Composition
Cap 250 mg/500 mg: Ampicillin (as trihydrate) 250 mg/500 mg. Drop Paed: Per 1.25 ml: Ampicillin (as trihydrate) 125 mg; powder for reconstitution. Inj250 mg/500 mg/1 gm/2 gm: Ampicillin (as s
Indications & Dosage
Susceptible infections including bronchitis, urinary-tract infections, otitis media, sinusitis, pneumonia, salmonellosis: ORAL: Adult: 0.5-1 g every 6 hours Children 1-11 months: 125 mg 4 times a day; increased if necessary up to 30 mg/kg 4 times a day; 1-4 yrs: 250 mg 4 times a day; increased if necessary up to 30 mg/kg 4 times a day; 5-11 yrs: 500 mg 4 times a day; increased if necessary up to 30 mg/kg 4 times a day (max. per dose1 g); 12-17 yrs: 500 mg 4 times a day; increased ifnecessary to 1 g 4 times a day, use increased dose insevere infection BY IV OR IM INJ, OR BY IV INF: Adult: 500 mg every 4-6 hours. Endocarditis (in combination with another antibiotic), Listerial meningitis (in combination withanother antibiotic): BY IV INF: Adult: 2 g every 4 hours. Lower & Upper Respiratory Tract Infections: Adults & Children above20 kg body weight: 250 mg every 6 hr. less than 20 kg body weight: 50 mg/kg/day divided as 6 hourly or 8 hourly dose. BY IV OR IM INJ: Adults: 250-500 mg four to six times daily; Children: Half adult dose. Meningitis: BY IV INJ: Adults & Children: 150-200 mg/kg/day given every 3-4 hr.
Administration
May be administered by direct IV push over 3-5 min at a rate not to exceed 100 mg/min or IV intermittent infusion over 15-30 min at concentration not to exceed 30 mg/ml .Add 1.2 ml of SWFI or bacteriostatic water for injection to each 125 mg vial, 1 ml of diluent to each 250 mg vial, 1.8 ml of diluent to each 500 mg vial, 3.5 ml of diluent to each 1 gm vial, or 6.8 ml of diluents to each 2 gm vial. Intermittent infusion: Add 5 ml of SWFI or bacteriostatic water for injection to each 125, 250, or 500 mg vial or 7.4 to 10 ml of diluent to each 1 or 2 gm vial.
Compatibility
Stable in D5W, NS. At Y-site administration, incompatible with amphotericin B cholesterylsulphate complex, epinephrine, fluconazole, hydralazine, midazolam, ondansetron, sargramostim, verapamil, vinorelbine. In syringe, incompatible with erythromycin lactobionate, gen-tamicin, hydromorphone, kanamycin, lincomycin, metoclopramide. When admixed, incompatible with amikacin, chlorpromazine, dopamine, gentamicin, hydralazine, prochlorperazine.
Stability
Solutions for IM or direct IV should be used within 1 hour. Solutions for IV infusion will be inactivated by dextrose at room temperature. If dextrose containing solutions are to be used, the resultant solution will only be stable for 2 hours versus 8 hours in NS. Stability of parenteral admixture in NS at room temperature (25C) is 8 hours and at refrigeration (4C) is 2 days.
Contraindications
History of flucloxacillin associated jaundice/hepatic dysfunction, hypersensitivity to penicillins, cephalosporins or other beta-lactams.
Precautions
Renal impairment, acute or chronic lymphocytic leukaemia and cytomegalovirus infection (increased risk of erythematous rashes), glandular fever, maintainadequate hydration with high doses (particularly duringparenteral therapy). Accumulation of sodium can occurwith high parenteral IV doses, risk of crystalluria with high doses. Monitor renal, hepatic and haematological function in neonates.
Interactions
Anticoagulants, allopurinol, probenecid.
Pregnancy
Caution advised
Lactation
Caution advised
Side Effects
Hypersensitivity reaction, GI disturbance, nausea and vomiting. Rarely hepatitis, cholestatic jaundice, haematological and CNS effects, pseudomembranous colitis, increased INR, Stevens-Johnsons syndrome, toxic epidermal necrosis.