Ticarcillin

Evidence Level: L5

Predicted Indications: 10

Ticarcillin

Pharmacist Assessment Report

Ticarcillin: From Bacterial Infections to Lymph Node Palisaded Myofibroblastoma

One-Sentence Summary

Ticarcillin is a beta-lactam (penicillin-class) antibiotic, originally used to treat bacterial infections such as urinary tract infection, bacterial pneumonia, and pelvic inflammatory disease. The TxGNN model’s top-ranked prediction is lymph node palisaded myofibroblastoma, which has no supporting evidence. The best-supported candidate is disease of peritoneum (rank 9), with 0 clinical trials and 20 publications, mostly older, small, or non-randomized studies, many on the ticarcillin/clavulanate combination.

Quick Overview

Item	Content
Original Indication	Bacterial infections (urinary tract infection, bacterial pneumonia, staphylococcal infection, pelvic inflammatory disease, etc.)
Predicted New Indication	Lymph node palisaded myofibroblastoma (rank 1); disease of peritoneum (rank 9) is the only candidate with literature support
TxGNN Prediction Score	0.9982 (rank 1); 0.9981 (disease of peritoneum)
Evidence Level	L5 (rank 1); L3 (disease of peritoneum)
India Market Status	Listed in a compiled Indian medicine price dataset (15 of 15) – CDSCO approval status is not included in this data
Number of Listed Products	15 (valid: 15)
Recommended Decision	Hold (rank 1); Hold overall, with disease of peritoneum as a research question

The India approved-indication text was not available in the data compiled for this report, so the original indication above is not drawn from an India-specific approved-indication text.

Why is This Prediction Reasonable?

Currently, detailed mechanism of action data is not available. Based on known information, ticarcillin is a beta-lactam antibacterial that acts on bacterial cell wall synthesis. Its efficacy in bacterial infections is established.

Rank 1 (lymph node palisaded myofibroblastoma): This is a benign mesenchymal neoplasm, and no mechanistic link to an antibacterial was identified. The high score is a computational prediction only, with no trial or literature support.

Disease of peritoneum (rank 9): This is the only prediction with some plausibility. Ticarcillin, usually combined with clavulanate, has broad Gram-negative and anaerobic coverage relevant to polymicrobial peritonitis and intra-abdominal sepsis. Several clinical reports describe the combination in intra-abdominal infection. However, this is an extension of the existing antibacterial class use rather than a novel mechanism. The evidence is mostly for the combination product rather than ticarcillin alone, and the combination has been largely superseded by newer agents.

Other predictions: Most of the remaining top-10 candidates (ectopic pregnancy, cystic lymphangioma, celiac trunk compression syndrome, sacrum chordoma, pelvic varices) are non-infectious conditions with no plausible antibacterial mechanism. Urethral disease and disease of uterine broad ligament are conceptually adjacent to existing infectious indications but are nonspecific categories without direct evidence. Urethral disease largely overlaps with the existing urinary tract infection indication rather than being true repurposing.

Clinical Trial Evidence

Currently no related clinical trials registered.

Literature Evidence

The table below covers the best-supported candidate, disease of peritoneum. The other nine predicted indications have no literature. Studies are ordered by clinical relevance, and study types follow the classification in the compiled data.

PMID	Year	Type	Journal	Key Findings
2691475	1989	Prospective clinical study	J Antimicrob Chemother	50 consecutive patients with secondary peritonitis received ticarcillin/clavulanate 5.2 g three times daily as initial therapy
2024225	1991	Clinical study	Surg Gynecol Obstet	Ticarcillin/clavulanate as an alternative to aminoglycoside-containing regimens for intra-abdominal sepsis in the elderly, given the nephrotoxicity risk of aminoglycosides
3302345	1987	Clinical study	Jpn J Antibiot	Clavulanic acid/ticarcillin in 76 cases of intraperitoneal and biliary tract infections, 10-day drip infusion
3499526	1987	Clinical study	Jpn J Antibiot	Clavulanic acid/ticarcillin in pelvioperitonitis (14 patients) and Douglas’ abscess (4 patients)
10768063	2000	Clinical study	Antibiot Khimioter	Ticarcillin/clavulanate in 19 patients with peritonitis and abdominal sepsis; clinical and bacteriological effects in 84.2% and 87.5% of cases
367159	1978	Clinical and laboratory study	Am J Med Sci	Eleven patients with serious anaerobic infections treated with carbenicillin or ticarcillin were all cured
9451930	1998	Review	World J Surg	Antibiotic therapy for abdominal infection, with coverage of E. coli and Bacteroides species as the key principle
1734854	1992	Guideline	Arch Surg	Surgical Infection Society guidelines for anti-infective selection in intra-abdominal infection
3112102	1987	Animal study	J Antimicrob Chemother	Pseudomonas peritonitis in neutropenic rats treated with amikacin, ceftazidime and ticarcillin, alone and in combination
3536827	1986	In vitro study	J Antibiot	Ticarcillin/clavulanic acid was active against ticarcillin-resistant S. aureus, E. coli and K. pneumoniae

None of these are randomized controlled trials. Some are indirect (for example, a review on temocillin, a different drug, and observational data on dialysis patients).

India Market Information

Fifteen valid registrations were found. Approved indication text was not available for any of them. The five main ones are listed below.

Review correction (2026-11-06): Originally stated: “Fifteen valid single-ingredient registrations were found.” Removed: it described the products as single-ingredient or combination products in a way that did not match the Indian medicine data (the Indian Medicine Dataset as of 2026-11-06). Source: Indian Medicine Dataset.

Authorization Number	Product Name	Dosage Form	Approved Indication
228363	Ticwise 3000mg/100mg Injection	Vial of 1 injection	Not available
216070	Ticarnic 3.1 Injection	Vial of 1 injection	Not available
224103	Ticar C 3000mg/100mg Injection	Vial of 1 injection	Not available
217640	Timentin 3.1 Injection (GlaxoSmithKline)	Vial of 1 injection	Not available
222573	Timcyn 3000 mg/100 mg Injection	Vial of 1 injection	Not available

All products are injectables.

Safety Considerations

Contraindication-related conditions (knowledge graph): kidney disease, pyoureter, Clostridium difficile colitis, perinatal necrotizing enterocolitis, infectious mononucleosis, and chronic Epstein-Barr virus infection syndrome. These come from drug-disease relationships in the knowledge graph, not from package insert text.
Drug Interactions: 23 interactions were recorded. Most are Moderate:
- Tetracyclines: doxycycline, tetracycline, minocycline, demeclocycline, oxytetracycline
- Aminoglycosides: kanamycin, streptomycin, amikacin (including liposomal), gentamicin
- Anticoagulants: warfarin, dicoumarol (Moderate); heparin (Minor)
- Others (Moderate): chloramphenicol, picosulfuric acid, ethinylestradiol, iodide I-123, iodide I-131
- Minor: clarithromycin, erythromycin
Renal function: A pharmacokinetic study (PMID 1107435) showed ticarcillin half-life rising from about 71 minutes with normal renal function to about 14.8 hours when creatinine clearance is below 10 mL/min, so dose adjustment is relevant in renal impairment.

Please refer to the package insert for label warnings and contraindications.

Conclusion and Next Steps

Decision: Hold

Rationale: The top-ranked prediction (lymph node palisaded myofibroblastoma) has no mechanistic link and no trial or literature evidence, so it is a computational artifact. Disease of peritoneum has L3-level literature, but it consists of older, small, mostly non-randomized studies on the ticarcillin/clavulanate combination, and it largely represents existing antibacterial use rather than genuine repurposing. It is best treated as a research question rather than a development candidate.

To proceed, the following is needed:

Package insert warnings and contraindications for the India-registered products (currently a blocking gap for safety screening)
Approved indication text for the India registrations
Detailed mechanism of action data (MOA)
For disease of peritoneum: a comparison against current standard intra-abdominal infection regimens and evidence specific to ticarcillin rather than the combination product
Route compatibility and similarity-to-original assessment for any candidate that advances

Review Log

Below is the review log for this page: statements checked against official Indian medicine data (the Indian Medicine Dataset used by this site). Corrections are limited to basic factual statements; model predictions, evidence levels, and conclusions were not rewritten.

Review date	Item	Action	Source
2026-11-06	Removed: “single-ingredient”	Corrected	Indian Medicine Dataset

Disclaimer

This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.