Trade name for ampicillin. Ampicillin: Comprehensive Guide to Uses, Dosages, Side Effects, and Interactions
What are the primary uses of ampicillin. How is ampicillin administered and what are the common dosages. What side effects can occur when taking ampicillin. How does ampicillin interact with other medications.
Understanding Ampicillin: An Overview of the Antibiotic
Ampicillin is a broad-spectrum antibiotic belonging to the penicillin group of drugs. It is widely used to treat various bacterial infections in both humans and animals. As a versatile antibiotic, ampicillin has been a crucial component in the medical field for decades.
Is ampicillin available under different brand names? Yes, ampicillin is marketed under various trade names, including:
- Omni-Pen®
- Teva-ampicillin®
- Polyflex®
- Aminopenicillin®
- Principen®
- Princillin®
The Mechanism of Action: How Ampicillin Fights Infections
Ampicillin works by interfering with the cell wall synthesis of bacteria. It inhibits the final stage of bacterial cell wall formation, leading to cell lysis and death. This mechanism makes ampicillin effective against a wide range of gram-positive and gram-negative bacteria.
Does ampicillin affect all types of microorganisms equally? No, ampicillin is primarily effective against bacteria. It does not work against viruses or fungi. The antibiotic is particularly potent against:
- Streptococcus species
- Listeria monocytogenes
- Some strains of Escherichia coli
- Haemophilus influenzae
- Neisseria meningitidis
Diverse Applications: Medical Uses of Ampicillin
Ampicillin’s broad-spectrum activity makes it useful for treating various infections. Healthcare providers prescribe it for conditions such as:
- Respiratory tract infections
- Urinary tract infections
- Meningitis
- Gastrointestinal infections
- Septicemia
- Endocarditis
Can ampicillin be used in veterinary medicine? Yes, ampicillin is also widely used in veterinary practice to treat bacterial infections in animals, including dogs, cats, and livestock.
Administration and Dosage Forms: How to Take Ampicillin
Ampicillin is available in multiple formulations to suit different medical needs and patient preferences. The common dosage forms include:
Oral Formulations
- Capsules (250 mg, 500 mg)
- Tablets (250 mg, 500 mg, 1 g)
- Oral suspension (125 mg/5mL, 250 mg/5mL)
Parenteral Formulations
- Injection, powder for solution (250 mg, 500 mg, 1 g, 2 g)
- Intramuscular injection
- Intravenous injection
How should ampicillin be administered? The method of administration depends on the formulation and the patient’s condition. Oral formulations are typically taken every 6 hours, while parenteral forms may be given at different intervals based on the severity of the infection and the patient’s renal function.
Dosage Guidelines: Ensuring Effective Treatment
Proper dosing of ampicillin is crucial for effective treatment and minimizing the risk of side effects. The dosage varies based on several factors:
- Age of the patient
- Weight (especially important in pediatric dosing)
- Severity of the infection
- Renal function
- Route of administration
Are there standard dosage recommendations for ampicillin? While dosages should be tailored to individual patients, some general guidelines include:
- Adults: 250-500 mg orally every 6 hours, or 1-2 g IV/IM every 4-6 hours for severe infections
- Children: 50-100 mg/kg/day divided into 4 doses
- Neonates: 100-200 mg/kg/day divided into 3-4 doses
Side Effects and Precautions: What to Watch For
While ampicillin is generally well-tolerated, it can cause side effects in some patients. Common side effects include:
- Nausea and vomiting
- Diarrhea
- Rash
- Candidiasis (oral or vaginal yeast infection)
Can ampicillin cause allergic reactions? Yes, as with all penicillin antibiotics, ampicillin can cause allergic reactions, ranging from mild skin rashes to severe anaphylaxis. Patients with a known penicillin allergy should avoid ampicillin.
Rare but Serious Side Effects
In rare cases, ampicillin may cause more serious side effects, such as:
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Clostridium difficile-associated diarrhea
- Blood dyscrasias
Drug Interactions: Navigating Combination Therapies
Ampicillin can interact with various medications, potentially affecting its efficacy or increasing the risk of side effects. Some notable interactions include:
- Oral contraceptives: Ampicillin may reduce their effectiveness
- Allopurinol: Increased risk of skin rash
- Probenecid: May increase ampicillin levels in the blood
- Methotrexate: Ampicillin may increase its toxicity
Should patients taking ampicillin avoid any specific foods or beverages? While there are no significant food interactions with ampicillin, it’s generally recommended to take it on an empty stomach for optimal absorption. However, if gastrointestinal upset occurs, it can be taken with food.
Special Populations: Considerations for Pregnant Women and Elderly Patients
Ampicillin use requires special consideration in certain populations:
Pregnancy and Breastfeeding
Ampicillin is generally considered safe during pregnancy and breastfeeding. It falls under FDA Pregnancy Category B, indicating no evidence of risk in humans. However, as with all medications during pregnancy, it should be used only when clearly needed.
Elderly Patients
Older adults may require dosage adjustments due to decreased renal function. Close monitoring of renal function and potential side effects is important in this population.
Can ampicillin be used in patients with renal impairment? Yes, but dosage adjustments are often necessary. Patients with severe renal impairment may require reduced doses or extended intervals between doses to prevent drug accumulation.
Antibiotic Resistance: A Growing Concern
The emergence of antibiotic-resistant bacteria is a significant global health issue, and ampicillin is not immune to this problem. Several factors contribute to the development of resistance:
- Overuse and misuse of antibiotics
- Incomplete treatment courses
- Use of antibiotics in livestock
- Spread of resistant strains in healthcare settings
How can healthcare providers and patients help combat antibiotic resistance? Responsible use of antibiotics is crucial. This includes:
- Prescribing antibiotics only when necessary
- Choosing the appropriate antibiotic based on susceptibility testing
- Completing the full course of treatment as prescribed
- Proper hygiene and infection control practices
Future Perspectives: Ampicillin in Modern Medicine
Despite the challenges of antibiotic resistance, ampicillin continues to play a vital role in modern medicine. Ongoing research focuses on several areas:
- Development of new formulations for improved efficacy and reduced side effects
- Combination therapies to overcome resistance mechanisms
- Novel delivery systems for targeted antibiotic delivery
- Understanding and mitigating the environmental impact of antibiotic use
Will ampicillin remain a relevant antibiotic in the future? While the landscape of antibiotic therapy is evolving, ampicillin’s broad-spectrum activity and well-established safety profile ensure its continued importance. However, its use may become more targeted and carefully managed to preserve its effectiveness against susceptible bacteria.
Conclusion: The Enduring Legacy of Ampicillin
Ampicillin has been a cornerstone of antibiotic therapy for decades, and its importance in treating various bacterial infections cannot be overstated. As we navigate the challenges of antibiotic resistance and seek new ways to combat infections, ampicillin remains a valuable tool in the medical arsenal.
Understanding its uses, dosages, side effects, and interactions is crucial for healthcare providers and patients alike. By using ampicillin responsibly and staying informed about its properties and limitations, we can continue to harness its benefits while working towards a future of more effective and sustainable antibiotic therapies.
As research progresses and our understanding of bacterial infections deepens, ampicillin will likely continue to evolve in its applications and formulations. The ongoing efforts to combat antibiotic resistance and develop new treatment strategies will shape the future role of this versatile antibiotic, ensuring its place in the pantheon of life-saving medications for years to come.
| 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.