Ampicillin

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

Oral: 250 mg – 1 g every 6 hours
IM/IV: 500 mg – 2 g every 4–6 hours

PHARMACOKINETICS

  • Molecular weight                           :
    349.4
  • %Protein binding                           :
    20
  • %Excreted unchanged in urine     :
    Oral: 20–60;
    Parenteral: 60–80
  • Volume of distribution (L/kg)       :
    0.17–0.31
  • half-life – normal/ESRD (hrs)      :
    1–1.5/7–20

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : 250 mg – 2 g every 6 hours
  • <10           :
    250 mg –1 g every 6 hours

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :
    Not dialysed. Dose as in
    GFR <10 mL/min
  • HD                     :
    Dialysed. Dose as in GFR
  • <10           : mL/
    min
  • HDF/high flux   :
    Dialysed. Dose as in GFR
  • <10           : mL/
    min
  • CAV/VVHD      :
    Dialysed. Dose as in GFR=10–
    20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
    Ciclosporin: may increase ciclosporin

    levels
    Reduces excretion of methotrexate

    (increased risk of toxicity)

    ADMINISTRATION

    Reconstition

    Use water for injection: 5 mL for each

    250 mg (1.5 mL for 250 mg or 500 mg for
    IM administration)

    Route

    Oral, IV, IM

    Rate of Administration

    Slow IV bolus over 3–4 minutes. Doses

    greater than 500 mg should be given by
    infusion

    Comments

    Can be diluted in glucose 5% or sodium

    chloride 0.9%

    OTHER INFORMATION

  • Rashes more common in patients withrenal impairment
  • Can cause nephrotoxicity if dose notreduced in renal impairment
  • Sodium content of injection1.47 mmol/500 mg vial
  • Ampicillin may be used in peritonealdialysis fluids for treatment of peritonitis
    Do not mix with aminoglycosides
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