Temocllin is a penicillin antibiotic and should NOT be used in patients who are allergic to penicillin.
This guidance is for NHS Lothian prescribing Temocillin for adults.
Temocillin is a WATCH antibiotic and should only be used with guidance from Medical Microbiology or Infectious Diseases.
The usual indication for Temocillin is for the treatment of urinary tract infection caused by susceptible Gram-negative bacteria.
Based on EUCAST recommendations Temocillin susceptibility is now reported by the microbiology laboratory as either ‘I’ or ‘R’. For patients with normal renal function (creatinine clearance >60ml/min) the recommended dose is 2g every 8 hours. Temocillin dosing is reduced in renal impairment to avoid adverse effects related to high penicillin doses.
Use creatinine clearance and dose as per table below. In patients with renal impairment monitor renal function daily. In patients with acute kidney injury that may rapidly reverse after treatment of sepsis it may be more appropriate to dose adjust only if renal function does not improve quickly.
| Creatinine Clearance (ml/min) | Temocillin dose |
| 60> | 2g every 8 hours |
| 40 - 60 | 2g every 12 hours |
| 20 - 39 | 2g stat then 1g every 12 hours |
| <20 | 2g stat then 1g every 24 hours |
Antimicrobial prescribing: NHS Lothian