Ampicillin: Difference between revisions

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==General==
==General==
*Type:  
Ampicillin is an antibiotic in the beta-lactam family of antibiotics. It is a Penicillin derivative.
*Dosage Forms:
 
*Common Trade Names:  
*Type: [[Is PenicillinType::Amino]]-[[Is DrugClass::Penicillin]]
*Dosage Forms: capsule, oral suspension, powder for injection
*Dosage Strengths: capsule: 250, 500mg; oral suspension: 125, 250mg/5mL; powder for injection: 125mg, 250mg, 500mg, 1g, 2g, 10g
*Routes of Administration: PO, IV, IM
*Common Trade Names: Ampi, Omnipen, Penglobe, Principen


==Adult Dosing==
==Adult Dosing==
===Endocarditis===
*12 g daily (continuous IV infusion or in 6 equally divided dosages) in conjunction with gentamicin
===Perinatal Group B Streptococcal Prevention===
*Initial 2 g dose at time of labor or rupture of membranes, followed by 1 g q4hrs until delivery


==Pediatric Dosing==
==Pediatric Dosing==
===[[Pneumonia (peds)]]===
*150-200mg/kg/day IV divided Q6hours (max dose: 4g per day)
===Other Pediatric Bacterial Infections===
*100-400mg/kg/day IM/IV divided q4-16Hours (max dose 12g/day IM/IV)


==Special Populations==
==Special Populations==
*Pregnancy:
*[[Drug pregnancy categories|Pregnancy Rating]]: B
*Lactation:
*Lactation: Excreted in breastmilk, use caution
*Renal Dosing
*Renal dosing:
**Adult
**CrCl <10 mL/min: Administer q12-24hr
**Pediatric
**CrCl 10-50 mL/min: Administer q6-12hr
*Hepatic Dosing
**CrCl >50 mL/min: Administer q6hr
**Adult
*Hepatic Dosing: not studied
**Pediatric


==Contraindications==
==Contraindications==
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==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Pseudomembranous colitis, enterocolitis
*Agranulocytosis
*Seizure
*Interstitial nephritis
*Stridor
*Anaphylaxis


===Common===
===Common===
*Rash, urticaria
*Diarrhea, nausea
*Fever
*Oral candidiasis
*Stomatitis, glossitis
*Anemia/hemolytic anemia, leukopenia, thrombocytopenia, eosinophilia
*Serum sickness like reaction
*Elevated AST
*Erythema multiforme


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 1-1.8 hr (normal renal function); 7-20 hr (anuria/ESRD)
*Metabolism:  
*Metabolism: Hepatic
*Excretion:  
*Excretion: Urine
*Mechanism of Action:
*Mechanism of Action: Bactericidal; inhibits bacterial cell wall synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||I
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||'''S'''
|-
| ||[[Enterococcus faecium]]||I
|-
| ||[[MSSA]]||R
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||R
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||R
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||R
|-
| ||[[H. influenzae]]||I
|-
| ||[[E. coli]]||I
|-
| ||[[Klebsiella]] sp||R
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||R
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||I
|-
| ||[[Shigella]] sp||I
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||R
|-
| ||[[Providencia sp.]]||R
|-
| ||[[Morganella sp.]]||R
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||R
|-
| ||[[Citrobacter sp.]]||R
|-
| ||[[Aeromonas sp]]||R
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||R
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||R
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
 
<references/>
<references/>
[[Category:Drugs]]
[[Category:Pharmacology]] [[Category:ID]]

Latest revision as of 17:42, 18 July 2025

General

Ampicillin is an antibiotic in the beta-lactam family of antibiotics. It is a Penicillin derivative.

  • Type: Amino-Penicillin
  • Dosage Forms: capsule, oral suspension, powder for injection
  • Dosage Strengths: capsule: 250, 500mg; oral suspension: 125, 250mg/5mL; powder for injection: 125mg, 250mg, 500mg, 1g, 2g, 10g
  • Routes of Administration: PO, IV, IM
  • Common Trade Names: Ampi, Omnipen, Penglobe, Principen

Adult Dosing

Endocarditis

  • 12 g daily (continuous IV infusion or in 6 equally divided dosages) in conjunction with gentamicin

Perinatal Group B Streptococcal Prevention

  • Initial 2 g dose at time of labor or rupture of membranes, followed by 1 g q4hrs until delivery

Pediatric Dosing

Pneumonia (peds)

  • 150-200mg/kg/day IV divided Q6hours (max dose: 4g per day)

Other Pediatric Bacterial Infections

  • 100-400mg/kg/day IM/IV divided q4-16Hours (max dose 12g/day IM/IV)

Special Populations

  • Pregnancy Rating: B
  • Lactation: Excreted in breastmilk, use caution
  • Renal dosing:
    • CrCl <10 mL/min: Administer q12-24hr
    • CrCl 10-50 mL/min: Administer q6-12hr
    • CrCl >50 mL/min: Administer q6hr
  • Hepatic Dosing: not studied

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Pseudomembranous colitis, enterocolitis
  • Agranulocytosis
  • Seizure
  • Interstitial nephritis
  • Stridor
  • Anaphylaxis

Common

  • Rash, urticaria
  • Diarrhea, nausea
  • Fever
  • Oral candidiasis
  • Stomatitis, glossitis
  • Anemia/hemolytic anemia, leukopenia, thrombocytopenia, eosinophilia
  • Serum sickness like reaction
  • Elevated AST
  • Erythema multiforme


Pharmacology

  • Half-life: 1-1.8 hr (normal renal function); 7-20 hr (anuria/ESRD)
  • Metabolism: Hepatic
  • Excretion: Urine
  • Mechanism of Action: Bactericidal; inhibits bacterial cell wall synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium I
MSSA R
MRSA R
CA-MRSA R
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae R
N. meningitidis S
Moraxella catarrhalis R
H. influenzae I
E. coli I
Klebsiella sp R
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp I
Shigella sp I
Proteus mirabilis S
Proteus vulgaris R
Providencia sp. R
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus R
Citrobacter sp. R
Aeromonas sp R
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica R
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi R
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces S
Bacteroides fragilis R
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum S
Peptostreptococcus sp. S

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

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
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