Drug Index

Ampicillin

 
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Mechanism :

Ampicillin trihydrate is a semisynthetic penicillin. Ampicillin is bactericidal at low concentrations and is effective not only against the gram-positive organisms but also against a variety of gram-negative organisms.


Indication :

• Infections of the Genitourinary Tract Including gonorrhoea

• Infections of the Respiratory Tract

• Infections of the Gastrointestinal Tract

• Bacterial meningitis/septicaemia

• Endocarditis treatment

• Endocarditis prophylaxis (off-label)

• Soft tissue infections


Contraindications :

A history of hypersensitivity to any penicillin is a contraindication. Infectious mononucleosis patients develop a rash, and therefore use is avoided. Renal and hepatic function should be monitored.


Dosing :

In general in children: Oral dose is 50-100 mg/kg/day divided every 6 hours with a maximum dose of 2-4 gm/day.

IV: 100-300 mg/kg/day (based on severity of infection) every 6-8 hourly. For meningitis, use 200-400 mg/kg/day in 4 divided doses for 14 days. Maximum dose: 12 gm/day.

Neonates <7 days of life:

<2000 gm: 50-100 mg/kg/day IV/IM divided into 12 hourly doses.

>2000 gm: 75-150 mg/kg/day IV/IM divided into 8 hourly doses.

Neonates >7 days of life:

<1200 gm: 50-100 mg/kg/day IV/IM divided into12 hourly doses.

1200-2000 gm: 75-150 mg/kg/day IV/IM divided into 8 hourly doses.

>2000 gm: 100-200 mg/kg/day IV/IM divided into 6 hourly doses.

Endocarditis prophylaxis (off-label):

50 mg/kg IV/IM (+/- gentamicin) within 30-60 minutes before procedure; max dose: 2 gm.


Adverse Effect :

Nausea, vomiting, diarrhea, black hairy tongue, pseudomembranous colitis, serum sickness-like reactions, erythematous maculopapular rashes, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, hypersensitivity vasculitis and urticaria.


Interaction :

Probenecid: Decreases the renal tubular secretion of amoxicillin, concurrent use may result in increased and prolonged blood levels of amoxicillin.
Warfarin: Prolongation of prothrombin time.
OCPs: Decreased effectiveness.
Allopurinol: Increases frequency of rashes.
Chloroquine: Reduces absorption of ampicillin.


08/10/2019 20:32:50 Ampicillin
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