Ampicillin and Sulbactam
Broad-spectrum Penicillin · Beta-lactamase inhibitor/Broad-spectrum penicillin
Indications
Treatment of susceptible bacterial infections involved with skin and skin structure, intra-abdominal infections, gynaecological infections.
Dosage
Adults: Susceptible infections: IM/IV: 1.5-3 gm every 6 hrs. Max 12 gm daily. Amnionitis, cholangitis, diverticulitis, endomyometritis (with doxycycline), endophthalmitis, epididymitis/orchitis, liver abscess (with metronidazole), or peritonitis: IV: 3 gm every 6 hrs. Orbital cellulitis: IV: 3 gm every 6 hrs. Osteomyelitis (diabetic foot): IV: 3 gm every 6 hrs. Pelvic inflammatory disease (alternative to preferred treatment): IV: 3 gm every 6 hrs with doxycycline oral or IV. Urinary tract infections, pyelonephritis: IV: 3 gm every 6 hrs for 14 days. Children: Susceptible infections: IV: 100-200 mg ampicillin/kg/day every 6 hrs. Max 8 gm ampicillin daily or 12 gm ampicillin/sulbactam daily. Severe infections: IV: 200 mg ampicillin/kg/day every 6 hrs. Max 8 gm ampicillin daily or 12 gm ampicillin/sulbactam daily.
Administration
Administer around-the-clock to promote less variation in peak and trough serum levels. IV: Administer by slow inj over 10-15 mins or as an IV infusion over 15-30 mins. IM: Inject deep IM into large muscle mass; a conc of 375 mg/mL amp/sulb is recommended. Reconstitution: For direct IV administration and IV inf, reconstitute with SWFI. NS is the diluent of choice for IV inf use. For IM administration, reconstitute with SWFI or 0.5% or 2% lidocaine HCl inj. Compatibility: Stable in NS. Y-site administration: Drug to Drug IV Compatibility: Amifostine, aztreonam, bivalirudin, cefepime, dexmedetomidine, docetaxel, enalaprilat, etoposide PO4, famotidine, fenoldopam, filgrastim, fluconazole, fludarabine, gatifloxacin, gemcitabine, granisetron, heparin, insulin, linezolid, meperidine, morphine, paclitaxel, remifentanil, tacrolimus, teniposide, theophylline, thiotepa, vancomycin. Drug to Drug IV…
Adverse Effects
Pain at inj site, diarrhoea, thrombophlebitis, rash, abdominal pain, chest pain, chills, dizziness, headache, urinary retention, vomiting.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: History of cholestatic jaundice or hepatic dysfunction associated with ampicillin/sulbactam. Patients with infectious mononucleosis. Precautions: Renal impairment, hepatic impairment. Penicillin, cephalosporin or other allergen hypersensitivity.
Interactions
BCG (intravesical), cholera vaccine; avoid. Methotrexate, vitamin K antagonists, acemetacin, allopurinol, probenecid, mycophenolate, sodium picosulphate, typhoid vaccine, chloroquine, tetracyclines, lanthanum.
Advice to Patient
Contact prescriber if you have any serious side effects, including pain/swelling at injection site (if this drug is injected into a vein), chest pain, difficult/painful urination, easy bruising/bleeding, signs of liver disease (such as persistent nausea/vomiting, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine), rash, itching, new signs of infection (such as fever, persistent sore throat). Do not use anti-diarrhoeal products or narcotic pain medications if you have any of the following symptoms because these products may make them worse. Contact prescriber immediately if you develop persistent diarrhoea, abdominal or stomach pain/cramping, blood/mucus in your stool. Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact prescriber if you notice white patches in your mouth, a change in vaginal…
Pharmacokinetics
AMPICILLIN: Absorption: Oral: 50%. Half-life elimination: Neonates: PNA 2-7 days: 4 hrs. PNA 8-14 days: 2.8 hrs. PNA 15-30 days: 1.7 hrs. Children and Adults: 1-1.8 hrs. Anuric patients: 8-20 hrs. Time to peak serum concentration: Oral: Within 1-2 hrs. Excretion: Urine; faeces. SULBACTAM: Half-life elimination: Children 1-12 yrs (normal renal function): Mean range: Approx. 0.7-0.9 hrs. Adults (normal renal function): 1-1.3 hrs. Excretion: Urine (approx. 75%-85%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.