Drug interactions- summary

Allopurinol -
Increased risk of rash with allopurinol

Probenicid-
Concurrent use with probenecid may delay renal tubular secretion of ampicilin and sulbactam

Aminoglycosides-
If used with aminoglycosides two slitiuons should not be mixed and must be administered
at different sites

Fusidic acid-
concurrent use with fusidic acid may decrease the eficacy of penicilins
Penicillins should be given at least 2 hours before fusidic acid administration

Warfarin-
May increase effects of warfarin

Endocarditis
Community acquired pneumonia
Hospital acquired pneumonia
Susceptible infections
 

Fatal anaphylaxis

Pain at injection site,thrombophlebitis,diarrhoea,itching,

Nausea,vomiting,flatulence,candidiasis,fatigue,malaise,

Headache,chest pain,glossitis,abdominal distension,dysuria,

Urinary retension,edema,erythema,epitaxis,mucosal bleeding.

Allergy to penicillins,infectious mononucleosis.

Special precautions:

Monitor for signs of anaphylaxis during 1st dose

Monitor haematologic , renal, and hepatic function uring prolonged treatment

Monitor for signs of superinfection with mycotic or bacterial pathogens during treatment

Prolonged use may increase the risk of oral candidiasis

Pregnancy., lactation

Indication-

Endocarditis
Community acquired pneumonia
Hospital acquired pneumonia
Suseceptible infections

Dosage-
Endocarditis-

Adult- Amipicillin 3g ( 2g + sulbactum 1g )- every 6 hr for 4-6 weeks to be used
with gentamycin or vancomycin

Community acquired infection/hospital acquired infection-

Adult- for aspiration , community acquired pneumonia-
1.5 - 3g (ampicillin and sulbactum) 0.5 to 1g every 6 hours

Hospital acquired pneumonia
3g (ampicillin 2g + sulbactum) 1g every 6 hours

Susceptible infection-
Adult- 1.5 to 3g ( ampicillin 1-2g + sulbactum 0.5 to 1g ) every 6 hours
Dose may be given via deep IM inj or slow IV inj
Max - 12g ( ampicilin 8g and sulbactum 4g ) daily

Child - > 1yr - usual dose - 300mg ( ampicillin 200mg + sulbactum 100mg ) kg/day
to be given in 4 equally divided doses.
upto 200-300mg mg/kg/day of ampicillin may be used in infants > 1mth of age
Recommended duration - not exceeding 14 days  

Observe caution