Firstline - Clinical Decisions

C difficile risk Low

Oral Bioavailability Low (20 to 40%)

Cost $$/day (IV)

Spectrum of Activity

General Spectrum of Activity

Antibiogram Data

Adult

Renal

Common Usage

Pathogen directed therapy for CNS, intravascular, intraabdominal, urinary and other infections especially Enterococcus and Listeria.

Amoxicillin is preferred for PO since ampicillin has boor PO bioavailability.

Adverse Effects

Allergy and rash as for all beta-lactams.

EBV related rash (not allergy).

Rare: cytopenias, Coombs+.

Major Interactions

Increased risk of rash with allopurinol
Decreased bioavailability of hydroxycholoroquine (separate by 2 hours)
Increased risk of seizures with other agents that lower threshold (eg, bupropion, donepezil)

Additional Information

Cost based on dose of 2g IV q4h.

Pharmacology

Antimicrobial class: Aminopenicillin

Pregnancy category: B

Average serum half life: 1-2 hous

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Low (but adequate uptake in inflamed meninges)

Biliary penetration: Therapeutic