AMPICILLIN injectable

Therapeutic action

• Penicillin antibacterial

Indications

• Severe bacterial infections: meningitis, pneumonia, severe cutaneous anthrax, pyelonephritis, postpartum upper genital tract infection, etc., in combination with other antibacterials

Forms and strengths, route of administration

• Powder for injection, in 500 mg and 1 g vials, to be dissolved in 5 ml of water for injection
• Prefer administration by slow IV injection (3 to 5 minutes) or IV infusion (30 minutes) in 0.9% sodium chloride or 5% glucose for high doses; use IM route only if correct IV administration is not possible.
• In neonates, administer only by slow IV injection or IV infusion.

Dosage

Meningitis in young children, in combination with cefotaxime or gentamicin 

• Neonate:
  •    0 to 7 days (< 2 kg): 100 mg/kg every 12 hours 
  •    0 to 7 days (≥ 2 kg): 100 mg/kg every 8 hours 
  •    8 days to < 1 month: 100 mg/kg every 8 hours 
• Child 1 to 3 months: 100 mg/kg every 8 hours 

Pneumonia and pyelonephritis, in combination with gentamicin

• Neonate 
  •    0 to 7 days (< 2 kg): 50 mg/kg every 12 hours 
  •    0 to 7 days (≥ 2 kg): 50 mg/kg every 8 hours 
  •    8 days to < 1 month: 50 mg/kg every 8 hours 
• Child 1 month and over: 50 mg/kg every 6 to 8 hours 
• Adult: 1 g every 6 or 8 hours (2 g every 6 hours in pyelonephritis) 

Postpartum upper genital tract infection, in combination with metronidazole and gentamicin

• Adult: 2 g every 8 hours 

Severe cutaneous anthrax, in combination with clindamycin

• Child 1 month and over: 50 mg/kg (max. 3 g) every 6 hours or 65 mg/kg (max. 4 g) every 8 hours 
• Adult: 3 g every 6 hours or 4 g every 8 hours

For administration by IV infusion, dilute each dose of ampicillin in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in children 20 kg and over and in adults.

Duration

• According to indication and clinical response.

Change to oral treatment as soon as possible with amoxicillin or a combination of antibacterials, depending on the indication.

Contra-indications, adverse effects, precautions

• Do not administer to patients with infectious mononucleosis (risk of skin eruption) or to penicillin allergic patients.
• Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur) or patients with severe renal impairment (reduce dosage).
• May cause: skin eruption, gastrointestinal disturbances, allergic reactions sometimes severe.
• Do not combine with methotrexate (increased methotrexate toxicity).
• Pregnancy: no contra-indication
• Breast-feeding: no contra-indication

Remarks

• Do not mix with another drug in the same syringe or infusion.
• Injectable amoxicillin is used for the same indications.

Storage