Ampicillin

Ampicillin is a broad-spectrum antibacterial bactericidal agent from the group of semisynthetic penicillins. It is obtained by acetylation of 6-aminopenicillanic acid with an aminophenylacetic acid residue. It is acid-resistant. This antibiotic inhibits peptidoglycan polymerase and transpeptidase. It prevents the formation of peptide bonds and disrupts the late stages of the synthesis of dividing microorganism’s cell walls. It results in a decrease in the osmotic resistance of the bacterial cell and causes its lysis.

Ampicillin is active against gram-positive (alpha and beta-hemolytic streptococci, Streptococcus pneumoniae, Staphylococcus spp., Bacillus anthracis, Clostridium spp., Most enterococci, including Enterococcus faecalis, and Neem-negative (Haemophiliss prussitrie merizaidae meninga, influenza Pasteurella multocida many species of Salmonella spp., Shigella spp., Escherichia coli) microorganisms, aerobic non-spore forming bacteria (Listeria spp.).

Indications

Bacterial infections caused by sensitive microflora:

• respiratory tract and ENT organs (sinusitis, tonsillitis, pharyngitis, otitis media, bronchitis, pneumonia, lung abscess);
• kidney and urinary tract infections (pyelonephritis, pyelitis, cystitis, urethritis;
• infections of the biliary system ( cholangitis, cholecystitis), gonorrhea, chlamydial infections in pregnant women (with erythromycin intolerance);
• cervicitis, infections of the skin and soft tissues: erysipelas, impetigo, secondarily infected dermatoses;
• musculoskeletal infections;
• pasteurellosis;
• listeriosis;
• infections of the gastrointestinal tract (typhoid and paratyphoid fever, dysentery, salmonellosis, salmonella carriage, peritonitis).

Oral administration. The dosage regimen of Ampicillin in adults is 0.25 g 4 times a day for 0.5-1 hours before meals with a small amount of water. If necessary, increase the dose to 3 g/day.

Infections of the gastrointestinal tract and organs of the genitourinary system: 0.5 g 4 times a day.

Gonococcal urethritis – 3.5 g once.

A mild infection in children, it is preferable to use a suspension.

Children over 4 years old are prescribed 1-2 g per day. The daily dose is divided into 4-6 doses.

The duration of therapy depends on the condition severity (from 5-10 days to 2-3 weeks, in chronic processes – for several months).

The most common contraindications of Ampicillin are:

• hypersensitivity (including to other penicillins, cephalosporins, carbapenems);
• infectious mononucleosis;
• lymphocytic leukemia;
• liver failure;
• a history of gastrointestinal tract diseases (especially colitis associated with the use of antibiotics);
• lactation;
• children (up to 4 years).

Take this antibiotic with caution in the following cases:

• bronchial asthma;
• hay fever;
• allergic diseases;
• renal failure;
• a history of bleeding;
• pregnancy.

• Allergic reactions: possible – skin peeling, itching, urticaria, rhinitis, conjunctivitis, Quincke’s edema; rarely – fever, arthralgia, eosinophilia, erythematous and maculopapular rash, exfoliative dermatitis, erythema multiforme, including Stevens-Johnson syndrome, reactions similar to serum sickness, in isolated cases – anaphylactic shock.
• Digestive system: dysbiosis, stomatitis, gastritis, dry mouth, taste change, abdominal pain, vomiting, nausea, diarrhea, stomatitis, glossitis, impaired liver function, a moderate increase in hepatic transaminases, pseudomembranous enterocolitis.
• Central nervous system: agitation or aggressiveness, anxiety, confusion, behavior change, depression, convulsions (with high-dose therapy).
• Laboratory indicators: leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia.
• Other: interstitial nephritis, nephropathy, superinfection (especially in patients with chronic diseases or reduced body resistance), vaginal candidiasis.

• Antacids, glucosamine, laxatives, food slow down and reduce absorption; ascorbic acid increases absorption.
• Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) – synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) – antagonistic.
• Ampicillin increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index).
• It reduces the effectiveness of estrogen-containing oral contraceptives (additional contraceptive methods must be used), drugs that metabolize para-amino-benzoic acid, ethinyl estradiol.
• Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, non-steroidal anti-inflammatory drugs; drugs that block tubular secretion increase the concentration (due to a decrease in tubular secretion).
• Allopurinol increases the risk of developing a skin rash.
• Ampicillin reduces clearance and increases the toxicity of methotrexate and enhances digoxin absorption.