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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ampicillin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
AMPICILLIN 500 MG CAPSULE | Generic | $0.48 each |
Ontology: Ampicillin (C0002680)
Definition (NCI) | A broad-spectrum, semi-synthetic, beta-lactam penicillin antibiotic with bactericidal activity. Ampicillin binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis. Ampicillin is stable against hydrolysis by a variety of beta-lactamases, therefore, can be used in wide range of gram-positive and -negative infections. |
Definition (MSH) | Semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic. |
Definition (CSP) | semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic. |
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | D000667 |
SnomedCT | 31087008, 387170002 |
LNC | LP15762-5, MTHU007962 |
English | Aminobenzyl Penicillin, Aminobenzylpenicillin, Penicillin, Aminobenzyl, 4-Thia-1-azabicyclo(3.2.0)heptane-2-carboxylic acid, 6-((aminophenylacetyl)amino)-3,3-dimethyl-7-oxo-, (2S-(2alpha,5alpha,6beta(S*)))-, (2S,5R,6R)-6-((R)-2-Amino-2-phenylacetamido)-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo(3.2.0)heptane-2-carboxylic Acid, ampicillin (medication), ampicillin, Ampicillin [Chemical/Ingredient], aminobenzylpenicillin, ampicillins, Ampicillin, AMPICILLIN, Ampicillin (product), Ampicillin (substance) |
Swedish | Ampicillin |
Czech | ampicilin |
Finnish | Ampisilliini |
German | Aminobenzylpenizillin, Ampicillin, Penizillin, Aminobenzyl- |
Russian | PENITSILLIN, AMINOBENZIL, AMPITSILLIN, АМПИЦИЛЛИН, ПЕНИЦИЛЛИН, АМИНОБЕНЗИЛ |
Japanese | アミノベンジルペニシリン, アンピシリン, ペニシリン-アミノベンジル |
Croatian | AMPICILIN |
Polish | Penicylina aminobenzylowa, Ampicylina |
Spanish | Aminobencilpenicilina, aminobenzilpenicilina, ampicilina (producto), ampicilina (sustancia), ampicilina, Ampicilina, Aminobencil Penicilina |
French | Ampicilline |
Italian | Ampicillina |
Portuguese | Aminobenzilpenicilina, Ampicilina |