Ampicillin injections instructions for use
Ampicillin is a semi-synthetic antibiotic of the penicillin group. It is characterized by a wide range of antibacterial action against gram-positive and gram-negative pathogenic flora.
Release form and composition
Ampicillin is produced in the form of a powder for preparing an injection solution in dosages of 0.5 g and 1 g. In a package of 10 bottles.
Pharmacodynamics. Ampicillin is active against gram-positive bacteria - staphylococcus not forming penicillinase, streptococci, meningococcus, gonococcus, pneumococci, enterococci and most Gram-negative organisms - Escherichia coli, Salmonella, Klebsiella pneumoniae and Haemophilus influenzae. The drug is not resistant to the effects of penicillinase, therefore, it is not effective against penicillin-forming strains. Ampicillin violates the synthesis of bacterial cell walls, thereby reducing the resistance of the bacterial cell and causing its death.
Pharmacokinetics. When injected, the active substance circulates in high concentrations in the blood. The maximum concentration of ampicillin in the blood is noted already after 15 minutes with intravenous administration and after 30–60 minutes with intramuscular administration.
Ampicillin penetrates into body fluids and tissues (in the bile the concentration of a substance can be 4–100 times higher than the amount of ampicillin in the blood), including breast milk. Does not penetrate the blood-brain barrier. Up to 30% of the drug can bind to plasma proteins. The substance is practically not subjected to splitting and excreted from the body in its original form.
Most of the injected ampicillin is excreted by the kidneys, small amounts - with bile. During 12 hours, about 45–70% of the administered dose of ampicillin is eliminated. With functional disorders of the kidneys, the concentration of Ampicillin in the blood increases, excretion slows down. Normally, the half-life of ampicillin is 60–120 minutes; in patients with renal disease, this figure can reach 12 hours. With repeated injections, the active substance does not accumulate in the body, which allows long-term treatment with an antibiotic.
Indications for use
Ampicillin can be used to treat various diseases caused by bacteria that are susceptible to the effects of ampicillin. Namely:
- infectious inflammations of the upper respiratory tract and respiratory tract (otitis media, pharyngitis , sinusitis, bronchitis , pneumonia, lung abscess);
- infections of the urogenital system and kidneys ( cystitis , urethritis, pyelitis, pyelonephritis, gonorrhea );
- infectious inflammation of the biliary tract ( cholecystitis , cholangitis);
- typhoid and paratyphoid fever;
- whooping cough;
- infectious diseases of the musculoskeletal system;
- infectious inflammation of the skin and soft tissues.
Contraindications to the use of ampicillin are:
- individual intolerance to drugs of the penicillin group and other β-lactam antibacterial agents (carbapenems and cephalosporins);
- severe functional disorders of the liver;
- severe functional disorders of the kidneys;
- diseases of the digestive system, including colitis, which occurred while taking antibacterial agents;
- Infectious mononucleosis;
- HIV infection;
- breastfeeding period.
Dosing and Administration
Ampicillin injection solution is administered intramuscularly or intravenously (the method of injection is jet or drip, depending on the administered dose of ampicillin).
For intravenous administration, the recommended single dose of ampicillin for adults is 0.25 - 0.5 g (injection frequency - every 4-6 hours), the maximum daily dose - from 1 g to 3 g. In severe conditions, the dosage can be reduced to 10 g. .
For newborns, the daily dose is 100 mg per 1 kg of body weight, children of a different age - 50 mg per 1 kg of body weight. If necessary, doses can be doubled.
For the preparation of injection solution (for intravenous administration) a single dose of the drug (no more than 2 g) is diluted in 5-10 ml of water for injection or isotonic sodium chloride solution. The drug is administered slowly (3-5 minutes). If the prescribed single dosage of Ampicillin exceeds 2 g, the drug is administered intravenously. The required dose of ampicillin is dissolved in water for injection (for 2 g of ampicillin 7.5 ml of water for injection). The prepared antibiotic solution is added to an isotonic solution of sodium chloride or 5% glucose solution (125–250 ml). The mixture is administered dropwise at a rate of 60–80 drops per minute. When administered to children, the solution is prepared with 5% or 10% glucose.
Ampicillin solution is prepared immediately before administration, the daily dose is divided into 3-4 injections. Therapeutic course is usually 5-7 days. The duration of treatment is determined by the doctor individually, depending on the severity of the infection, the general condition, age and associated diseases of the patient, the effectiveness of the treatment. If necessary, treatment is continued with the transition to intramuscular administration of the drug.
Intramuscular administration of ampicillin
Intramuscularly Ampicillin is administered in a dose of 0.25–0.5 g every 4–6 hours, the daily dose is 1–3 g. In severe infectious inflammations, the dosage may be overestimated up to 10 g per day. The maximum daily dose should not exceed 14 g Ampicillin.
The dosage for newborns is 100 mg per 1 kg of body weight, for older children - 50 mg per 1 kg of body weight. In severe infections, the dose is doubled.
To prepare the injection solution, the powder is diluted with 2 ml or 4 ml of water for injection.
Ampicillin is usually well tolerated. But sometimes there is the development of side effects from various body systems.
From the nervous system (when using large doses of the drug in patients with renal insufficiency):
- convulsions ;
From the digestive system:
- dyspeptic symptoms (diarrhea, nausea, vomiting);
- abdominal pain;
- intestinal dysbiosis ;
- dry mouth and a change in taste;
- gastritis ;
- cholestatic jaundice;
- conjunctivitis ;
- skin rash, accompanied by itching;
- urticaria ;
- joint pains;
- very rarely - angioedema and anaphylactic shock;
- itching and swelling at the injection site;
Patients with a weakened immune system after prolonged treatment with ampicillin may develop superinfection caused by pathogens that are not sensitive to the effect of the drug (some gram-negative bacteria, fungi). Along with the accession of a secondary infection, reversible disorders of the hematopoietic system (thrombocytopenia, leukopenia, agranulocytosis, hemolytic anemia) can develop.
When overdosing Ampicillin has a toxic effect on the nervous system (possible hallucinations, convulsions), causes indigestion (vomiting or nausea, diarrhea), allergic inflammation (skin rash). If there are signs of overdose, the drug is canceled, hemodialysis is carried out (if necessary), symptomatic treatment. With the development of anaphylactic shock, immediate medical attention is required.
During treatment with ampicillin, it is important to take into account the following points:
- Before starting treatment, it is necessary to exclude an allergic reaction to ampicillin;
- it is strictly forbidden to mix the prepared injection solution with other drugs;
- during the course of treatment, strict monitoring of the composition of peripheral blood, renal and hepatic functions should be carried out;
- for patients with impaired renal function, the daily dosage should be adjusted by reducing the single dose or increasing the time between injections;
- in case of concomitant allergic pathologies (hay fever, asthmatic illness of the bronchi and others) Ampicillin is prescribed in combination with desensitizing drugs;
- Ampicillin does not affect the speed of motor and mental reactions, the ability to control transport and other mechanisms; however, some patients may develop side effects of ampicillin on the central nervous system, so the drug should be taken with caution to people who need concentration and attention when working with dangerous mechanisms;
- in the treatment of ampicillin with simultaneous administration of anticoagulants and antibiotics of the aminoglycoside group, their therapeutic effect is enhanced;
- Ampicillin reduces the therapeutic effect of oral contraceptives;
- Ampicillin's toxic effect increases with simultaneous use of probenecid;
- the combination of ampicillin with allopurinol increases the risk of an allergic reaction, manifested skin rash;
- the simultaneous use of ampicillin with β-blockers increases the risk of anaphylactic shock;
- Ampicillin is incompatible with chloramphenicol, clindamycin, tetracycline, amphotercin, erythromycin, lincomycin, polymyxin B, metronidazole, acetylcysteine, metoclopramide, dopamine, heparin;
- prolonged or repeated treatment with ampicillin can cause the development and growth of resistant flora resistant to the action of the antibacterial agent;
- Ampicillin is excreted into breast milk, so breast feeding should be discontinued during therapy;
Use during pregnancy
Ampicillin treatment of pregnant women is carried out only in situations where the expected benefit to the mother exceeds the potential hazard to the fetus.
Terms and conditions of storage
To store the drug in a place protected from moisture and sunlight, difficult for children, at a temperature not higher than 25 ° C.
Structural analogues of ampicillin are drugs:
Prices for Ampicillin Injections
Ampicillin powder for solution for intravenous and intramuscular administration of 1 g, 1 pc. - from 14 rubles.