Ampicillin (Ampicillinum) is a semisynthetic beta-lactam antibacterial preparation of the penicillin group for systemic use. Has a wide range of antibacterial activity. It acts on gram-positive and gram-negative pathogenic flora.
Form of issue and composition
The drug is produced in tablets of 0.25 g of 10 and 20 tablets per package. Tablets are white, round, with a flat surface and a dividing strip. In 1 tablet contains the active substance - ampicillin trihydrate, corresponding to 250 mg ampicillin.
Excipients: talcum, calcium stearate, potato starch.
Pharmacodynamics. Ampicillin suppresses the synthesis of cell walls of bacteria, which is due to its antibacterial effect. The drug acts on coccal microorganisms (staphylococci, not forming penicillinase, as well as streptococci, pneumococci, meningococci, gonococci) and most Gram-negative bacteria (E. coli, salmonella, enterobacteria of the genus Proteus and others). Under the action of penicillinase Ampicillin is destroyed, therefore, is not effective with respect to penicillinase-forming strains.
Pharmacokinetics. The drug is rapidly absorbed into the blood and other body fluids and tissues. Resistant to acidic gastric environment. Ampicillin practically does not penetrate the blood-brain barrier (in the inflammatory processes of the meninges the permeability increases), it penetrates well through the placental barrier.
The maximum concentration of the active substance in the blood is determined after 1.5-2 hours after administration. Half-life is 1-2 hours. It is excreted from the body by the kidneys (while the urine determines the high content of the substance unchanged), the rest is excreted with bile. 30% of the active substance is split in the liver. Within 6-8 hours after taking up to 30% of the active substance is removed, in 24 hours - about 60%.
The drug is low-toxic, does not have the ability to accumulate in the body, so it can be used in large doses for a long time.
Indications for use
The use of the drug is indicated in infectious pathologies caused by microorganisms sensitive to the action of Ampicillin. These include:
- inflammatory diseases of the lower parts of the respiratory tract and ENT organs (otitis, sinusitis, pharyngitis , tonsillitis , bronchitis , bronchopneumonia and pneumonia);
- urological pathology ( cystitis , pyelitis, pyelonephritis, prostatitis, gonorrhea , urethritis);
- infectious inflammation of the biliary tract ( cholecystitis , cholangitis);
- intestinal infections (salmonellosis, enterocolitis, dysentery, typhoid fever, paratyphoid, gastroenteritis);
- Infectious inflammation of the skin and soft tissues;
- gynecological infectious pathologies;
- scarlet fever ;
Contraindications to the use of Ampicillin are:
- individual intolerance to penicillin group drugs;
- severe functional disorders of the liver;
- Infectious mononucleosis;
- HIV infection;
- the period of breastfeeding;
- age is less than 6 years.
Dosing and Administration
The drug is prescribed by a doctor. Tablets are taken orally, 30 minutes before or 2 hours after ingestion.
For adults and children over 14 years, the standard single dose is from 0.25 g to 1 g, the recommended daily dosage is 2-3 g, the maximum daily dosage is 4 g. Doses are selected individually, taking into account the severity of the pathology, the localization of the infectious process and the type of pathogen.
Doses of the drug for adults, depending on the type and location of infection:
- infection of the ENT organs and the respiratory tract (except for pneumonia) - 0.25 g every 6 hours;
- pneumonia - 0.5 g every 6 hours;
- infections of the genitourinary system - 0.5 g every 6 hours;
- typhoid fever, paratyphoid - 1-2 g every 6 hours;
- uncomplicated gonorrhea - 2 g once in combination with probenecid.
For children from 6 to 14 years, a standard daily dose of 100 mg / kg is prescribed. The calculated daily dosage is divided into 4-6 receptions.
The course of treatment is determined individually for each patient, depending on the severity of the disease and the sensitivity of infectious microorganisms to Ampicillin, can range from 7 days to 3 or more weeks.
- conjunctivitis ;
- skin rash and hives ;
- rarely - joint pain, fever, exfoliative dermatitis, eosinophilia;
- extremely rarely - Quincke's edema and anaphylactic shock.
With the development of an allergic reaction, it is necessary to discontinue the drug and prescribe desensitizing agents that reduce the sensitivity of the organism to an allergen, and antihistamines. With the development of anaphylactic shock, urgent medical care is provided.
From the digestive system:
- change in taste;
- abdominal pain;
- hemorrhagic colitis;
- gastritis ;
- intestinal dysbiosis .
From the hepatobiliary system:
- cholestatic jaundice;
In case of overdose Ampicillin has a toxic effect on the central nervous system, causing:
- convulsions , tremors, neuropathy (in patients with renal insufficiency).
If there are side effects or signs of overdose, Ampicillin must be withdrawn and symptomatic treatment: gastric lavage, sorbents and salt laxatives, normalization of water and salt balance, hemodialysis.
With long-term treatment with ampicillin in patients with weakened immunity, as well as with repeated treatment with the drug, superinfection may occur, caused by micro-organisms insensitive to Ampicillin - some gram-negative bacteria, yeast-like fungi. In such cases, simultaneous intake of B group vitamins and ascorbic acid is advisable, according to indications - nystatin or lignin.
During therapy, the following points should be considered:
- Before starting treatment, it is necessary to exclude the presence of an allergic reaction to Ampicillin;
- During the therapeutic course, regular diagnosis of liver and kidney function, cellular composition of peripheral blood should be carried out;
- patients with allergic diseases (hay fever, bronchial asthma and others) the drug is administered in combination with desensitizing agents;
- patients who carry out potentially dangerous or require special attention to work (including driving) should be careful when taking the drug;
- with functional disorders of the kidneys, it is necessary to correct the dosages of the drug by reducing the single dose or increasing the time interval between doses;
- pregnant women Ampicillin is prescribed only if the intended health benefits for women exceed the potential hazard to the fetus;
- Ampicillin in low doses is determined in breast milk, therefore at the time of taking the drug, breastfeeding should be abolished.
Interaction with other drugs
- increases the effect of oral anticoagulants;
- reduces the effect of sodium benzoate;
- increases absorption of digoxin;
- increases the toxicity of methotrexate;
- reduces the therapeutic effect of oral contraceptives;
- with simultaneous administration with cephalosporins, aminoglycosides, vancomycin, rifampicin, cycloserine, antibacterial action is enhanced;
- with simultaneous administration with antibiotics of the group of tetracyclines, macrolides, levomycetin, sulfonamides and lincosamides, the effectiveness of both drugs decreases;
- Ampicillin is incompatible with levomycetin, tetracycline, erythromycin, lincomycin, clindamycin, amphotericin, polymyxin B, acetylcysteine; hydralazine, domamine, metoclopramide, heparin;
- antacid and laxative drugs reduce the absorption of Ampicillin;
- Vitamin C enhances the absorption of Ampicillin.
The drug is stored in the original packaging, protected from light and out of reach of children at a temperature of 15 to 25 ° C. The shelf life of Ampicillin tablets is 3 years.
Analogues of the drug for the active substance: Ampicillin-Ferein, Ampicillin AMP, Ampicillin Innotek, Ampicillin-AKOS,, Penodyl, Pentrexyl, Zetsil, Messillin, Kampitsilin.
Prices for Ampicillin
Ampicillin tablets 250 mg, 20 pcs. - from 19 rubles.