Ampicillin: Effective Broad-Spectrum Antibiotic Treatment
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Synonyms | |||
Ampicillin is a broad-spectrum aminopenicillin antibiotic derived from penicillin, widely prescribed for its efficacy against both gram-positive and gram-negative bacteria. It functions by inhibiting bacterial cell wall synthesis, leading to bacterial cell lysis and death. This semi-synthetic antibiotic is particularly valuable for treating a range of infections, including respiratory, urinary, gastrointestinal, and meningeal infections, and is available in oral and parenteral formulations for flexible administration based on clinical need.
Features
- Broad-spectrum bactericidal activity against susceptible organisms
- Available in oral capsules (250 mg, 500 mg), oral suspension (125 mg/5 mL, 250 mg/5 mL), and injectable forms
- Stability in acidic environments allows for effective oral absorption
- Synergistic activity with beta-lactamase inhibitors such as sulbactam
- Well-established safety profile with decades of clinical use
Benefits
- Effectively treats a wide range of bacterial infections, reducing the need for multiple antibiotics
- Rapid onset of action with bactericidal effects, promoting quicker patient recovery
- Suitable for both adult and pediatric populations with appropriate dosing adjustments
- Oral bioavailability allows for outpatient treatment in many cases, improving patient compliance
- Cost-effective option compared to newer broad-spectrum antibiotics
Common use
Ampicillin is commonly prescribed for infections caused by susceptible strains of bacteria, including:
- Respiratory tract infections such as bronchitis and pneumonia
- Urinary tract infections including cystitis and pyelonephritis
- Gastrointestinal infections caused by Salmonella and Shigella species
- Bacterial meningitis, particularly in pediatric populations
- Septicemia and endocarditis when caused by susceptible organisms
- Otitis media and sinusitis in appropriate clinical scenarios
Dosage and direction
Dosage varies significantly based on infection severity, patient age, renal function, and route of administration:
Adults:
- Mild to moderate infections: 250-500 mg orally every 6 hours
- Severe infections: 1-2 g IV or IM every 4-6 hours
- Urinary tract infections: 500 mg orally every 8 hours
- Meningitis: 2 g IV every 4 hours
Pediatrics:
- 50-100 mg/kg/day in divided doses every 6-8 hours for mild infections
- 100-200 mg/kg/day in divided doses every 4-6 hours for severe infections
- Maximum dose should not exceed adult dosing
Administration guidelines:
- Oral administration: Take on empty stomach (1 hour before or 2 hours after meals) for optimal absorption
- Injectable forms: Reconstitute according to manufacturer instructions
- Duration of therapy typically ranges from 7-14 days depending on infection type and severity
- Complete full course of therapy even if symptoms improve earlier
Precautions
- Use with caution in patients with history of hypersensitivity reactions to penicillins, cephalosporins, or other beta-lactam antibiotics
- Monitor renal function during therapy; dosage adjustment required in renal impairment
- May cause antibiotic-associated colitis; evaluate patients who develop diarrhea
- Use during pregnancy only if clearly needed (Category B)
- Excreted in breast milk; consider temporary discontinuation of nursing
- Periodic assessment of organ system function recommended during prolonged therapy
- Superinfection with fungi or resistant bacteria may occur
Contraindications
- History of serious hypersensitivity reaction to ampicillin or other penicillins
- Infectious mononucleosis due to high incidence of rash
- Previous history of ampicillin-associated cholestatic jaundice/hepatic dysfunction
- Concomitant use with bacteriostatic antibiotics may reduce efficacy
Possible side effect
Common (≥1%):
- Gastrointestinal: diarrhea, nausea, vomiting, abdominal pain
- Dermatological: rash, urticaria
- Mucocutaneous: candidiasis (oral/vaginal)
Less common (<1%):
- Hypersensitivity reactions: anaphylaxis, angioedema, serum sickness-like reactions
- Hematological: eosinophilia, leukopenia, thrombocytopenia
- Hepatic: elevated liver enzymes, hepatitis
- Renal: interstitial nephritis
- Central nervous system: headache, dizziness
- Other: black hairy tongue, tooth discoloration (with suspension)
Drug interaction
- Probenecid: decreases renal excretion of ampicillin, increasing serum levels
- Oral contraceptives: may reduce efficacy of hormonal contraception
- Allopurinol: increases incidence of skin rashes
- Warfarin: may potentiate anticoagulant effect
- Bacteriostatic antibiotics (e.g., tetracyclines, chloramphenicol): may antagonize bactericidal effect
- Methotrexate: may increase methotrexate toxicity
Missed dose
- Take the missed dose as soon as remembered
- If it is almost time for the next dose, skip the missed dose and resume regular schedule
- Do not double doses to make up for missed dose
- Maintain consistent timing to ensure stable antibiotic levels
- Contact healthcare provider if multiple doses are missed
Overdose
- Symptoms may include nausea, vomiting, diarrhea, electrolyte imbalance, and neuromuscular hypersensitivity
- Management is primarily supportive with attention to electrolyte and fluid balance
- Hemodialysis may be effective in removing ampicillin from circulation
- Contact poison control center or emergency department immediately
- Provide supportive care including maintenance of airway and circulation
Storage
- Store capsules and powder for oral suspension at controlled room temperature (20-25°C/68-77°F)
- Keep container tightly closed and protect from moisture
- Reconstituted oral suspension: refrigerate and discard after 14 days
- Injectable forms: follow specific storage instructions for reconstituted product
- Keep out of reach of children and pets
- Do not use beyond expiration date
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Ampicillin is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Dosage and treatment duration must be determined by a physician based on individual patient factors. Never self-medicate or share antibiotics with others. Report any adverse reactions to your healthcare provider immediately.
Reviews
“Clinical experience with ampicillin spans decades, demonstrating consistent efficacy against susceptible organisms when used appropriately. Its broad spectrum makes it valuable for empirical therapy while awaiting culture results. The oral formulation provides excellent bioavailability, allowing for step-down therapy from IV administration in many cases.” - Infectious Disease Specialist, 15 years experience
“While newer antibiotics have emerged, ampicillin remains a workhorse in pediatric infections, particularly for otitis media and urinary tract infections. The suspension formulation is generally well-accepted by children, and the safety profile is well-established in this population.” - Pediatric Pharmacist, 8 years experience
“In hospital settings, IV ampicillin continues to play a crucial role in treating serious infections including meningitis and endocarditis. Its synergy with aminoglycosides for enterococcal infections makes it particularly valuable. Monitoring renal function is essential, especially in elderly patients.” - Hospital Clinical Pharmacist, 12 years experience