Ampicillin/Sulbactam
General
- Type: Amino-Penicillins
- Dosage Forms: powder for solution
- Dosage Strengths: 1.5g, 3g, 15g
- Routes of Administration: IM, IV
- Common Trade Names: Unasyn
Adult Dosing
General
- 1.5-3g IV/IM q6 hours
- Max: 12g/day
Bite (for Pasteurella multocida Coverage)
- 1.5-3g IM/IV q6 hours
Orbital Cellulitis
- 3g IM/IV q6 hours
Diabetic Foot Osteomyelitis[1]
- 3g IM/IV q6 hours
PID
- 3g IM/IV q6 hours + doxycycline
Pneumonia
- Aspiration or CAP
- 1.5-3g IM/IV q6 hours
- Hospital-acquired: 3g IM/IV q6 hours
UTI, Pyelonephritis
- 3g IM/IV q6 hours x 14 days
Pediatric Dosing (<40kg)
Unasyn (ampicillin/sulbactam) is formulated at a 2:1 ratio (3g vial = 2g ampicillin + 1g sulbactam)
General[2]
- Mild-moderate
- 100-200mg ampicillin/kg/day IM/IV divided q6 hours
- First Dose: 25-50mg ampicillin/kg IM/IV x 1 (37.5-75mg Unasyn/kg IM/IV x 1)
- Max: 1000mg ampicillin (1500mg Unasyn)
- Severe
- 200mg ampicillin/kg/day IM/IV divided q6 hours
- First Dose: 50mg ampicillin/kg IM/IV x 1 (75mg Unasyn/kg IM/IV x 1)
- Max: 2000mg ampicillin (3000mg Unasyn)
Meningitis
- 400mg ampicillin/kg/day IM/IV divided q6 hours
- First Dose: 100mg ampicillin/kg IM/IV x 1 (150mg Unasyn/kg IM/IV x 1)
- Max: 2000mg ampicillin (3000mg Unasyn)
Endocarditis
- 200mg ampicillin/kg/day IM/IV divided q4-6 hours +/- gentamicin x 4-6 weeks
SSTI
- 200mg ampicillin/kg/day IM/IV divided q6 hours
Special Populations
- Pregnancy: B
- Lactation: Use caution
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Anaphylaxis
Common
- Headache
- Itching
- Nausea
- Vomiting
Pharmacology
- Half-life: One hour
- Metabolism:
- Excretion: Renal (75% excreted in active form), Bile (very small amount)[3]
- Mechanism of Action: Bactericidal (Binds to penicillin-binding proteins to block cell wall synthesis), coupled with β-lacatamase inhibitor
Antibiotic Sensitivities[4]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- Lipsky, 2004
- Red Book, 2012
- Campoli-Richards DM, Brogden RN. (1987). ". Sulbactam/ampicillin: a review of its antibacterial activity, pharmacokinetic properties, and therapeutic use". Drugs. 33 (6): 577–609. doi:10.2165/00003495-198733060-00003. PMID 3038500
- Sanford Guide to Antimicrobial Therapy 2014
This article is issued from
Wikem.
The text is licensed under Creative
Commons - Attribution - Sharealike.
Additional terms may apply for the media files.