Ampicillin / Sulbactam Dosage

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Usual Adult Dose for Aspiration Pneumonia

1.5 to 3 g IV every 6 to 8 hours. Parenteral therapy should continue until the patient's condition stabilizes, at which time appropriate oral antimicrobial therapy may be initiated.

Therapy of documented anaerobic pleuropulmonary infections should be continued until after the infiltrate has been cleared, or a residual scar forms, sometimes requiring as long as 2 to 4 months.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Deep Neck Infection

1.5 to 3 g IV or IM every 6 to 8 hours. Parenteral therapy should continue until the patient's condition stabilizes, at which time appropriate oral antimicrobial therapy may be initiated.

Therapy should continue for 2 to 3 weeks, depending on the nature and severity of the infection.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Epiglottitis

1.5 to 3 g IV every 6 to 8 hours. Parenteral therapy should continue until the patient's condition stabilizes, at which time appropriate oral antimicrobial therapy may be initiated.

Therapy should continue for 7 to 10 days, depending on the nature and severity of the infection.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Intraabdominal Infection

1.5 to 3 g IV every 6 to 8 hours for 7 to 14 days, depending on the nature and severity of the infection.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Joint Infection

1.5 to 3 g IV or IM every 6 to 8 hours for 3 to 4 weeks, depending on the nature and severity of the infection. Longer therapy, for 6 weeks or more, may be required for prosthetic joint infections.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Osteomyelitis

1.5 to 3 g IV or IM every 6 to 8 hours for 4 to 6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require additional oral antibiotic therapy, possibly for up to 6 months.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Pelvic Inflammatory Disease

1.5 to 3 g IV or IM every 6 to 8 hours. Parenteral therapy should be continued for at least 48 hours after clinical signs of improvement are observed. Oral therapy may then be substituted to complete a 14 days course.

Oral doxycycline therapy for 7 days should be considered to treat possible concurrent chlamydia infection in males and nonpregnant females. Evaluation of the patient's sexual partner(s) is also recommended.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Peritonitis

1.5 to 3 g IV every 6 to 8 hours for 10 to 14 days, depending on the nature and severity of the infection.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Pneumonia

1.5 to 3 g IV or IM every 6 to 8 hours. Therapy should continue for 7 days if pneumococcal pneumonia is suspected and up to 21 days if other organisms are responsible.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Pyelonephritis

1.5 to 3 g IV or IM every 6 to 8 hours. Parenteral therapy should continue until the patient is clinically stable at which time, oral therapy may be instituted and continued until a 14 day course of treatment has been completed.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Skin or Soft Tissue Infection

1.5 to 3 g IV or IM every 6 to 8 hours for 7 to 10 days, or for 3 days after acute inflammation resolves, depending on the nature and severity of the infection.

For more severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Surgical Prophylaxis

1.5 to 3 g IV or IM once shortly before induction of anesthesia. The dose may be continued every 6 hours for 24 hours if desired.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Adult Dose for Urinary Tract Infection

1.5 g IV or IM every 6 hours for 3 to 7 days, depending on the nature and severity of the infection.

Dosages expressed reflect the combined ampicillin and sulbactam components (in a constant 2:1 ratio).

Usual Pediatric Dose for Meningitis

1 month to 1 year: 50 to 75 mg/kg (ampicillin) IV every 6 hours

>1 year to 12 years: 50 to 100 mg/kg (ampicillin) IV every 6 hours
Maximum dose: 8 g ampicillin/24 hours

Renal Dose Adjustments

Adults:
CrCl > 30 mL/min: 1.5 to 3 g IV every 6 to 8 hours
CrCl 15 to 29 mL/min: 1.5 to 3 g IV every 12 hours
CrCl < 15 mL/min: 1.5 to 3 g IV every 24 hours

Liver Dose Adjustments

No adjustment required

Precautions

Ampicillin antibiotics should not be used to treat mononucleosis due to a high incidence of erythematous skin rashes.

Safety and efficacy have not been established in pediatric patients with intra-abdominal infections.

Dialysis

Ampicillin may be removed from circulation by hemodialysis. The molecular weight, degree of protein binding and pharmacokinetics profile of sulbactam suggest that this compound may also be removed by hemodialysis.

Other Comments

The maximum dose of sulbactam is 4 g/day.

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