Temocillin is an alternative to treat urinary tract infections with bacteria producing extended spectrum beta-lactamase (ESBL). The objective is to evaluate the use of temocillin in urinary tract infections.
A systematic review of literature was carried out according to PRISMA criteria. All national and international recommendations have been reviewed regarding the indication of the use of temocillin in urology. Data collection on the use of temocillin in urinary tract infection has been performed from the Cochrane, LILACS and the Medline database. The following keywords were used: temocillin, extended spectrum beta-lactamase, urinary tract infections, urine, prostate, epididymis, testis, diffusion, pharmacokinetics, pharmacodynamics. The selection was based on the methodology, language of publication (English/French), relevance to the topic and date of publication of the articles collected. The endpoint was to provide exhaustive scientific information allowing urologists to use this antibiotic in febrile urinary infections.
Bacteria producing ESBL has a relatively high susceptible to temocillin, ranging from 61 % to 90 %. These rates would allow its use in probabilistic. The dosage recommended is currently, in the normo-renal patient, 4g per day by intermittent infusion or continuously after a loading dose of 2g. Some studies argue, particularly in case of difficult clinical situations or obese patients, for administration of high doses (6g/24h) rather continuous infusion. There is no evident relationship between high doses and side effects. With an excellent urinary and prostatic diffusion, temocilllin might be recommend for the treatment of ESBL prostatitis.
Temocillin is known to have good urinary and prostatic diffusion. According to our results, this antibiotics is now a reliable alternative for the treatment of documented ESBL urinary tract infections.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2017 Aug 28 [Epub ahead of print]
M Vallée, F Bruyère, F Roblot, L Brureau
Service d'urologie et de transplantations rénales, Hôtel Dieu, CHRU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. Electronic address: ., Service d'urologie, CHRU de Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France., Inserm U1070, service de médecine interne, maladies infectieuses et tropicale, CHU de Poitiers-La Miletrie, 2, rue de La Miletrie, 86021 Poitiers cedex, France., Inserm, U1085-IRSET, service d'urologie, CHRU de Pointe-à-Pitre/Abymes, BP 465, 97159 Pointe-à-Pitre cedex, Guadeloupe.