AMPICILLIN-SULBACTAM

Antibacterial Activity

Effective against most gram-positive including enteroccoci
Effective against most gram-negative (eg. H. influenza, M. catarrhalis)
Effective against  anaerobes
Effective against  b-lactamase producing organisms

Pregnancy Risk Factor

Category B

Contraindication/Precaution

Hypersensitivity to ampicillin or sulbactam or any penicillins or any component
Not FDA approved use for children <12 years old, but many still use it Use caution with patient who are allergic to cephalosporin, they could have an hypersensibility to penicillins Use caution if EBV, CMV or LLA: may develop rash Use caution if impaired renal/liver function Mechanism of Action Selective inhibitors of bacterial cell wall synthesis, by binding to penicillins binding proteins (PBP'S) Sulbactam inhibits b-lactamase Pharmacodynamics/Kinetics Metabolism:  Liver (partially) Half-life:  both: 1 hour, change with renal function. Elimination:  both: excreted  in urine Dosage Children: (max 8 g/day (ampi), 4g/day (sulbactam)) Body weight > 2000 g
> 28 days old: 100-300 mg/kg/d  (ampi) IM/IV div q6h

Adults: (max 8 g/day (ampi), 4g/day (sulbactam))

1.5-3 g  (ampi) IM/IV q6h

Dosage In Renal Failure

Creatinine clearance (ml/min):
<10: same dose but q24h 10-50: same dose but q12h 50-80: unchanged >80: unchanged
Dialysis
Hemo: N/A
CAPD: N/A