ampicillin/ sulbactam

Adult Dosing .

Dosage forms:  INJ

Special Note

[strength clarification]

Info: doses expressed as total ampicillin + sulbactam amt; 1.5 g ampicillin/sulbactam contains 1 g ampicillin + 0.5 g sulbactam

infections, bacterial

[1.5-3 g IM/IV q6h]

Max: 12 g/day; Info: dose, duration varies w/ infection type, severity

intra-abdominal infections

[1.5-3 g IM/IV q6h]

Max: 12 g/day; Info: dose, duration varies w/ severity

skin/skin structure infections, bacterial

[1.5-3 g IM/IV q6h]

Max: 12 g/day; Info: dose, duration varies w/ severity

PID, severe

[3 g IV q6h x14 days]

Info: give w/ doxycycline; not 1st-line agent; switch to PO regimen ASAP to complete course

sinusitis, severe acute (off-label)

[1.5-3 g IV q6h x7-10 days]

infection prophylaxis, surgical (off-label)

[3 g IV x1]

Start: w/in 60min preop; Info: may repeat dose q2h intraop

pneumonia, community-acquired (off-label)

[1.5-3 g IV q6h for at least 5 days]

Info: for inpatient tx; may be part of multi-drug regimen; refer to IDSA guidelines

renal dosing

[adjust dose frequency]

CrCl 15-30: give usual dose q12h; CrCl 5-14: give usual dose q24h; CrCl <5: not defined

HD: give usual dose q12-24h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: give usual dose q12h; no supplement

hepatic dosing

[see below]

ampicillin/sulbactam-assoc. hepatic impairment hx: contraindicated

Peds Dosing .

Dosage forms:  INJ

Special Note

[strength clarification]

Info: doses expressed as total ampicillin + sulbactam amt; 1.5 g ampicillin/sulbactam contains 1 g ampicillin + 0.5 g sulbactam

intra-abdominal infections

[1 yo and older, <40 kg]

Dose: 300 mg/kg/day IV divided q6h; Max: 12 g/day; Info: duration varies w/ severity

[1 yo and older, >40 kg]

Dose: 1.5-3 g IV q6h: Max: 12 g/day; Info: dose, duration varies w/ severity

skin/skin structure infections, bacterial

[1 yo and older, <40 kg]

Dose: 300 mg/kg/day IV divided q6h; Max: 12 g/day; Info: duration varies w/ severity

[1 yo and older, >40 kg]

Dose: 1.5-3 g IV q6h: Max: 12 g/day; Info: dose, duration varies w/ severity

infections, mild-moderate bacterial (off-label)

[1-23 mo]

Dose: 150-225 mg/kg/day IV divided q6h; Info: dose, duration varies w/ infection type, severity

[2-12 yo]

Dose: 150-300 mg/kg/day IV divided q6h; Max: 12 g/day; Info: dose, duration varies w/ infection type, severity

infections, severe bacterial (off-label)

[1-23 mo]

Dose: 300-450 mg/kg/day IV divided q6h; Info: dose, duration varies w/ infection type, severity

[2-12 yo]

Dose: 300-600 mg/kg/day IV divided q4-6h; Max: 12 g/day; Info: dose, duration varies w/ infection type, severity

PID, severe (off-label)

[adolescents]

Dose: 3 g IV q6h x14 days; Info: give w/ doxycycline; not 1st-line agent; switch to PO regimen ASAP to complete course

sinusitis, severe acute (off-label)

[children]

Dose: 200-400 mg/kg/day IV divided q6h x10-14 days

infection prophylaxis, surgical (off-label)

[1 yo and older]

Dose: 50 mg/kg/dose IV x1; Start: w/in 60min preop; Max: 3000 mg/dose; Info: dose based on ampicillin component; may repeat dose q2h intraop

renal dosing

[adjust dose frequency]

CrCl 15-29: give usual divided dose q12h; CrCl <15: give usual divided dose q24h

HD: give usual divided dose q24h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: give usual divided dose q24h; no supplement

hepatic dosing

[see below]

ampicillin/sulbactam-assoc. hepatic impairment hx: contraindicated