(see also: Penicillin Family / Ampicillin / Aumentin)
Discussion
- for beta lactamase producing Staph aereus, Eneterococcus, H. influenza, Klebsiella, Proteus mirablis, Bacteroides
- adult: 1.5-3 gm IM/IV q6hr (2:1 ampicillin sodium:sulbactam) adjust w/ Renal failure;
- good diffusion from blood into CSF only with inflammation;
- inflammed meninges: 5-10;
- peds: Dosed as Ampicillin;
- supplied: Powder for Injection 1.5 gm, 3.0 gm vials;
sulbactam
- is semisynthetic beta-lactamase inhibitor w/ activity against a broad range of beta-lactamases, including those produced by bacteroides,
Haemophilus, Klebsiella, E. coli, and N. gonorrhoeae; - it is currently available as parenteral preparation in combination w/ ampicillin (Unasyn -- 2 g of ampicillin and 1.0 g of sulbactam);
- given every six hours, combination has been successful in treatment of variety of infections, including intraabdominal & pelvic infections,
infections of skin, soft tissue, and bones and joints, and uncomplicated urethritis caused by pen-sensitive and pen-resistant N. gonorrhoeae;
cautions
- dosing regimens for patients with renal insufficiency;
- dose for 70 kg Adult {gm/dosing interval in hours} CrCl >80: 1.5-3/6-8; CrCl:50-79: 1.5-3/6-8; CrCl:30-49: 1.5-3/6-8; CrCl:10-29: 1.5-3/12;
- note prophylaxis of bacterial endocarditis: Amp 2.0gm IM or IV 30min before procedure + Gent 1.5mg/kg IM or IV 30min before procedure;
- watch for hypersensitivity, erythematous maculopapular rash occurring 2-4 weeks after 1st dose