CARBENICILLIN INDANYL SODIUM

Use

Carbenicillin indanyl sodium has been shown to reduce blood pressure in mammals and also has been used as a β-lactam antibiotic. Efforts to obtain orally active forms of carbenicillin led to theeventual release of the 5-indanyl ester carbenicillin indanyl,6-[2-phenyl-2-(5-indanyloxycarbonyl)acetamido]penicillanicacid (Geocillin), in 1972. Approximately 40% of theusual oral dose of indanyl carbenicillin is absorbed. After absorption,the ester is hydrolyzed rapidly by plasma and tissueesterases to yield carbenicillin. Thus, although the highlylipophilic and highly protein-bound ester has in vitro activitycomparable with that of carbenicillin, its activity in vivo isdue to carbenicillin. Indanyl carbenicillin thus provides anorally active alternative for the treatment of carbenicillinsensitivesystemic and urinary tract infections caused byPseudomonas spp., indole-positive Proteus spp., and selectedspecies of Gram-negative bacilli.Clinical trials with indanyl carbenicillin revealed a relativelyhigh frequency of GI symptoms (nausea, occasionalvomiting, and diarrhea). It seems doubtful that the highdoses required for the treatment of serious systemic infectionscould be tolerated by most patients. Indanyl carbenicillinoccurs as the sodium salt, an off-white, bitter powderthat is freely soluble in water. It is stable in acid. It should beprotected from moisture to prevent hydrolysis of the ester.