Ampicillin injections instructions for use
Ampicillin is a semisynthetic antibiotic of the penicillin group. It is characterized by a wide spectrum of antibacterial action against gram-positive and gram-negative pathogenic flora.
Form of issue and composition
Ampicillin is released in the form of a powder for the preparation of an injection solution in dosages of 0.5 g and 1 g. The package contains 10 vials.
Pharmacodynamics. Ampicillin is active against gram-positive microorganisms - staphylococci, not forming penicillinase, streptococcus, meningococcus, gonococcus, pneumococcus, most enterococci and Gram-negative microorganisms - Escherichia coli, Salmonella, Klebsiella pneumonia and hemophilic rod. The drug is not resistant to penicillinase, and therefore is not effective against penicillinase-forming strains. Ampicillin disrupts the synthesis of cell walls of bacteria, thereby reducing the resistance of the bacterial cell and causing its death.
Pharmacokinetics. When injected, the active substance circulates in the blood at high concentrations. The maximum concentration of Ampicillin in the blood is noted after 15 minutes with intravenous administration and after 30-60 minutes with intramuscular injection.
Ampicillin penetrates into the body fluids and tissues (in bile the concentration of the substance can be 4-100 times higher than 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 cleavage and is excreted from the body in its original form.
Most of the administered Ampicillin is excreted by the kidneys, insignificant amounts - with bile. Within 12 hours, about 45-70% of the administered dose of Ampicillin is excreted. With functional disorders of the kidneys concentration of Ampicillin in the blood increases, excretion slows down. Normally, the half-life of Ampicillin is 60-120 minutes, in patients with kidney diseases, this figure can reach 12 hours. With repeated administration, the active substance does not accumulate in the body, which allows for prolonged antibiotic treatment.
Indications for use
Ampicillin can be used to treat various diseases caused by bacteria that are sensitive to the action of Ampicillin. Namely:
- Infectious inflammation of the ENT organs and the respiratory tract (otitis media, pharyngitis , sinusitis, bronchitis , pneumonia, lung abscess);
- Infection of the genitourinary system and kidneys ( cystitis , urethritis, pyelitis, pyelonephritis, gonorrhea );
- Infectious inflammation of the biliary tract ( cholecystitis , cholangitis);
- Typhoid fever and paratyphoid;
- 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 impairment of liver function;
- Severe functional impairment of kidney function;
- Diseases of the digestive system, including colitis, which arose on the background of taking antibacterial drugs;
- Infectious mononucleosis;
- HIV infection;
- The period of breastfeeding.
Dosage and Administration
Injection solution Ampicillin is administered intramuscularly or intravenously (the method of administration is jet or drop, depends on the administered dose of ampicillin).
Intravenous administration of Ampicillin
When administered intravenously, the recommended single dose of Ampicillin for adults is 0.25-0.5 g (the frequency of injection is every 4-6 hours), the maximum daily dose is from 1 g to 3 g. In severe conditions, the dosage can be adjusted to 10 g .
For newborns, the daily dose is 100 mg per 1 kg of body weight, children of another age - 50 mg per 1 kg of body weight. If necessary, the doses can be doubled.
To prepare the 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 injected slowly (3-5 minutes). If the prescribed single dose Ampicillin exceeds 2 g, the drug is administered intravenously drip. The required dose of ampicillin is dissolved in water for injection (2 g ampicillin 7.5 ml 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 introduced dropwise, at a rate of 60-80 drops per minute. When drip introduction 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. The therapeutic course is usually 5-7 days. The duration of therapy is set by the doctor individually, depending on the severity of the infection, the general condition, age and concomitant diseases of the patient, the indicators of the effectiveness of the treatment. If necessary, treatment is continued with the transition to intramuscular injection 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 to 10 g per day. The maximum daily dose should not exceed 14 g of Ampicillin.
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.
Usually Ampicillin is well tolerated. But sometimes there is a development of side effects from various systems of the body.
From the side of the nervous system (when using large doses of the drug in patients with renal insufficiency):
- Convulsions ;
From the digestive system:
- Dyspeptic phenomena (diarrhea, nausea, vomiting);
- abdominal pain;
- Intestinal dysbiosis ;
- Dry mouth and taste changes;
- Gastritis ;
From the side of the liver:
- Cholestatic jaundice;
- Conjunctivitis ;
- Skin rash, accompanied by itching;
- Urticaria ;
- Joint pain;
- Very rarely - Quincke's edema and anaphylactic shock;
- Itching and swelling at the injection site;
In patients with a weakened immune system, after long-term treatment with Ampicillin, superinfection may occur, caused by drugs that are not sensitive to the action of the drug (some gram-negative bacteria, fungi). Along with the addition of secondary infection, reversible disorders of the hematopoietic system (thrombocytopenia, leukopenia, agranulocytosis, hemolytic anemia) can develop.
In case of overdose Ampicillin has a toxic effect on the nervous system (hallucinations, convulsions), indigestion (vomiting or nausea, diarrhea), allergic inflammation (skin rash). If there are signs of an overdose, the drug is canceled, hemodialysis is performed (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 the beginning of treatment it is required to exclude allergic reaction to ampicillin;
- It is strictly forbidden to mix the prepared injectable solution with other preparations;
- During the treatment course, strict control of the peripheral blood composition, renal and hepatic function should be carried out;
- For patients with impaired renal function, the daily dosage should be adjusted by reducing the single dose or increasing the length of time between injections;
- With associated allergic pathologies (hay fever, asthmatic bronchial disease 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 require concentration and concentration when working with dangerous mechanisms;
- When Ampicillin is treated with simultaneous administration of anticoagulants and antibiotics of the aminoglycoside group, their therapeutic effect is enhanced;
- Ampicillin reduces the therapeutic effect of oral contraceptives;
- Toxic effects Ampicillin increases with simultaneous application with a probenicide;
- The combination of Ampicillin with allopurinol increases the risk of allergic reaction, manifested by skin rash;
- Simultaneous application of ampicillin with β-adrenoblockers increases the risk of anaphylactic shock;
- Ampicillin is incompatible with levomycetin, clindamycin, tetracycline, amphotercin, erythromycin, lincomycin, polymyxin B, metronidazole, acetylcysteine, metoclopramide, dopamine, heparin;
- Prolonged or repeated treatment Ampicillin may cause the development and growth of resistant flora, resistant to the action of the antibacterial agent;
- Ampicillin is excreted in breast milk, so during the therapy should stop breastfeeding;
Application in 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
Keep the drug in a place protected from moisture and sunlight, hard to reach for children, at a temperature of no higher than 25 ° C.
Structural analogues of Ampicillin are preparations:
Prices for injections Ampicillin
Ampicillin powder for solution for intravenous and intramuscular injection 1 g, 1 pc. - from 14 rubles.