ampicillin sodium
Ampicin†, Ampicyn‡, Omnipen-N, Penbritin†, Totacillin-N
ampicillin trihydrate
Pregnancy Risk Category B
Omnipen, Penbritin†, Totacillin
How supplied
Capsules: 250 mg, 500 mg
Oral suspension: 125 mg/5 ml, 250 mg/5 ml
Injection: 125 mg, 250 mg, 500 mg, 1 g, 2 g
Action
An aminopenicillin that inhibits cell-wall synthesis during microorganism multiplication. Bacteria resist ampicillin by producing penicillinases-enzymes that hydrolyze ampicillin.
Indications & dosage
Systemic infections and acute and chronic urinary tract infections due to susceptible strains of gram-positive and gram-negative organisms-
Adults and children weighing 40 kg (88 lb) or more: 250 to 500 mg P.O. q 6 hours; or 1 to 12 g I.M. or I.V. daily in divided doses q 4 to 6 hours.
Children weighing under 40 kg: 25 to 100 mg/kg/day P.O. in equally divided doses q 6 hours; or 25 to 50 mg/kg/day I.M. or I.V. in divided doses q 6 to 8 hours. Pediatric dosages shouldn't exceed recommended adult dosages.
Meningitis-
Adults: 150 to 200 mg/kg/day I.V. in divided doses q 3 to 4 hours. May be given I.M. after 3 days of I.V. therapy.
Children: 100 to 200 mg/kg I.V. daily in divided doses q 3 to 4 hours. Give I.V. for 3 days; then give I.M.
Uncomplicated gonorrhea-
Adults and children weighing over 45 kg (99 lb): 3.5 g P.O. with 1 g probenecid given as a single dose.
Endocarditis prophylaxis for dental and GI/GU procedures-
Adults: 2 g I.M. or I.V. within 30 minutes before procedure.
Children: 50 mg/kg I.M. or I.V. within 30 minutes before procedure.
Note: Give drug with gentamicin in high-risk procedures.
Adverse reactions
CNS: lethargy, hallucinations, seizures, anxiety, confusion, agitation, depression, dizziness, fatigue.
CV: vein irritation, thrombophlebitis.
GI: nausea, vomiting, diarrhea, glossitis, stomatitis, gastritis, abdominal pain, enterocolitis, pseudomembranous colitis, black "hairy" tongue.
GU: interstitial nephritis, nephropathy, vaginitis.
Hematologic: anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, hemolytic anemia, agranulocytosis.
Other: hypersensitivity reactions (erythematous maculopapular rash, urticaria, anaphylaxis), overgrowth of nonsusceptible organisms, pain at injection site.
Interactions
Drug-drug. Allopurinol: increased incidence of rash. Monitor patient.
Oral contraceptives: efficacy of oral contraceptives may be decreased. Recommend additional form of contraception during penicillin therapy.
Probenecid: increased blood levels of ampicillin and other penicillins. Probenecid may be used for this purpose.
Effects on diagnostic tests
Drug alters results of urine glucose tests that use cupric sulfate (Benedict's reagent or Clinitest). Make urine glucose determinations with glucose oxidase methods (Diastix or Chemstrip uG). Ampicillin may falsely decrease serum aminoglycoside levels.
Contraindications
Contraindicated in patients with hypersensitivity to drug or other penicillins.
Nursing considerations
I.V. administration
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING