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 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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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