Difference between revisions of "Ampicillin"

(Created page with "==General== *Type: *Dosage Forms: *Common Trade Names: ==Adult Dosing== ==Pediatric Dosing== ==Special Populations== *Pregnancy: *Lactation: *Renal Dosing **Adult **Pedia...")
 
(9 intermediate revisions by 5 users not shown)
Line 1: Line 1:
 
==General==
 
==General==
*Type:  
+
*Type: [[Penicillin]]
*Dosage Forms:
+
*Dosage Forms: capsule, oral suspension, powder for injection
*Common Trade Names:  
+
*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==
  
 
==Pediatric Dosing==
 
==Pediatric Dosing==
 +
===[[Pneumonia (peds)]]===
 +
*150-200mg/kg/day IV divided Q6hours (max dose: 4g per day)
  
 
==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==
Line 23: Line 26:
 
==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]]

Revision as of 17:09, 19 September 2019

General

  • Type: 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

Pediatric Dosing

Pneumonia (peds)

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

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