II. Indications
III. Contraindications
-
Penicillin Allergy
- Cephalexin and Cefaclor have similar side chains and risk of cross reactivity with Ampicillin
IV. Dosing
- Adult (or child with weight >40 kg)
- Mild/Moderate Infections (typical dose): 1 to 2 g IV every 4 to 6 hours
- Severe Infections (Sepsis, Meningitis): 150 to 200 mg/kg/day IV divided every 4 hours
- Child (weight <40 kg)
- Mild/Moderate Infections (typical dose): 100 to 150 mg/kg/day IM or IV divided every 6 hours
- Severe Infections (Sepsis, Meningitis): 200 to 400 mg/kg/day IM or IV divided every 6 hours
- Newborns (weight >2 kg): 25 to 50 mg/kg IV every 8 hours until age >1 week, then every 6 hours
-
Renal Dosing
- eGFR 30 to 50 ml/min: Dose every 6 to 8 hours
- eGFR 10 to 30 ml/min: Dose every 8 to 12 hours
- eGFR <10 ml/min: Dose every 12 to 24 hours (after Hemodialysis)
V. Mechanism
- See Aminopenicillin
VI. Adverse Effects
- See Aminopenicillin
- See Penicillin
- Maculopapular rash
- Onset 5-7 days after initiating medication
- Typically not IgE mediated (non-allergic)
- No immediate allergy (e.g. Urticaria), systemic symptoms or mucous membrane involvement
- Typically safe to use Amoxicillin in future if non-allergic rash alone
- Consider IgE Skin Testing if unclear rash etiology
- References
- Orman and Hayes in Herbert (2017) EM:Rap 17(7): 7-8
-
Diarrhea
- More common with Augmentin
- Modifications can decrease stools
- Dose exactly by kilogram for children
- Avoid food before dose
- Consider eating yogurt with each dose
VII. Safety
- Pregnancy Category B
- Safe in Lactation
VIII. Resources
IX. References
- (2008) Comparison of Amoxicillin Products, Presc Lett, #240425
- Miller (2002) J Midwifery Womens Health 47(6):426-34 +PMID: 12484664 [PubMed]
- Bush (2016) Cold Spring Harb Perspect Med 6(8):a025247 +PMID: 27329032 [PubMed]
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Related Studies
| ampicillin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| AMPICILLIN 500 MG CAPSULE | Generic | $0.48 each |