Ver el código de «Ampicillin/Sulbactam»

==General==
*Type: Amino-[[Is DrugClass::Penicillin]] with a bacterial [[Is PenicillinType::beta-lactamase inhibitor]]
*Dosage Forms: powder for solution
*Dosage Strengths: 1.5g, 3g, 15g
*Routes of Administration: IM, IV
*Common Trade Names: Unasyn

==Adult Dosing==
===General===
*1.5-3g IV/IM q6 hours 
*Max: 12g/day

===[[Bite]] (for Pasteurella multocida Coverage)===
*1.5-3g IM/IV q6 hours

===[[Orbital Cellulitis]]===
*3g IM/IV q6 hours

===[[Diabetic Foot]] Osteomyelitis<ref>Lipsky, 2004</ref>===
*3g IM/IV q6 hours

===[[PID]]===
*3g IM/IV q6 hours + [[doxycycline]]

===[[Pneumonia]]===
*Aspiration or CAP
**1.5-3g  IM/IV q6 hours
*Hospital-acquired: 3g IM/IV q6 hours

===[[UTI]], [[Pyelonephritis]]===
*3g IM/IV q6 hours x 14 days

==Pediatric Dosing (<40kg)==
'''Unasyn (ampicillin/sulbactam) is formulated at a 2:1 ratio (3g vial = 2g ampicillin + 1g sulbactam)'''

===General<ref>Red Book, 2012</ref>===
*'''Mild-moderate'''
**100-200mg ampicillin/kg/day IM/IV divided q6 hours
**First Dose: 25-50mg ampicillin/kg IM/IV x 1 (37.5-75mg Unasyn/kg IM/IV x 1)
**Max: 1000mg ampicillin (1500mg Unasyn)
*'''Severe'''
**200mg ampicillin/kg/day IM/IV divided q6 hours
**First Dose: 50mg ampicillin/kg IM/IV x 1 (75mg Unasyn/kg IM/IV x 1)
**Max: 2000mg ampicillin (3000mg Unasyn)

===[[Meningitis]]===
*400mg ampicillin/kg/day IM/IV divided q6 hours
*First Dose: 100mg ampicillin/kg IM/IV x 1 (150mg Unasyn/kg IM/IV x 1)
*Max: 2000mg ampicillin (3000mg Unasyn)

===[[Endocarditis]]===
*200mg ampicillin/kg/day IM/IV divided q4-6 hours +/- [[gentamicin]] x 4-6 weeks

===[[SSTI]]===
*200mg ampicillin/kg/day IM/IV divided q6 hours

==Special Populations==
*[[Drugs in Pregnancy|Pregnancy]]: B
*Lactation: Use caution
*Renal Dosing
**Adult
**Pediatric
*Hepatic Dosing
**Adult
**Pediatric

==Contraindications==
*Allergy to class/drug

==Adverse Reactions==
===Serious===
*Anaphylaxis

===Common===
*Headache
*Itching
*Nausea
*Vomiting

==Pharmacology==
*Half-life: One hour
*Metabolism: 
*Excretion: Renal (75% excreted in active form), Bile (very small amount)<ref>Campoli-Richards DM, Brogden RN. (1987). ". Sulbactam/ampicillin: a review of its antibacterial activity, pharmacokinetic properties, and therapeutic use". Drugs. 33 (6): 577–609. doi:10.2165/00003495-198733060-00003. PMID 3038500</ref>
*Mechanism of Action: Bactericidal (Binds to penicillin-binding proteins to block cell wall synthesis), coupled with β-lacatamase inhibitor

==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||I
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||'''S'''
|-
| ||[[Enterococcus faecium]]||'''S'''
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||R
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||R
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||R
|-
| ||[[Citrobacter sp.]]||R
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||'''S'''
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||I
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||'''S'''
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||'''S'''
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X2
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}

===Key===
{{Template:Antibacterial Spectra Key}}

==See Also==
*[[Antibiotics (Main)]]

==References==
<references/>
[[Category:Pharmacology]]