Trade name for ampicillin. Ampicillin: Comprehensive Guide to Uses, Dosages, Side Effects, and Interactions
What are the main uses of ampicillin. How is ampicillin administered. What are the common side effects of ampicillin. How does ampicillin interact with other medications. What precautions should be taken when using ampicillin.
Understanding Ampicillin: A Broad-Spectrum Antibiotic
Ampicillin is a widely used broad-spectrum antibiotic belonging to the penicillin group. It is effective against various bacterial infections and has been a staple in medical practice for decades. This versatile medication is available under several trade names and in various formulations, making it adaptable to different clinical needs.
What is Ampicillin?
Ampicillin is a semi-synthetic penicillin derivative that works by inhibiting bacterial cell wall synthesis. It is particularly effective against gram-positive and some gram-negative bacteria. The drug’s broad spectrum of activity makes it a valuable tool in treating a wide range of infections.
Common Brand Names
Ampicillin is marketed under various trade names, including:
- Omni-Pen®
- Teva-ampicillin®
- Polyflex®
- Aminopenicillin®
- Principen®
- Princillin®
Indications and Uses of Ampicillin
Ampicillin is prescribed for a variety of bacterial infections affecting different parts of the body. Its broad-spectrum activity makes it an effective choice for many common ailments.
Primary Uses
Ampicillin is commonly used to treat:
- Respiratory tract infections
- Urinary tract infections
- Gastrointestinal infections
- Meningitis
- Endocarditis
- Septicemia
Is ampicillin effective against all types of bacteria?
While ampicillin is effective against many bacterial strains, it is not a universal antibiotic. Some bacteria have developed resistance to ampicillin, and certain types of infections may require alternative antibiotics. Healthcare providers typically perform sensitivity tests to determine the most appropriate antibiotic for specific infections.
Dosage Forms and Administration of Ampicillin
Ampicillin is available in various formulations to suit different administration routes and patient needs. Understanding these options is crucial for proper use and effectiveness.
Oral Formulations
Oral ampicillin is available in several forms:
- Capsules (250 mg, 500 mg)
- Tablets (250 mg, 500 mg, 1 g)
- Oral suspension (125 mg/5mL, 250 mg/5mL)
Injectable Formulations
For more severe infections or when oral administration is not possible, ampicillin can be given via injection:
- Intramuscular injection
- Intravenous injection
- Powder for reconstitution (various strengths)
How should ampicillin be administered?
The administration of ampicillin depends on the formulation and the patient’s condition. Oral ampicillin is typically taken on an empty stomach, about an hour before or two hours after meals. Injectable forms are administered by healthcare professionals in clinical settings. It’s crucial to follow the prescribed dosage and complete the full course of treatment, even if symptoms improve before the medication is finished.
Mechanism of Action: How Ampicillin Fights Bacterial Infections
Understanding how ampicillin works in the body is essential for appreciating its effectiveness and potential side effects. The drug’s mechanism of action is key to its broad-spectrum antibacterial activity.
Cell Wall Inhibition
Ampicillin primarily works by interfering with bacterial cell wall synthesis. It inhibits enzymes responsible for cross-linking peptidoglycan, a crucial component of bacterial cell walls. This interference weakens the cell wall, leading to bacterial cell lysis and death.
Bactericidal Action
Unlike some antibiotics that merely inhibit bacterial growth, ampicillin is bactericidal. This means it actively kills bacteria rather than just preventing their reproduction. This property makes it particularly effective in treating severe infections.
How does ampicillin’s mechanism of action contribute to its effectiveness?
Ampicillin’s ability to target cell wall synthesis makes it effective against a wide range of bacteria. This mechanism is specific to bacterial cells, which have cell walls unlike human cells. This specificity allows ampicillin to attack bacteria while minimizing direct harm to human cells. Additionally, its bactericidal nature ensures rapid and effective elimination of susceptible bacteria, contributing to quicker resolution of infections.
Side Effects and Precautions Associated with Ampicillin Use
While ampicillin is generally well-tolerated, it can cause side effects in some individuals. Being aware of these potential effects and necessary precautions is crucial for safe and effective use.
Common Side Effects
Some of the more frequently reported side effects of ampicillin include:
- Nausea and vomiting
- Diarrhea
- Skin rash
- Headache
- Abdominal discomfort
Serious Side Effects
While less common, some serious side effects may occur and require immediate medical attention:
- Severe allergic reactions (anaphylaxis)
- Severe skin reactions (e.g., Stevens-Johnson syndrome)
- Clostridium difficile-associated diarrhea
- Blood disorders
What precautions should be taken when using ampicillin?
Several precautions are important when using ampicillin:
- Inform your healthcare provider of any allergies, especially to penicillins or cephalosporins.
- Disclose all medications you’re taking, including over-the-counter drugs and supplements.
- Mention any history of kidney disease, as dosage adjustments may be necessary.
- Be aware that ampicillin can reduce the effectiveness of oral contraceptives.
- Avoid alcohol consumption during treatment, as it may increase the risk of side effects.
Drug Interactions: Ampicillin’s Impact on Other Medications
Ampicillin can interact with various medications, potentially altering their effectiveness or increasing the risk of side effects. Understanding these interactions is crucial for safe and effective treatment.
Common Drug Interactions
Ampicillin may interact with several types of medications, including:
- Oral contraceptives
- Allopurinol
- Probenecid
- Methotrexate
- Certain antibiotics (e.g., tetracyclines, macrolides)
How do these interactions affect treatment?
Drug interactions can have various effects on treatment:
- Reduced efficacy of ampicillin or the interacting drug
- Increased risk of side effects
- Altered absorption or metabolism of medications
- Potential for toxicity due to increased drug levels
It’s essential to inform your healthcare provider about all medications you’re taking to avoid potential interactions and ensure safe, effective treatment.
Special Considerations: Ampicillin Use in Specific Populations
The use of ampicillin requires special consideration in certain populations due to potential risks or altered drug metabolism. Understanding these factors is crucial for safe and effective treatment.
Pregnancy and Breastfeeding
Ampicillin is generally considered safe during pregnancy and breastfeeding. However, it’s crucial to consult with a healthcare provider before use, as individual circumstances may affect the risk-benefit assessment.
Pediatric Use
Ampicillin is commonly used in pediatric patients. Dosage is typically based on the child’s weight and the severity of the infection. Special care should be taken to ensure accurate dosing in infants and young children.
Geriatric Use
Elderly patients may require dose adjustments due to age-related changes in kidney function. Close monitoring is often necessary to ensure efficacy and minimize the risk of side effects.
How does renal impairment affect ampicillin use?
Patients with kidney problems may require dosage adjustments when taking ampicillin. The drug is primarily excreted through the kidneys, and impaired renal function can lead to drug accumulation. This can increase the risk of side effects and toxicity. Healthcare providers typically assess kidney function and adjust the dosage accordingly, often extending the interval between doses or reducing the dose amount to ensure safe and effective treatment.
Resistance and Effectiveness: Challenges in Ampicillin Use
The effectiveness of ampicillin has been challenged by the emergence of antibiotic-resistant bacteria. Understanding this issue is crucial for appropriate use and expectations regarding treatment outcomes.
Mechanisms of Resistance
Bacteria can develop resistance to ampicillin through several mechanisms:
- Production of beta-lactamase enzymes that break down the antibiotic
- Alterations in penicillin-binding proteins
- Changes in cell membrane permeability
- Efflux pumps that expel the antibiotic from bacterial cells
Impact on Treatment
The prevalence of ampicillin-resistant bacteria has significant implications for treatment:
- Reduced efficacy in certain infections
- Need for alternative antibiotics or combination therapies
- Increased healthcare costs due to longer treatments or more expensive medications
- Potential for more severe or prolonged infections
How can the effectiveness of ampicillin be preserved?
Preserving the effectiveness of ampicillin and other antibiotics requires a multifaceted approach:
- Appropriate prescribing: Use ampicillin only when necessary and for the correct duration.
- Proper use: Patients should complete the full course of antibiotics as prescribed.
- Infection control: Implement measures to prevent the spread of resistant bacteria in healthcare settings.
- Antibiotic stewardship: Healthcare systems should have programs to optimize antibiotic use.
- Research and development: Ongoing efforts to develop new antibiotics and alternative treatments are crucial.
By understanding and addressing the challenges of antibiotic resistance, we can help ensure that ampicillin remains an effective treatment option for future generations.
| Injection, solution | Intravenous | 1 g/3mL |
| Tablet, film coated | Oral | 500 mg |
| Capsule, coated | Oral | 500 mg |
| Tablet, film coated | Oral | |
| Injection, powder, for solution | Intramuscular; Intravenous | 1.5 g |
| Injection, powder, for solution | Parenteral | 1 g |
| Injection, powder, for solution | Intramuscular; Intravenous | 1 g |
| Suspension | Oral | 2.5 g |
| Injection, powder, for solution | Parenteral | 1000 mg |
| Powder, for suspension | Oral | 5 g |
| Injection, powder, for solution | Intramuscular; Intravenous | 500 mg |
| Injection, powder, for suspension | Parenteral | 500 mg |
| Injection, powder, for solution | Parenteral | 500 mg |
| Capsule, coated | Oral | 250 mg |
| Tablet | Oral | 250 mg |
| Tablet | Oral | 1 g |
| Powder, for suspension | Oral | 2. 5 g |
| Capsule | Oral | 250 mg/1 |
| Capsule | Oral | 500 mg/1 |
| Injection, powder, for solution | Intramuscular; Intravenous | 1 g/1 |
| Injection, powder, for solution | Intramuscular; Intravenous | 1 g/1mL |
| Injection, powder, for solution | Intramuscular; Intravenous | 125 mg/1 |
| Injection, powder, for solution | Intramuscular; Intravenous | 2 g/1 |
| Injection, powder, for solution | Intramuscular; Intravenous | 250 mg/1mL |
| Injection, powder, for solution | Intramuscular; Intravenous | 250 mg/1 |
| Injection, powder, for solution | Intramuscular; Intravenous | 500 mg/1mL |
| Injection, powder, for solution | Intramuscular; Intravenous | 500 mg/1 |
| Injection, powder, for solution | Intravenous | 1 g/1 |
| Injection, powder, for solution | Intravenous | 10 g/1 |
| Injection, powder, for solution | Intravenous | 10 g/100mL |
| Injection, powder, for solution | Intravenous | 2 g/1mL |
| Injection, powder, for solution | Intravenous | 2 g/1 |
| Injection, powder, for solution | Intravenous | 250 mg/1 |
| Injection, powder, for solution | Intravenous | 500 mg/1 |
| Powder, for solution | Intramuscular; Intravenous | 1 g/1g |
| Powder, for solution | Intramuscular; Intravenous | 2 g/2g |
| Powder, for solution | Intramuscular; Intravenous | 250 mg/250mg |
| Powder, for solution | Intramuscular; Intravenous | 500 mg/500mg |
| Suspension | Oral | 125 mg/5mL |
| Suspension | Oral | 25 mg/1mL |
| Suspension | Oral | 250 mg/5mL |
| Suspension | Oral | 50 mg/1mL |
| Injection, powder, for solution | Intramuscular; Intravenous | |
| Injection, powder, for solution | Intravenous | |
| Injection, powder, for suspension | Intramuscular; Intravenous | |
| Powder, for solution | Intramuscular; Intravenous | 10 g / vial |
| Powder, for solution | Intramuscular; Intravenous | 2 g / vial |
| Powder, for solution | Intramuscular; Intravenous | 1000 mg / vial |
| Powder, for solution | Intramuscular; Intravenous | 2000 mg / vial |
| Powder, for solution | Intramuscular; Intravenous | 500 mg / vial |
| Suspension | Oral | |
| Tablet | Oral | |
| Injection, powder, for solution | Parenteral | |
| Injection, powder, for solution | 1 G | |
| Injection, powder, for solution | Intramuscular; Intravenous | 500 MG/2. 5ML |
| Powder | Intramuscular; Intravenous | 1000 MG |
| Powder | Intramuscular; Intravenous | 250 MG |
| Injection, powder, for solution | Intramuscular | |
| Powder, for solution | Intravenous | 2 g / vial |
| Ointment | Ophthalmic | |
| Solution / drops | Oral | |
| Injection | Intramuscular; Intravenous | 250 mg |
| Injection, powder, for solution | Intramuscular; Intravenous | 2 g |
| Injection, powder, for solution | Parenteral | 1 G/4mL |
| Injection, powder, for solution | Parenteral | 500 MG/2.5mL |
| Powder, for suspension | Oral | 250 MG |
| Powder, for suspension | Oral | 250 MG/5ML |
| Solution / drops | Oral | 2 g/20ml |
| Suspension | Oral | 3 g |
| Granule | ||
| Tablet, soluble | Oral | 250 mg |
| Injection, solution | Intramuscular; Intravenous | |
| Liquid | Oral | 125 mg / 5 mL |
| Injection | Intramuscular; Intravenous | |
| Tablet | Oral | |
| Injection | Intramuscular | |
| Injection, powder, for solution | ||
| Powder, for suspension | Oral | 5000 mg |
| Tablet | Oral | 1000 mg |
| Injection, solution | Intramuscular | |
| Injection | Intramuscular; Intravenous | |
| Tablet | Oral | 1 gr |
| Tablet | Oral | 500 mg |
| Powder, for solution | Oral | 500 mg / 5 mL |
| Powder, for solution | Oral | 125 mg / 5 mL |
| Powder, for solution | Oral | 250 mg / 5 mL |
| Suspension | Oral | 125 mg / 5 mL |
| Suspension | Oral | 250 mg / 5 mL |
| Injection | Intramuscular; Intravenous | 1 g |
| Injection | Intramuscular; Intravenous | 500 mg |
| Injection, powder, for solution | ||
| Injection, powder, for solution | Intramuscular; Intravenous | 250 mg |
| Powder, for solution | Intramuscular; Intravenous | 1 g / vial |
| Liquid | Intramuscular; Intravenous | 2 g / vial |
| Powder, for solution | Intravenous | 1 g / vial |
| Powder, for solution | Intramuscular; Intravenous | 125 mg / vial |
| Powder, for solution | Intramuscular; Intravenous | 250 mg / vial |
| Syrup | ||
| Suspension | Oral | 80 ml |
| Solution / drops | Oral | 30 ml |
| Suspension | Oral | 8 ml |
| Powder, for suspension | Oral | |
| Capsule; tablet | Oral | |
| Injection, powder, for solution | Parenteral | |
| Capsule | Oral | |
| Capsule | Oral | 250 mg / cap |
| Capsule | Oral | 500 mg / cap |
| Powder | ||
| Injection, powder, for solution | Intramuscular; Intravenous | 1 g |
| Injection, powder, for solution | Intramuscular; Intravenous | 2 g |
| Injection, powder, for solution | Intramuscular; Intravenous | 500 mg |
| Injection, powder, lyophilized, for solution | Intramuscular; Intravenous | |
| Injection, powder, for solution | 1 g/vial | |
| Injection, powder, for solution | 250 mg | |
| Injection, powder, for solution | 500 mg | |
| Capsule | Oral | 250 mg |
| Capsule | Oral | 500 mg |
| Powder, for suspension | Oral | 125 mg/5ml |
| Tablet | Oral | 125 mg |
| Tablet, film coated | Oral | 125 mg |
Ampicillin | VCA Animal Hospitals
What is ampicillin?
Ampicillin (brand names: Omni-Pen®, Teva-ampicillin®, Polyflex, Aminopenicillin®, Principen®, Princillin®, Totacillin®) is an antibacterial medication used to treat certain bacterial infections in small and large animals.
Its use in cats, dogs, and other small animals to treat certain conditions is ‘off label’ or ‘extra-label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their direction may be significantly different from those on the label.
How is ampicillin given?
Ampicillin trihydrate injection is given under the skin or into the muscle, but should NOT be given into the vein, as this can cause sudden death. If giving subcutaneous injections at home, use a new needle and syringe for each injection, and dispose of the needle and syringe into a proper sharps disposal container. Ampicillin sodium is given in the hospital by injection into the vein (IV).
Ampicillin is also available as a liquid oral solution, tablet, or capsule and is given by mouth. If given by mouth, give on an empty stomach at least 1 hour before or 2 hours after feeding.
If vomiting occurs after dosing on an empty stomach, try giving future doses with food or a small treat.
This medication will take effect quickly, in about 1 to 2 hours, but effects may not be visibly obvious for a few days.
What if I miss giving my pet the medication?
If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.
Are there any potential side effects?
Side effects are not common, but may include allergic reaction, lack of appetite, pain at the injection site, vomiting, and diarrhea. In dogs, incoordination is associated with very high doses. Increased breathing rate, breathing problems, swelling, increased heart rate, and elevated liver values on bloodwork have been reported. In cats, if there is a complete loss of appetite, contact your veterinarian immediately.
This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.
Ampicillin can cause false positives with certain urine glucose tests.
Are there any risk factors for this medication?
Ampicillin should not be used in patients that are hypersensitive to penicillin-type antibiotics and should be used with caution in patients that are hypersensitive to beta-lactam antibiotics. Avoid use of this medication in rabbits, guinea pigs, chinchillas, or hamsters.
Using ampicillin during pregnancy and lactation has not been shown to be problematic, but it has not been clearly established as safe. Therefore, ampicillin should be used with caution in pregnant or lactating pets, and only used when the benefits will outweigh the risks.
Are there any drug interactions I should be aware of?
The following medications should be used with caution when given with ampicillin: allopurinol, aminoglycosides, atenolol, bacteriostatic antimicrobials, dichlorphenamide, lanthanum, methotrexate, mycophenolate, pantoprazole, probenecid, and warfarin.
Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.
Is there any monitoring that needs to be done with this medication?
There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working.
How do I store ampicillin?
Ampicillin trihydrate powder should be stored below 25°C (77°F) with trips permitted up to 30°C (86°F), and the reconstituted suspension should be stored for up to 3 months in the refrigerator between 2°C to 8°C (36°F to 46°F). Tablets, capsules, and powder for oral use should be stored at room temperature between 15°C and 30°C (59°F to 86°F). Once reconstituted, the oral suspension should be stored in the refrigerator and discarded after 14 days. It may be stored at room temperature, but in these cases, it should be discarded after 7 days.
What should I do in case of emergency?
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.
Active substance AMPICILLIN (AMPICILLINUM) | Compendium – drug reference book
- Pharmacological properties
- Indications AMPICILLIN
- Application of AMPICILLIN
- Contraindications
- Side effects
- Special instructions
- Interactions
- Overdose
- Diagnosis
- Recommended alternatives
- Trade names
Medicinal preparations containing the active substance AMPICILLIN
Prices in pharmacies
Prices in pharmacies
Prices in pharmacies
Semi-synthetic antibiotic of the penicillin group.
It has a bactericidal effect by competitive blocking of transpeptidases involved in the synthesis of the mucopeptide, which is part of the cell membrane. Active against proliferating bacteria. Effective against gram-positive and some gram-negative microorganisms, including E. coli, Proteus mirabilis, Salmonella spp., Shigella spp., Haemophilus influenzae, Bordetella pertussis, Neisseria gonorrhoeae, Neisseria meningitidis. Ampicillin is also active against gram-positive anaerobic cocci and bacteria (Peptococcus spp., Pertosteptococcus spp., Clostridium spp., Corynebacterium spp.). Penicillinase-forming staphylococci are resistant to ampicillin.
When taken orally, ampicillin is not destroyed in the acidic environment of the stomach and is well absorbed in the digestive tract. Simultaneous ingestion of food reduces the absorption of the antibiotic. C max in the blood is achieved 1-2 hours after administration and slowly decreases over 6 hours.
Cmax max in blood plasma after i / m administration is reached after 1 hour.
About 28% of ampicillin binds to plasma proteins. T ½ from blood plasma is 1-2 hours, in newborns, the elderly and patients with impaired renal function may be lengthened.
Ampicillin is well distributed in tissues and body fluids. Weakly penetrates through the BBB, with meningitis its concentration in the cerebrospinal fluid increases. Penetrates through the placental barrier. Small amounts are found in breast milk. It is excreted unchanged by the kidneys by glomerular filtration and tubular secretion, about 20% of the antibiotic is excreted in the bile. Partially removed during hemodialysis.
infections caused by ampicillin-susceptible organisms, including bronchitis, pneumonia, lung abscess, pyelonephritis, cystitis, otitis media, sinusitis, tonsillitis, gynecological infections, biliary tract infections, digestive tract infections caused by shigella or salmonella (ampicillin is also used for sanitation of carriers), infections of the skin and soft tissues, sepsis, meningitis, endocarditis, prevention of postoperative complications.
orally, IM, IV. The dose of ampicillin is set individually depending on the localization of the process and the severity of the disease.
Adults usually take 250-500 mg 4 times a day. In severe infections, the dose of ampicillin may be increased.
Children are prescribed at a dose of 50-100 mg/kg of body weight per day in 4 divided doses. Children weighing >20 kg – at the adult dose. In severe infections, the dose of ampicillin may be increased.
Duration of treatment – 7-14 days or more. Treatment with ampicillin should be continued for at least 48-72 hours after normalization of body temperature and the disappearance of symptoms of the disease. For infections caused by hemolytic streptococcus, the duration of treatment should be at least 10 days.
In renal insufficiency, the dose and interval between injections must be adjusted according to the plasma creatinine concentration.
hypersensitivity to penicillin antibiotics.
possible allergic reactions, nausea, vomiting, diarrhea, candidiasis of the oral mucosa, pseudomembranous colitis (both during treatment and a few weeks after its termination), reversible disorders of hematopoiesis and, in some cases, interstitial nephritis are rarely noted.
During treatment with ampicillin, transient increases in plasma aminotransferases, LDH, alkaline phosphatase, and creatinine, a false-positive glucosuric test, and a false-positive Coombs reaction may occur.
An antibiotic susceptibility test should be performed before using ampicillin. With extreme caution prescribed to patients with hypersensitivity to cephalosporins, griseofulvin or penicillamine. With long-term treatment with ampicillin, it is recommended to periodically monitor the function of the kidneys, liver and hematopoietic organs.
The possibility of superinfection caused by pathogenic fungi or resistant bacteria should be considered. With the development of superinfection, adequate therapy is prescribed.
If combined parenteral treatment with ampicillin and aminoglycoside antibiotics is required, they should be administered at different sites with an interval of 1 hour due to the risk of inactivation. Ampicillin may cause a decrease in the effectiveness of oral hormonal contraceptives.
Ampicillin in high doses reduces the level of atenolol in the blood plasma, so it is recommended to use these drugs separately, with atenolol taken before the use of ampicillin. Simultaneous use with allopurinol significantly increases the likelihood of skin rashes. Probenecid may reduce the excretion of ampicillin by the kidneys and lead to an increase in plasma concentrations.
During treatment with ampicillin, false-positive results of non-enzymatic glucosuric tests may be determined.
symptomatic treatment. In patients with impaired renal function, antibiotics such as ampicillin can be removed by hemodialysis, but not by peritoneal dialysis.
MR Ampicillin sodium salt powder for injection – Merrymed farm
Pharmacological properties
Ampicillin is a broad-spectrum antibiotic from the group of semi-synthetic penicillins. It acts bactericidal, inhibiting the synthesis of the cell wall of microorganisms. Destroyed by penicillinase.
The following microorganisms are constantly sensitive to the drug: Streptococci A, B, C, F, G, Str. pneumoniae that do not produce penicillinase; L. monocytogernes, Corynebacteriumdiphtheriae, Erysipelotrixrhusopathiae, Eikenella, N. Meningitides, Bordetellapertussis, Clostridiumspp., Propioniobacteriumacnes, Peptostreptococcusspp., Actinomycesspp., Leptospiraspp., Treponema; not always sensitive: Enterococcusfaecalis, E.Coli, Proteusmirabilis, Salmonellaspp., Vibriocholerae, H.Influenzae, N.gonorrhoeae, Fusobacteriumspp., Prevotella.
Resistant to the drug: Staphylococcusspp., B.catarrhalis, Klebsiellaspp., Enterobacterspp., C.diversus, C.freundii, Proteusvulgaris, Providenciarettgeri, Morganellamoranii, Y.enterocolitica.,Pseudomonasspp., Acinetbacterspp., Xanthomonasspp., Flavob acterium spp., Alcaligenesspp., Nocardiaspp., Campylobacterspp., Legionellapneumophila, Mycobacteriumspp., Bacteriodesspp., Mycoplasmaspp., Chlamydiaspp.
Pharmacokinetics
After parenteral administration, it penetrates into tissues and body fluids, is found in therapeutic concentrations in pleural, peritoneal and synovial fluids, in bile.
The drug crosses the placental barrier, is excreted in breast milk. The elimination half-life is approximately 1 hour, with anuria it increases to 12-20 hours. The main part is excreted from the body by the kidneys, and a very high concentration of the antibiotic is created in the urine. The drug does not accumulate during repeated injections, which makes it possible to use it in large doses and for a long time.
Indications for use
Bacterial infections: bronchitis, pneumonia, dysentery, salmonellosis, long-term carriage of salmonella, cholecystitis, whooping cough, pyelonephritis, urethritis, endocarditis, infections of the skin and soft tissues, gynecological infections, infections of the ear, throat, nose, odontogenic infections, meningitis, sepsis and other infections caused by microorganisms sensitive to the drug.
Methods of administration and doses
Parenterally: intramuscularly (IM) and intravenously (IV) (stream or drip).
With both methods of administration for adults, 250-500 mg 4-6 times a day; in severe infections, the daily dose may be increased to 10 g or more; children, depending on age in a daily dose: newborns 100 mg / kg, under the age of 1 year 50 mg / kg, from 1 year to 4 years 50-75 mg / kg, over 4 years 50 mg / kg.
The duration of treatment depends on the severity of the condition and the effectiveness of therapy (from 5-10 days to 2-3 weeks or more).
Solution for intramuscular injection is prepared extempore by adding 2 ml of water for injection or 0.5% solution of novocaine for injection to the contents of the vial (with the exception of patients with hypersensitivity to novocaine). For intravenous jet administration, a single dose of the drug (not more than 2 g) is dissolved in 5-10 ml of sterile water for injection or isotonic sodium chloride solution, injected slowly.
Side effects
Allergic reactions (urticaria, erythema, Quincke’s edema, rhinitis, conjunctivitis; rarely – fever, joint pain, eosinophilia; extremely rarely – anaphylactic shock).
Perhaps a toxic effect on the central nervous system (when using high doses in patients with renal insufficiency), dyspeptic symptoms (diarrhea, nausea, vomiting), candidiasis, intestinal dysbacteriosis.
Contraindications
Hypersensitivity (including to other penicillins, cephalosporins, carbapenems), severe hepatic impairment, breastfeeding (must be stopped during treatment).
Drug interactions
Simultaneous administration with bacteriostatic antibiotics (tetracycline, chloramphenicol, erythromycin and others) causes mutual antagonism. With aminoglycoside antibiotics, there is synergism in antimicrobial efficacy. Co-administration of probenecid reduces the excretion of the drug in the urine and leads to an increase in its content in the blood serum, and with allopurinol it slows down the metabolism of the drug and increases the incidence of skin rashes. The drug in rare cases weakens the effect of oral contraceptives.
Special instructions
In case of allergic reactions it is necessary to stop taking the drug and carry out desensitizing therapy. When using the drug in patients with sepsis, a bacteriolysis reaction (the Jarisch-Gerksgeimer reaction) is possible. In debilitated patients with long-term treatment, it is possible to develop superinfection caused by drug-resistant microorganisms (yeast-like fungi, gram-negative microorganisms). It is advisable for these patients to prescribe vitamins of group B and vitamin C during treatment with the drug, if necessary, give nystatin or levorin. With bronchial asthma, hay fever and other allergic diseases, if necessary, the drug is used with the simultaneous appointment of desensitizing agents.
Systematic monitoring of kidney function, liver function and blood count is required. Caution should be exercised when prescribing the drug to patients with renal insufficiency.
Keep out of the reach of children and should not be used after the expiration date.