Antimicrobials
Ampicillin/Sulbactam

Ampicillin/Sulbactam

Dosing

General Information

Administration IM

  • Inject deep into large muscle mass Intravenous
  • Slow injection over 10-15 minutes or as IV infusion over 15-30 minutes
  • Do not co-administer aminoglycosides through the same tubing due to possibility of AG inactivation

Preparation IM

  • Dilute with SWFI, lidocaine 0.5% or lidocaine 2%
  • Concentration of 375mg/mL (250mg ampicillin/125mg sulbactam per mL) Intravenous
  • Reconstitute vial with SWFI then further with NS for IV infusion

Compatibility

  • NS

Skin and soft tissue, intra-abdominal, gynecological infections most common uses.

Off-label uses:

  • Bite wound treatment (animal or human)
  • bloodstream infections
  • endocarditis
  • pneumonia
  • surgical prophylaxis (thoracic, biliary, colorectal, head and neck, hysterectomy, plastic surgery, and urologic procedures)
  • surgical site infections

Tier One

  • Narrow spectrum, possible transition for discharge, IV to PO
  • Strategy: total EBM duration set (inpatient and outpatient)

Monitor renal, hematologic, and hepatic function periodically with prolonged use.

Pre-existing hepatic impairment: monitor function at regular intervals.

  • Pain at injection site (more common with IM administration) and thrombophlebitis
  • Skin rash
  • Diarrhea, nausea and vomiting
  • Chloroquine: Ampicillin concentration can be reduced, separate doses by at least 2 hours
  • Allopurinol: may enhance allergic or hypersensitivity reactions to Ampicillin
  • Aminoglycosides: can be inactivated by most penicillins if administered through the same line

Binds to penicillin-binding proteins (PBPs) which inhibits bacterial cell wall synthesis

Bile penetration: Therapeutic

Tissue penetration: Therapeutic

CSF penetration: poor with uninflamed meninges, therapeutic concentration when inflamed

Excreted in the urine with 75-85% unchanged drug