Ampicillin

When ATH:
J01CA01

Characteristic.

Semisynthetic antibiotic penicillin group of broad-spectrum parenteral and oral administration. Kislotostabilen. Destroyed penicillinase.

IN clinical practice using ampicillin, ampicillin sodium salt, ampicillina trigidrat.

Ampicillin - white crystalline powder, bitter taste. It is soluble in water, practically insoluble in ethanol, xloroforme, ether. Molecular weight 349,40.

Ampicillin sodium - powder or porous mass of white (or kremovatym) colors, bitter taste. Easily soluble in water, soluble in alcohol. Hygroscopicity. Molecular weight 371,39.

Ampicillin trihydrate - a white crystalline powder. Soluble in water (1:300), practically insoluble in ethanol.

Pharmacological action.
Broad-spectrum antibacterial, bactericide.

Application.

Infectious-inflammatory diseases, caused by susceptible microorganisms: respiratory tract infections and otolaryngology (pneumonia, lung abscess, bronchitis, sinusitis, tonsillitis, pharyngitis, otitis media), infections of the urinary tract (cystitis, pyelonephritis, pyelitis, uretrit), infection of the biliary system (kholangit, cholecystitis), chlamydial infection in pregnant women (intolerance erythromycin), cervicitis, pasteurellosis, Listeriosis, infections of skin and soft tissue (mug, impetigo, secondarily infected dermatoses), infection of the musculoskeletal system, GI infections (typhoid and paratyphoid, dysentery, dysenteries, salmonellosis, Salmonella carrier), abdominal infections (peritonitis), bacterial endocarditis (Prevention and treatment), gonorrhea, meningitis, sepsis, pertussis.

Contraindications.

Hypersensitivity (incl. other penicillins), kissing disease, Lymphocytic Leukemia, hepatic failure, digestive diseases in history (especially colitis, associated with the use of antibiotics), Children up to age 1 Months.

Restrictions apply.

Bronchial asthma, pollen disease, renal failure, bleeding history.

Pregnancy and breast-feeding.

When pregnancy is possible, if the effect of therapy outweighs the potential risk to the fetus.

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: headache, tremor, convulsions (with high dose therapy).

Cardio-vascular system and blood (hematopoiesis, hemostasis): leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia.

From the digestive tract: stomatitis, gastritis, dry mouth, change in taste, abdominal pain, nausea, vomiting, diarrhea, psevdomembranoznыy colitis, increase in liver transaminases.

Allergic reactions: hives, redness and itching of the skin, fever, bronchospasm, angioedema, rhinitis, conjunctivitis, arthralgia, anaphylactic shock, toxic epidermal necrolysis (Lyell's syndrome), eozinofilija, vesicular eruptions, erythema multiforme exudative, Stevens-Johnson syndrome.

Other: interstitial nephritis, nephropathy, superimposed infection (especially in patients with chronic diseases or low resistance of the organism); dysbiosis, vaginal candidiasis; at the injection site - thrombophlebitis, pain, erythema and / or infiltration (when i / m administration), phlebitis (at / in the introduction).

Cooperation.

Pharmaceutical incompatible with aminoglycosides. When co-administered with allopurinol increases the likelihood of skin rash. In an application with oral medications estrogensoderjath marked decrease in the efficiency of oral contraceptives, c ethinyl estradiol - the risk of breakthrough bleeding (reduces the effect of). Ampicillin enhances the action of oral anticoagulants, aminoglycoside antibiotics series. Bactericidal antibiotics (incl. cephalosporins, vancomycin, rifampicin, aminoglikozidy) - Synergism, bacteriostatic (incl. makrolidы, chloramphenicol, lincosamides, tetracikliny, sulfonamides) - Antagonizm. Diuretic, allopurinol, probenecid, blockers tubular secretion, NSAIDs, incl. phenylbutazone, reduce tubular secretion, increase the concentration of ampicillin.

Overdose.

Symptoms: toxic effect on the CNS (especially in patients with renal insufficiency); nausea, vomiting, diarrhea, disruption of water and electrolyte balance (as a consequence of vomiting and diarrhea).

Treatment: gastric lavage, Activated carbon, saline laxatives, maintaining water and electrolyte balance, simptomaticheskaya therapy. Displays by hemodialysis.

Dosing and Administration.

Inside, / m, I /. Dosing regimen and route of administration adjusted individually, depending on the severity of the infection. Inside, single dose for adults - 0,25-0,5 g, daily - 2-3 grams. With infections of moderate flow introduce adults / m of 0.25-0.5 g every 6-8 hours, in severe infections - 1-2 g every 4-6 hours, or in / on 0,5 g every 6 no. Children up 1 months is not assigned, in older age are used at the rate of 100-200 mg / kg body weight, the daily dose is divided into 4-6 receptions. The duration of treatment depends on the severity of the condition and effectiveness of therapy (from 5-10 days to 2-3 weeks or more).

Precautions.

In exchange treatment is necessary to monitor the state functions of blood, kidney and liver.

After the disappearance of symptoms therapy should continue for 48-72 hours.

Perhaps the development of superinfection due to growth insensitive to the drug microflora. In the case of superinfection requires the abolition of drugs and the corresponding change in antibiotic therapy.

When treating patients with sepsis may develop reactions bacteriolysis (Jarisch - Herxheimer).

Patients, with hypersensitivity to penicillins, possible cross-allergic reaction to other beta-lactam antibiotics.

In the treatment of mild diarrhea at the background of the course of therapy should be avoided antidiarrhoeal drugs, reduce peristalsis; You can use kaolin- or attapulgitsoderzhaschie antidiarrheals. In severe diarrhea, seek medical advice.

Cautions.

Prior to initiation of therapy should conduct appropriate tests for identification of microorganisms, cause disease, and evaluating the sensitivity to ampicillin. Ampicillin therapy may be initiated before the results of these tests. When the test results will be known, therapy should be continued in view of the received data.

Cooperation