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Ampicillin
Sub-sections

Ampicillin

Ampicillin Sodium

Ampicillin Trihydrate

Adverse Effects
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Precautions
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Interactions

Antimicrobial Action
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Pharmacokinetics
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Uses and Administration

Preparations
Ampicillin
Date of monograph review: 24-Mar-1997; 21-Jul-1998; 17-Feb-2000; 12Sep-2001; 02-Sep-2003; 25-Jul-2006; 10-Sep-2008; 17-Nov-2009; 20Aug-2010; (latest modification: 30-Jan-2013)
Drug Nomenclature (Latest modification: 12-Feb-2013)
Synonyms: Αμπικιλλίνη; Anhydrous Ampicillin; Aminobenzylpenicillin;
Ampicilin; Ampicilina; Ampicilinas, bevandenis; Ampicillin, vattenfritt;
Ampicilline anhydre; Ampicillinum; Ampicillinum Anhydricum; Ampicylina
bezwodna; Ampisilin; Ampisilliini; Ampisilliini, vedetön; AY-6108; BRL1341; NSC-528986; P-50; Vízmentes ampicillin; Wasserfreies Ampicillin;
無水アンピシリン; アンピシリン
BAN: Ampicillin
USAN: Ampicillin
INN: Ampicillin [rINN (en)]
INN: Ampicilina [rINN (es)]
INN: Ampicilline [rINN (fr)]
INN: Ampicillinum [rINN (la)]
INN: Ампициллин [rINN (ru)]
INN: ‫[ أم ب س ي ل ين‬rINN (ar)]
INN: 氨苄西林 [rINN (cn)]
Chemical name: (6R)-6-(α-D-Phenylglycylamino)penicillanic acid
Molecular formula: C16H19N3O4S =349.4
CAS: 69-53-4
ATC code: J01CA01; S01AA19
ATC code (veterinary): QJ01CA01; QJ51CA01; QS01AA19
UNII code: 7C782967RD
Chemical Structure of Ampicillin
NOTE:
Compounded preparations of ampicillin may be represented by the
following names:
Co-fluampicil (BAN)—flucloxacillin 1 part and ampicillin 1 part (w/w).
Pharmacopoeias:
In Eur. (see
), Jpn, and Viet.
Int. and US permit anhydrous or the trihydrate.
Ph. Eur. 7 (Ampicillin, Anhydrous; Ampicillin BP 2013). A white or
almost white, crystalline powder. It exhibits polymorphism. Sparingly
soluble in water; practically insoluble in alcohol, in acetone, and in fatty
oils. It dissolves in dilute solutions of acids and of alkali hydroxides. A
0.25% solution in water has a pH of 3.5 to 5.5. Store at a temperature
not exceeding 30 degrees in airtight containers.
USP 36 (Ampicillin). It is anhydrous or contains three molecules of
water of hydration. A white, practically odourless crystalline powder.
Slightly soluble in water and in methyl alcohol; insoluble in carbon
tetrachloride, in chloroform, and in benzene. pH of a 1% solution in
water is between 3.5 and 6.0. Store in airtight containers.
Ampicillin Sodium
Date of monograph review: 24-Mar-1997; 21-Jul-1998; 17-Feb-2000; 12Sep-2001; 02-Sep-2003; 25-Jul-2006; 10-Sep-2008; 17-Nov-2009; 20Aug-2010; (latest modification: 30-Jan-2013)
Drug Nomenclature (Latest modification: 30-Jan-2013)
Synonyms: Aminobenzylpenicillin Sodium; Ampicilin sodná sůl;
Ampicilina sódica; Ampicilino natrio druska; Ampicillin-Natrium;
Ampicillin-nátrium; Ampicilline sodique; Ampicillinnatrium; Ampicillinum
Natricum; Ampicylina sodowa; Ampisilliininatrium; Sodyum Ampisilin;
アンピシリンナトリウム
BAN: Ampicillin Sodium [BANM]
USAN: Ampicillin Sodium
INN: Ampicillin Sodium [rINNM (en)]
INN: Ampicilina sódica [rINNM (es)]
INN: Ampicilline Sodique [rINNM (fr)]
INN: Natrii Ampicillinum [rINNM (la)]
INN: Натрий Ампициллин [rINNM (ru)]
Molecular formula: C16H18N3NaO4S =371.4
CAS: 69-52-3
ATC code: J01CA01; S01AA19
ATC code (veterinary): QJ01CA01; QS01AA19
UNII code: JFN36L5S8K
Pharmacopoeias:
In Chin., Eur. (see
), Int., Jpn, and US.
Ph. Eur. 7 (Ampicillin Sodium). A white or almost white hygroscopic
powder. Freely soluble in water; sparingly soluble in acetone; practically
insoluble in liquid paraffin and in fatty oils. A 10% solution in water has
a pH of 8.0 to 10.0. Store in airtight containers.
USP 36 (Ampicillin Sodium). A white to off-white, odourless or
practically odourless, hygroscopic, crystalline powder. Very soluble in
water and in isotonic sodium chloride and glucose solutions. pH of a
solution in water containing the equivalent of ampicillin 1% is between
8.0 and 10.0. Store in airtight containers.
Physicochemical Characteristics (Latest modification: 23-Apr-2004)
Incompatibility
The incompatibility of ampicillin sodium and aminoglycosides is well
established. Incompatibilities have also been reported with many other
drugs, including other antibacterials, and appear to be more pronounced at
higher concentrations and in solutions also containing glucose.
(last reviewed 2010-08-20; last modified 2009-09-07)
Stability
The stability of solutions of ampicillin sodium is dependent on many factors
including concentration, pH, temperature, and the nature of the vehicle.
Stability decreases in the presence of glucose, fructose, invert sugar,
dextrans, hetastarch, sodium bicarbonate, and lactate. It is recommended
that reconstituted solutions of ampicillin sodium for injection should be
given within 24 hours of preparation, and should be stored at 2 degrees to
8 degrees but should not be frozen. Solutions for infusion are stable for
varying periods and details are given in licensed product information.
References.
(last reviewed 2010-08-20; last modified 2006-07-18)
1. 1. Lynn B. The stability and administration of intravenous penicillins. Br J
Intraven Ther 1981; 2(Mar): 22–39.
Ampicillin Trihydrate
Date of monograph review: 24-Mar-1997; 21-Jul-1998; 17-Feb-2000; 12Sep-2001; 02-Sep-2003; 25-Jul-2006; 10-Sep-2008; 17-Nov-2009; 20Aug-2010; (latest modification: 30-Jan-2013)
Drug Nomenclature (Latest modification: 30-Jan-2013)
Synonyms: Ampicillin; Ampicilin trihydrát; Ampicilina trihidrato;
Ampicilinas trihidratas; Ampicillin-trihidrát; Ampicillin-Trihydrat;
Ampicilline trihydratée; Ampicillintrihydrat; Ampicillinum Trihydricum;
Ampicylina trójwodna; Ampisilliinitrihydraatti
BAN: Ampicillin Trihydrate [BANM]
INN: Ampicillin Trihydrate [rINNM (en)]
INN: Ampicilina trihidrato [rINNM (es)]
INN: Ampicilline Trihydratée [rINNM (fr)]
INN: Ampicillinum Trihydricum [rINNM (la)]
INN: Ампициллин Тригидрат [rINNM (ru)]
Molecular formula: C16H19N3O4S,3H2O =403.4
CAS: 7177-48-2
ATC code: J01CA01; S01AA19
ATC code (veterinary): QJ01CA01; QS01AA19
UNII code: HXQ6A1N7R6
Pharmacopoeias:
In Eur. (see
), Jpn, and Viet. In Chin. under the title Ampicillin.
Int. and US permit anhydrous or the trihydrate under the title
Ampicillin.
Ph. Eur. 7 (Ampicillin Trihydrate). A white or almost white, crystalline
powder. Slightly soluble in water; practically insoluble in alcohol and in
fatty oils. It dissolves in dilute solutions of acids and of alkali hydroxides.
A 0.25% solution in water has a pH of 3.5 to 5.5. Store in airtight
containers.
USP 36 (Ampicillin). It is anhydrous or contains three molecules of
water of hydration. A white, practically odourless crystalline powder.
Slightly soluble in water and in methyl alcohol; insoluble in carbon
tetrachloride, in chloroform, and in benzene. pH of a 1% solution in
water is between 3.5 and 6.0. Store in airtight containers.
Adverse Effects (Latest modification: 07-Sep-2009)
As for Benzylpenicillin,
.
Skin rashes are among the most common adverse effects and are generally
either urticarial or maculopapular; the urticarial reactions are typical of
penicillin hypersensitivity, while the erythematous maculopapular eruptions
are characteristic of ampicillin and amoxicillin and often appear more than 7
days after starting treatment. Such rashes may be due to hypersensitivity to
the beta-lactam moiety or to the amino group in the side-chain, or to a toxic
reaction. The occurrence of a maculopapular rash during ampicillin use does
not necessarily preclude the subsequent use of other penicillins. However,
since it may be difficult in practice to distinguish between hypersensitive and
toxic responses, skin testing for hypersensitivity may be advisable before
another penicillin is used in patients who have had ampicillin rashes. Most
patients with infectious mononucleosis develop a maculopapular rash when
treated with ampicillin, and patients with other lymphoid disorders such as
lymphatic leukaemia, and possibly those with HIV infection, also appear to
be at higher risk. More serious skin reactions may occur and erythema
multiforme associated with ampicillin has occasionally been reported.
Gastrointestinal adverse effects, particularly diarrhoea and nausea and
vomiting, occur quite often, usually after oral use. Pseudomembranous
colitis has also been reported.
(last reviewed 2010-08-20; last modified 2009-09-07)
Effects on the liver (Latest modification: 02-Jan-2011)
Ampicillin has been associated with hepatic injury. Self-limiting cholestasis
was reported in a 23-year-old man who received oral ampicillin;1
recurrence followed each of 2 subsequent exposures to the drug. A case of
chronic cholestasis associated with ampicillin use has also been reported.2
Severe and prolonged cholestasis has also been reported after treatment
with ampicillin plus sulbactam; gradual resolution of the condition occurred
over 7 months.3
(last reviewed 2010-08-20; last modified 2011-01-02)
1. 1. Köklü S, et al. Recurrent cholestasis due to ampicillin. Ann
Pharmacother 2003; 37: 395–7. PubMed
2. 2. Cavanzo FJ, et al. Chronic cholestasis, paucity of bile ducts, red cell
aplasia, and the Stevens-Johnson syndrome: an ampicillin-associated case.
Gastroenterology 1990; 99: 854–6. PubMed
3. 3. Köklü S, et al. Probable sulbactam/ampicillin-associated prolonged
cholestasis. Ann Pharmacother 2004; 38: 2055–8. PubMed
Precautions (Latest modification: 18-Jul-2006)
As for Benzylpenicillin,
.
Ampicillin should be stopped if a skin rash occurs. It should preferably not be
given to patients with infectious mononucleosis since they are especially
susceptible to ampicillin-induced skin rashes; patients with lymphatic
leukaemia or possibly HIV infection may also be at increased risk of
developing skin rashes.
(last reviewed 2010-08-20; last modified 2006-07-18)
Myasthenia gravis (Latest modification: 25-Mar-2004)
The symptoms of a woman with myasthenia gravis were exacerbated
when she was given ampicillin.1
(last reviewed 2010-08-20; last modified 2004-03-25)
1. 1. Argov Z, et al. Ampicillin may aggravate clinical and experimental
myasthenia gravis. Arch Neurol 1986; 43: 255–6. PubMed
Porphyria (Latest modification: 03-Nov-2011)
The Drug Database for Acute Porphyria, compiled by the Norwegian
Porphyria Centre (NAPOS) and the Porphyria Centre Sweden, classifies
ampicillin as not porphyrinogenic; it may be used as a drug of first choice
and no precautions are needed.1
(last reviewed 2010-08-20; last modified 2011-11-03)
1. 1. The Drug Database for Acute Porphyria. Available at: online (accessed
18/10/11)
Sodium content (Latest modification: 25-Mar-2004)
Each g of ampicillin sodium contains about 2.7 mmol of sodium.
(last reviewed 2010-08-20; last modified 2004-03-25)
Interactions (Latest modification: 15-May-2010)
As for Benzylpenicillin,
.
(last reviewed 2010-08-20; last modified 2010-05-15)
Antigout drugs (Latest modification: 07-Sep-2009)
An increased frequency of skin rashes has been reported in patients
receiving ampicillin or amoxicillin, with allopurinol, compared with those
receiving the antibacterial alone,1 but this could not be confirmed in a
subsequent study.2
(last reviewed 2010-08-20; last modified 2009-09-07)
1. 1. Jick H, Porter JB. Potentiation of ampicillin skin reactions by allopurinol
or hyperuricemia. J Clin Pharmacol 1981; 21: 456–8. PubMed
2. 2. Hoigné R, et al. Occurrence of exanthems in relation to aminopenicillin
preparations and allopurinol. N Engl J Med 1987; 316: 1217. PubMed
Antimalarials (Latest modification: 07-Sep-2009)
The absorption of ampicillin has been reduced in healthy subjects taking
chloroquine.1
(last reviewed 2010-08-20; last modified 2009-09-07)
1. 1. Ali HM. Reduced ampicillin bioavailability following oral coadministration
with chloroquine. J Antimicrob Chemother 1985; 15: 781–4. PubMed
Antimicrobial Action (Latest modification: 26-Jul-2010)
Ampicillin is a beta-lactam antibacterial. It is bactericidal and has a similar
mode of action to that of benzylpenicillin (
), but as an aminopenicillin
with an amino group side-chain attached to the basic penicillin structure,
ampicillin is better able to penetrate the outer membrane of some Gramnegative bacteria and has a broader spectrum of activity.
Ampicillin resembles benzylpenicillin in its action against Gram-positive
organisms, including Streptococcus pneumoniae and other streptococci,
but, with the possible exception of activity against Enterococcus faecalis, it
is slightly less potent than benzylpenicillin.
Listeria monocytogenes is highly sensitive.
The Gram-negative cocci Moraxella catarrhalis (Branhamella catarrhalis),
Neisseria gonorrhoeae, and N. meningitidis are sensitive.
Ampicillin is more active than benzylpenicillin against some Gram-negative
bacilli, including Haemophilus influenzae and Enterobacteriaceae such as
Escherichia coli, Proteus mirabilis, Salmonella and Shigella spp. It is
inactive against Pseudomonas aeruginosa.
Ampicillin also has activity similar to benzylpenicillin against other
organisms including many anaerobes and Actinomyces spp.
Activity with other antimicrobials. There is synergy against some betalactamase-producing organisms between ampicillin and beta-lactamase
inhibitors such as clavulanic acid or sulbactam, and also penicillinase-stable
drugs such as cloxacillin or flucloxacillin. Synergy has also been shown
between ampicillin and aminoglycosides against a range of organisms,
including enterococci. Variable effects ranging from synergy to antagonism
have been reported between ampicillin and other beta lactams,
bacteriostatic drugs such as chloramphenicol, and rifampicin.
Resistance. Like benzylpenicillin, ampicillin is inactivated by beta lactamases,
although other mechanisms may be responsible for resistance in some
species. There are geographical variations in the incidence of resistance, but
most staphylococci and many strains of E. coli, H. influenzae, M. catarrhalis,
N. gonorrhoeae, and Salmonella and Shigella spp. are resistant.
(last reviewed 2010-08-20; last modified 2010-07-26)
Pharmacokinetics (Latest modification: 07-Sep-2009)
Ampicillin is relatively resistant to inactivation by gastric acid and is
moderately well absorbed from the gastrointestinal tract after oral doses.
Food can interfere with the absorption of ampicillin so doses should
preferably be taken at least 30 minutes before meals. Peak concentrations in
plasma occur in about 1 to 2 hours and after a 500-mg oral dose are
reported to range from 3 to 6 micrograms/mL.
Peak plasma concentrations of ampicillin after a 500-mg intramuscular dose
given as the sodium salt occur within about 1 hour and are reported to range
from 7 to 14 micrograms/mL.
Ampicillin is widely distributed and therapeutic concentrations can be
achieved in ascitic, pleural, and joint fluids. It crosses the placenta and small
amounts are distributed into breast milk. There is little diffusion into the CSF
except when the meninges are inflamed. About 20% is bound to plasma
proteins and the plasma half-life is about 1 to 1.5 hours, but this may be
increased in neonates, the elderly, and patients with renal impairment; in
severe renal impairment half-lives of 7 to 20 hours have been reported.
Ampicillin is metabolised to some extent to penicilloic acid which is excreted
in the urine.
Renal clearance of ampicillin occurs partly by glomerular filtration and partly
by tubular secretion; it is reduced by probenecid. About 20 to 40% of an oral
dose may be excreted unchanged in the urine in 6 hours; urinary
concentrations have ranged from 0.25 to 1 mg/mL after a dose of 500 mg.
After parenteral use about 60 to 80% is excreted in the urine within 6 hours.
Ampicillin is removed by haemodialysis. High concentrations are reached in
bile; it undergoes enterohepatic recycling and some is excreted in the
faeces.
Ampicillin with sulbactam. The pharmacokinetics of ampicillin and sulbactam
are broadly similar and neither appears to affect the other to any great
extent.
(last reviewed 2010-08-20; last modified 2009-09-07)
Uses and Administration (Latest modification: 02-Sep-2010)
Ampicillin is used in the treatment of a variety of infections due to
susceptible organisms (see Antimicrobial Action,
). They include biliary-
tract infections, bronchitis, endocarditis, gastro-enteritis (including
salmonella enteritis and shigellosis), gonorrhoea, listeriosis, meningitis,
perinatal streptococcal infections (intrapartum prophylaxis against group B
streptococci), peritonitis, pneumonia, septicaemia, typhoid and paratyphoid
fever, and urinary-tract infections. Resistance to ampicillin is increasingly a
problem in some infections, for example, gonorrhoea, pneumococcal
infections, respiratory-tract infections due to Haemophilus influenzae or
Moraxella catarrhalis (Branhamella catarrhalis), Salmonella infections,
shigellosis, and infections due to Escherichia coli. For details of these
infections and their treatment, see under Choice of Antibacterial,
.
If beta-lactamase-producing organisms are present, ampicillin can be given
with a beta-lactamase inhibitor such as sulbactam (see below) or a
penicillinase-resistant drug such as cloxacillin, dicloxacillin, or flucloxacillin
(known as co-fluampicil). It may also be used with an aminoglycoside to
increase the spectrum of organisms covered; it is advisable to give the
injections separately.
The dosage of ampicillin will depend on the severity of the disease, the age
of the patient, and renal function. Ampicillin is usually given orally as the
trihydrate and by injection as the sodium salt. Doses are expressed in terms
of the equivalent amount of ampicillin; 1.06 g of ampicillin sodium and
1.15 g of ampicillin trihydrate are each equivalent to about 1 g of ampicillin.
The usual oral dose is 0.25 to 1 g every 6 hours taken at least 30 minutes
before or 2 hours after food. For urinary-tract infections, ampicillin 500 mg
is given orally every 8 hours. The usual dose by injection is 500 mg every 4
to 6 hours intramuscularly or by slow intravenous injection over 3 to 5
minutes or by infusion, although for severe infections higher doses are often
used.
For typhoid and paratyphoid fever where Salmonella typhi strains remain
sensitive to ampicillin, an oral dose of 1 to 2 g may be given every 6 hours
for 2 weeks for acute infections, and for 4 to 12 weeks in carriers.
Ampicillin 2 g given with probenecid 1 g, as a single oral dose, has been
used in the treatment of uncomplicated gonorrhoea in areas where
gonococci remain sensitive; repeated doses are recommended in females.
In meningitis, higher parenteral doses may be used; 12 g daily given
intravenously in divided doses every 4 or 6 hours has been suggested for
listerial meningitis.
For intrapartum prophylaxis against group B streptococcal infection in the
neonate, a maternal dose of 2 g by intravenous injection initially then 1 g
every 4 hours until delivery has been suggested.
For details of doses in children, see
.
Ampicillin has been given by other routes, usually as a supplement to
systemic therapy. Intraperitoneal or intrapleural injections have been given
in a dose of 500 mg daily dissolved in 5 to 10 mL of water. For intra-articular
injection, ampicillin 500 mg daily has been given dissolved in up to 5 mL of
water or a solution of procaine hydrochloride 0.5%.
Ampicillin benzathine has also been given by intramuscular injection.
Ampicillin with sulbactam. The sodium salts of ampicillin and sulbactam (
) may be given intramuscularly or intravenously in the treatment of
infections due to beta-lactamase-producing organisms. Doses are expressed
in terms of the equivalent amounts of ampicillin and sulbactam; available
injections contain ampicillin and sulbactam in the ratio 2:1, respectively. The
usual dose is ampicillin 1 g with sulbactam 500 mg every 6 hours; doses
may be doubled in severe infections.
For oral use sultamicillin (
), a mutual prodrug of ampicillin and
sulbactam, may be given.
(last reviewed 2010-08-20; last modified 2010-09-02)
References.
(last reviewed 2010-08-20; last modified 2009-09-16)
1. 1. Malik ZA, Litman N. Ampicillin and amoxicillin. Pediatr Rev 2006; 27:
434–6. PubMed
2. 2. Rafailidis PI, et al. Ampicillin/sulbactam: current status in severe
bacterial infections. Drugs 2007; 67: 1829–49. PubMed
3. 3. Lode HM. Rational antibiotic therapy and the position of
ampicillin/sulbactam. Int J Antimicrob Agents 2008; 32: 10–28. PubMed
Administration in children (Latest modification: 06-Aug-2010)
Ampicillin may be given to neonates and children for the treatment of
infections caused by susceptible bacteria and may be given orally, by
intramuscular injection, by slow intravenous injection over 3 to 5 minutes,
or by intermittent intravenous infusion over 30 minutes.
In the UK, licensed oral doses for children up to 10 years of age are 125 to
500 mg every 6 hours, depending on the type and severity of the
infection. Additionally, the BNFC 2009 suggests the following oral dose
range for neonates and children up to 1 year of age:
neonates: 30 to 60 mg/kg, given every 12 hours for neonates less than
7 days old, every 8 hours for those 7 to 21 days old, and every 6 hours
for those 21 to 28 days old
children 1 month to 1 year of age: 62.5 to 125 mg 4 times daily
Recommended intravenous dose ranges in neonates and children are as
follows:
neonates: 30 to 60 mg/kg, given every 12 hours for neonates less than
7 days old, every 8 hours for those 7 to 21 days old, and every 6 hours
for those 21 to 28 days old. For treatment of meningitis, 100 mg/kg per
dose is recommended
children from 1 month of age: 25 to 50 mg/kg every 6 hours. For
listerial meningitis, group B streptococcal infection, and enterococcal
endocarditis, 50 mg/kg every 4 to 6 hours (to a maximum of 2 g every 4
hours) is recommended
In the USA, the American Academy of Paediatrics1 suggests the following
doses given intramuscularly or intravenously:
all neonates with a birth-weight less than 1.2 kg, and those less than 1
week old and weighing 1.2 to 2 kg: 25 to 50 mg/kg every 12 hours
neonates less than 1 week of age with a birth-weight of more than 2 kg,
and those 1 week of age or older with a birth-weight of 1.2 to 2 kg: 25
to 50 mg/kg every 8 hours
neonates 1 week of age or older with a birth-weight of more than 2 kg:
25 to 50 mg/kg every 6 hours
children 1 month and older: 100 to 150 mg/kg daily in 4 divided doses
(to a maximum of 4 g daily). For severe infections, a total daily dose of
200 to 400 mg/kg (to a maximum of 12 g) is recommended
Alternatively, for mild to moderate infections in children from 1 month of
age, 50 to 100 mg/kg orally, in 4 divided doses, may also be used.
Ampicillin is also used in some countries in children to eradicate chronic
carriage of Salmonella typhi and S. paratyphi, which can cause typhoid
and paratyphoid fever respectively; an intramuscular dose of 10 mg/kg (to
a maximum of 250 mg) every 6 hours for 4 to 6 weeks has been
recommended.
(last reviewed 2010-08-20; last modified 2010-08-06)
1. 1. American Academy of Pediatrics. 2009 Red Book: Report of the
Committee on Infectious Diseases, 28th ed. Elk Grove Village, Illinois,
USA: American Academy of Pediatrics, 2009.
Administration in renal impairment (Latest modification: 26-Nov-2010)
UK licensed product information advises that the dose of ampicillin should
be reduced, or the dose interval increased, in severe renal impairment
(creatinine clearance less than 10 mL/minute). Patients undergoing
dialysis should receive an additional dose after the session.
A review1 of antimicrobial dosing in critically ill patients receiving renal
replacement therapy recommends that patients undergoing continuous
renal replacement therapy (CRRT) receive a loading dose of 2 g, followed
by maintenance doses of 1 to 2 g at intervals depending on the type of
CRRT:
continuous venovenous haemofiltration (CVVH): every 8 to 12 hours
continuous venovenous haemodialysis (CVVHD): every 8 hours
continuous venovenous haemodiafiltration (CVVHDF): every 6 to 8 hours
For critically ill patients undergoing intermittent haemodialysis, the authors
suggest a dosing regimen of 1 to 2 g every 12 to 24 hours.1
(last reviewed 2010-08-20; last modified 2010-11-26)
1. 1. Heintz BH, et al. Antimicrobial dosing concepts and recommendations
for critically ill adult patients receiving continuous renal replacement
therapy or intermittent hemodialysis. Pharmacotherapy 2009; 29: 562–77.
PubMed
Preparations (Latest modification: 01-Jul-2013)
Single-ingredient Preparations (Latest modification: 01-Jul-2013)
The symbol ¤ denotes a preparation which is discontinued or no longer
actively marketed.
Argentina: Alpovex; Aminoxidin¤; Ampi-Bis; Ampi¤; Ampicler¤; Ampigen;
Ampigrand¤; Ampinox; Ampitenk; Ampixen¤; Atecilina; Bactilina; Decilina¤;
Fabopcilina¤; Galciclina; Grampenil¤; Histopen¤; Poenbiotico¤; Trifacilina;
Trimicro¤; Welticilina¤; Australia: Alphacin¤; Ampicyn; Austrapen;
Ibimicyn; Penbritin¤; Austria: Binotal¤; Doktacillin¤; Standacillin;
Belgium: Penbritin¤; Pentrexyl; Brazil: Ampi¤; Ampiciflan; Ampiciklyna¤;
Ampicil¤; Ampicilab; Ampicilase; Ampicilib¤; Ampicilil; Ampicilon;
Ampicimax¤; Ampicinal¤; Ampicler com Probenecide¤; Ampicler¤;
Ampicrom¤; Ampifar¤; Ampigran; Ampilong¤; Ampilozin; Ampispectrin¤;
Ampitotal¤; Ampitrat¤; Ampival¤; Ampixin¤; Amplacilina; Amplacin;
Amplibac¤; Amplimed¤; Amplitor¤; Amplofen¤; Bacterinil¤; Bacterion¤;
Binopen¤; Binotal; Binotine¤; Bipencil¤; Cilinon; Cilipen¤; Degona¤;
Emicilin; Expectocilin; Gonocilin¤; Gonol; Gonorrels¤; Gramcilina¤;
Lifacilina¤; Natuscilin¤; Notacilin¤; Parenzyme Ampicilina; Praticilin¤;
Probenzima¤; Tandrexin¤; Totapen¤; Canada: Ampicin-PRB¤; Ampicin¤;
Ampilean¤; Apo-Ampi; Nu-Ampi; Penbritin¤; China: Ai Luo Di; An Tai Lin;
Anbixian; Bixianshu; En Pu Luo; Lingxu; Yixide; Czech Republic: ApoAmpi¤; Penstabil¤; Standacillin¤; Denmark: Anhypen¤; Doktacillin¤;
Pentrexyl; Finland: A-Pen; France: Negmapen¤; Penicline¤; Prototapen¤;
Rosampline¤; Totapen¤; Ukapen¤; Germany: Amblosin¤; Ampensaar¤;
Ampi-Tablinen¤; Ampi¤; Ampicillat¤; Binotal¤; duraampicillin¤; Jenampin¤;
Pen-Bristol¤; Penstabil¤; Greece: Abetathen; Adelcopen; Allomycin;
Ampicipen; Competor; Comrarilin; Copercilex; Extrapen; Frateline;
Fraxicilline; Isticilline; Pentrexyl; Picilin; Spiracillin; Stopan; Toscapen;
Xanline; Hong Kong: Ampilin¤; Ampisul¤; Amprexyl; Apo-Ampi¤;
Dhacillin¤; Pamecil; Penbritin¤; Penodil¤; Pentrexyl¤; Uni-Ampicin¤;
Hungary: Penstabil¤; Semicillin; Standacillin; India: Albercilin; Alfacillin;
Ampijet; Ampilin; Ampipen; Ampisyn; Ampy; Aristocillin; Bacipen; Biocilin;
Broacil; Broadicilin; Campicillin; Cincillin; Dabcilin; Dynacil; Eskaycillin;
Ingacillin; Ipacillin¤; JP-Cilin; Maxamp; Megasyn; Monocilin; Natcocillin;
Neocillin; Nepocil; Osocillin; Roscillin; Synthocilin; Indonesia: Ambiopi;
Amcillin¤; Ampi; Arcocillin¤; Binotal; Biopensyn¤; Cetacillin¤; Corsacillin;
Kalpicilin; Opicillin; Parpicillin¤; Penbiotic¤; Penbritin¤; Phapin; Polypen;
Primacillin¤; Sanpicillin; Standacillin; Ultrapen¤; Viccillin; Xepacillin;
Ireland: Amfipen¤; Clonamp; Novapen¤; Penbritin¤; Pentrexyl¤;
Rimacillin¤; Vidopen¤; Israel: Penibrin; Pentrexyl¤; Vitapen¤; Italy:
Ampen¤; Ampi-Zoja¤; Ampilan¤; Ampilisa¤; Ampilux; Ampiplus Simplex¤;
Ampisint¤; Amplipenyl¤; Amplital; Amplizer¤; Citicil¤; Gramcillina¤;
Ibimicyn¤; Lampocillina¤; Penampil¤; Pentrexyl; Platocillina¤; Principen¤;
Radiocillina¤; Sesquicillina¤; Totalciclina¤; Japan: Herpen¤; Malaysia:
Ampilin; Biocil¤; Pamecil; Setcillin¤; Standacillin; Mexico: Acilmed;
Acimpil¤; Alphapen; Alvedrin¤; Am-An; Ambidrin¤; Ambiosol; Ampex; AmpiQuim; Ampi-Tecno; Ampibal¤; Ampicidar¤; Ampidrat¤; Ampigrin¤;
Ampilon¤; Ampimex; Ampiset¤; Ampisuspen¤; Amprexyn¤; Amsapen;
Anglopen¤; Azpencil¤; Bacticil¤; Bestcilina-A; Binotal; Bremecina¤; Brupen;
Deamcilina¤; Dibacilina; Diferin; Expicin; Fenipencil¤; Flamicina; GramipenF; Ifecin¤; Iqfacilina; Lampicin¤; Linapen¤; Luzampil; Marovilina;
Meprizina¤; Mexapin¤; Mibiot; Omnipen; Pebiot; Penbritin; Pentiver;
Pentrexyl; Procilina; Prodifer¤; Promecilina; Rayepen¤; Riganpil¤; Sinaplin;
Totipen¤; Tronex; Unicilin¤; Yapamicin¤; Zumorin; Netherlands: Amfipen¤;
Penbritin¤; Pentrexyl¤; Norway: Doktacillin¤; Pentrexyl; Philippines:
Aldribid; Ampicin; Ampiclin; Ampico; Ampinex; Ampisan; Ampitrex;
Ampizef; Bactimed¤; Cilisod; Clovillin; Dincil; Dinpen; Eurocin; Excillin;
Famacin; Gramcil; Mapciril; Microcilin; Obocil; Panacta; Penbritin;
Pentrexyl¤; Picaplin; Polypen; Rotocin; Shinapen; Sodampen; Trumepen;
Vatacil; Portugal: Amplifar¤; Britacil¤; Cilin¤; Estreptobroncol¤;
Hiperbiotico Retard; Hiperbiotico; Russia: Standacillin (Стандациллин);
Zetsyl (Зетсил); South Africa: Acupillin¤; Ampi-Rol¤; Ampicyn¤;
Ampimax¤; Ampipen; Ampisalt¤; Be-Ampicil; Co-Cillin¤; Dyna-Ampcil¤;
Excillin¤; Hexacillin¤; M-P-Cil; Penbritin¤; Penrite¤; Pentrex¤; Petercillin¤;
Ranamp; Spectracil¤; Statcillin¤; Singapore: Ampicap; Ampilin; Ampitab¤;
Dhacillin; Pamecil¤; Penbritin¤; Pricillin¤; Standacillin; Spain: Ampi Oral¤;
Ampiciman¤; Ampicur¤; Ampikel¤; Ampiplus¤; Amplimedix¤; Ampliomax¤;
Antibiopen¤; Bactosone Retard¤; Binotal¤; Britapen; Ciarbiot¤; Electopen¤;
Espectral¤; Gobemicina; Maxicilina¤; Nuvapen¤; Panestes¤; Penimaster¤;
Pentrexyl¤; Resan¤; Sintecilina¤; Togram¤; Ultrabion¤; Urebion¤;
Valmingina¤; Sweden: Doktacillin; Pentrexyl¤; Switzerland: Arcocillin¤;
Cimexillin¤; Servicillin¤; Thailand: Amcillin¤; Amicilin; Amilin¤; Ampac;
Ampat¤; Ampexin¤; Ampi Frx; Ampi-Oral; Ampi; Ampicin; Ampicyn¤;
Ampihof; Ampilin; Ampillin; Ampimycin; Ampipac; Ampra; Amprexyl;
Ampro¤; Eracillin¤; Medicillin; Penbritin¤; Pencotrex¤; Pentrexyl¤;
Servicillin¤; Siampicil¤; Sumapen¤; Utocillin; Vacillin¤; Viccillin¤; Turkey:
Alfasilin; Ampisid; Ampisina; Neosilin; Penbisin¤; Seskasilin; Silina; United
Arab Emirates: Julphapen; United Kingdom: Amfipen¤; Flu-Amp¤;
Magnapen¤; Magnapen; Magnapen; Penbritin; Rimacillin; Vidopen¤; United
States: D-Amp¤; Marcillin¤; Omnipen-N¤; Omnipen¤; Polycillin-N¤;
Polycillin-PRB¤; Polycillin¤; Principen with Probenecid¤; Principen; TotacillinN¤; Totacillin¤; Venezuela: Alampen; Ampen¤; Ampenina; Ampiga¤;
Ampilan; Arcocilin; Fibrapen¤; Intrapen¤; Neoampicil¤;
Multi-ingredient Preparations (Latest modification: 01-Jul-2013)
The symbol ¤ denotes a preparation which is discontinued or no longer
actively marketed.
Argentina: Aminoxidin Sulbactam; Ampi-Bis Plus; Ampigen SB;
Amplibenzatin Bronquial; Aseptobron Ampicilina¤; Cronopen Balsamico;
Grampenil Bronquial¤; Meticil; Prixin; Unasyna¤; Unsayna¤; Austria:
Totocillin¤; Unasyn; Brazil: Ambezetal; Ampifar Balsamico¤; Ampizan¤;
Amplotal¤; Benzotal Balsamico¤; Benzotal; Binotine Balsamico¤;
Combactan; Durapen Balsamico¤; Durapen¤; Expectocilin Balsamico¤;
Genitopen¤; Labfcilina¤; Optacilin Balsamico¤; Optacilin; Probenzima
Ampicilina¤; Soma Balsamico¤; Soma¤; Sulbacter¤; Unasyn; Urobiotic¤;
Uropielon; Chile: Auropennz; Unasyn; China: Fumaixin; Jielite; Kaifa; Pu
Shu; Shu An Xin; Shuanxilin; Shudi; Shutabituo; Stanyn; Unasyn; Xin An
Lin; Zhuo Tong; Czech Republic: Ampiclox¤; Bitammon; Unasyn; France:
Unacim; Germany: Ampicillin comp; Broncho-Binotal¤; Summopenil¤;
Totocillin¤; Unacid; Uro-Binotal¤; Greece: Begalin-P; Demotine; Hong
Kong: Ampiclox¤; APT-Ampicloxa¤; Cloxamp¤; Cloxampi¤; Cloxampilin¤;
Co-Amclox¤; Lampicin¤; Pamedox¤; Roscilox¤; Unasyn; Hungary: Unasyn;
India: ADC; Adilox; AK-60; Alcilox; Amci-Clox; Amclominus; Amclox;
Amiclox Plus; Amisul; Amklok; Ampicloxa; Ampilong; Ampilox-LB; Ampilox;
Ampitum; Amplus; Amplus; Ampoxin-LB; Ampoxin; Ampy C; Ampy S;
Ampylox; Ampysul; Amsat; Baciclox; Bactimox Plus; Bactimox; Baxin-D-LB;
Baxin-D; Baxin-LB; Baxin; Betamp; Biclopen; Bilactam; Broadiclox-LB;
Broadiclox; Campicillin Plus; Campilox-LB; Campilox; Cilclox; Cinclox-S;
Clacin; Clax; Climpen; Clomentin; Clompic; Clotrop; Cloxapene; Cloxcin;
Combilox-LB; Combilox; Combipen; D-Clox; Dabcilox; DC-Ped; DC; Duoclox;
Elclox Plus; Elclox; Emulox; Eradiclox; Euphoclox; G-Clox; Hclox; IntacloxD; Kloxamp; Magnacillin; Mediclox Plus; Megaclox LB; Megaclox; Megapen;
Napi-D; Nepoclox; Omnipen; Osocillin-S; Sulbacin; Ireland: Ampiclox¤;
Israel: Unasyn; Italy: Ampiplus¤; Amplium; Bethacil; Diamplicil¤;
Duplexcillina¤; Duplexil¤; Infectrin¤; Loricin; Sobrepin Antibiotico¤; Unasyn;
Japan: Sulperazon¤; Unasyn-S; Malaysia: Easyn; Shinasyn; Sulbacin;
Sulbamp; Unasyn; Mexico: Ampiclox-D¤; Anglotex¤; Bisolvon A; Brucilina;
Brupen Compuesto; Diamprex¤; Doxapen¤; Mucolin; Panac K¤; Panac;
Penbritin Ex; Pentibrom; Pentidix; Pentrexyl Expec; Unasyna; Netherlands:
Ampiclox¤; Philippines: Ambacitam; Ampimax; Ampisul; Dinocin; Silgram;
Subacillin; Sulbacin; Sultacillin; Unasan; Unasyn; Poland: Unasyn; Russia:
Libakcil (Либакцил); Oxamp (Оксамп); Oxampicine (Оксампицин);
Oxamsar (Оксамсар); Sulbacin (Сульбацин); Sultasin (Сультасин); Unasyn
(Уназин)¤; South Africa: Ampiclox¤; Ampoxin; Apen; Cloxam; Megamox;
Pentrex-F¤; Ranclosil¤; Singapore: Unasyn; Spain: Alongamicina Balsa¤;
Alongamicina¤; Amintestin¤; Ampiciliber Bronquial¤; Ampiciliber¤;
Ampilevel¤; Ampinova Simple¤; Ampiorus Balsamico¤; Ampipulmo¤;
Amplibiot¤; Angicilin¤; Anginum¤; Bacimex¤; Bactosone¤; Bio Espectrum¤;
Bisolvon Ampicil Retard¤; Bisolvon Ampicilina¤; Brixilon¤; Bronco
Pensusan¤; Broncobacter¤; Broncobioxin¤; Broncosolvente Mucolitic¤;
Broncotyfen¤; Combitorax Ampicilina¤; Complexobiotico Bals¤; Cusipen
Balsamico¤; Cusipen¤; Electopen Balsam Retard¤; Electopen Balsam¤;
Electopen Retard¤; Espectral Balsamico¤; Espectral¤; Espectrosira¤; Etro
Balsamico¤; Etro¤; Exapenil Mucolitico¤; Fidesbiotic Simple¤; Galotam¤;
Gobemicina Retard¤; Hispamicina Retard¤; Maxicilina Balsamica¤;
Maxicilina¤; Miliken Mucol Med Retard¤; Miliken Mucol Retard¤; Miliken
Mucolitico¤; Mucorex Ampicilina¤; Neo Penprobal¤; Neoflaina¤; Nuvapen
Mucolitico Retard¤; Nuvapen Retard¤; Panestes Retard¤; Pectosan
Ampicilina¤; Pectox Ampicilina¤; Penisintex Balsamico¤; Penisintex
Bronquial¤; Pentrexyl Balsamic¤; Pulminflamatoria¤; Pulmospin¤;
Pulmosterin Retard¤; Resan Mucolitico¤; Resan Retard¤; Resisten Retard¤;
Retarpen Balsamico¤; Retarpen Mucolitico¤; Retarpen; Sinus¤; Sulquibron¤;
Tosmina Retard¤; Tusolone¤; Ultrabion Balsamico¤; Ultrabion¤; Ultrapenil¤;
Unasyn¤; Switzerland: Pencloxin¤; Thailand: Ampcoxin; Ampiclox¤;
Polyclox¤; Sulam; Sulbaccin; Sulbacilline; Unasyn; Viccillin-S¤; Turkey:
Alfasid; Azosilin; Combicid; Devasid; Duobak; Duobaktam; Duocid; Nobecid;
Probicid; Sulbaksit; Sulcid; Sultasid; Sultibac; United Kingdom:
Ampiclox¤; Dicapen¤; Flu-Amp¤; Magnapen¤; Magnapen; Magnapen;
Ukraine: Unasyn (Уназин); United States: Unasyn; Venezuela:
Ampibactan; Ampitren¤; Fipexiam; Sinif; Unasyn;
Pharmacopoeial Preparations (Latest modification: 06-Dec-2011)
BP 2013: Ampicillin Capsules; Ampicillin Injection; Ampicillin Oral
Suspension; Co-fluampicil Capsules; Co-fluampicil Oral Suspension; USP
36: Ampicillin and Probenecid for Oral Suspension; Ampicillin and Sulbactam
for Injection; Ampicillin Capsules; Ampicillin for Injectable Suspension;
Ampicillin for Injection; Ampicillin for Oral Suspension; Ampicillin Tablets;
Martindale: The Complete Drug Reference © 2013 The Pharmaceutical Press.
MedicinesComplete © The Pharmaceutical Press 2013