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

    DOSE IN RENAL IMPAIRMENT


    GFR (mL/MIN)


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

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES


  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    Not dialysed. Dose as in
    GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/
    min
  • HDF/high flux &nbsp :
    Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/
    min
  • CAV/VVHD &nbsp &nbsp &nbsp:
    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 with

    renal impairment

  • Can cause nephrotoxicity if dose not

    reduced in renal impairment

  • Sodium content of injection

    1.47 mmol/500 mg vial

  • Ampicillin may be used in peritoneal

    dialysis fluids for treatment of peritonitis
    Do not mix with aminoglycosides