen (Bayer – Italy, UK, France, Spain, Austria, Ireland, Norway, Germany, Australia)