Antimicrobials
Ampicillin-sulbactam

Ampicillin-sulbactam

Spectrum of Activity

General Information

22-30 mg/kg IV/IM/SQ q6-8h

Peri-operative prophylaxis: 22 mg/kg IV 30-60 minutes before the first incision, redosed every 2 hours until surgery is complete.

22-30 mg/kg IV/IM/SQ q6-8h

Peri-operative prophylaxis: 22 mg/kg IV 30-60 minutes before the first incision, redosed every 2 hours until surgery is complete.

Used in some regions when an injectable potentiated penicillin is indicated. It can be used for the treatment of various soft tissue and urinary tract infections caused by beta-lactamase producing bacteria. It can also be used for surgical prophylaxis when a first generation cephalosporin cannot be used.

See ampicillin for more details about the ampicillin component. In general, the pharmacokinetics so sulbactam mirror those of ampicillin. Tissue penetration may be greater than is seen with clavulanic acid (but not necessarily enough to compensate for the weaker activity against beta-lactamases).

Sulbactam is generally safe, with few contraindications. It must be administered parenterally because of poor oral absorption. It is contraindicated in people with advanced hepatic dysfunction, and while small animal data are lacking, it is reasonable to avoid this drug in patients with severe hepatic disease.

While it is used by some as a parenteral analogue of amoxicillin-clavulanic acid, the beta-lactamase of sulbactam is much weaker and equivalent activity of the two drugs should not be assumed. It provides added spectrum vs ampicillin alone when treating patients that may have infections caused by beta-lactamase producing bacteria, but susceptibility data specifically for ampicillin-sulbactam are needed to have confidence in culture-directed treatment. It is likely most reasonably used for peri-operative prophylaxis given it's good staphylococcal coverage.