Generic Name:Â Ampicillin Sodium
Brand Name: Ampicin,Omnipen-N,Penbritin,Polycillin-N,SK-Ampicillin-N,Totacillin-N
Classifications:Â antiinfective; antibiotic; aminopenicillin
Pregnancy Category:Â B
Availability Â
250 mg, 500 mg capsules;Â 125 mg/5 mL, 250 mg/5 mL oral suspension;Â 125 mg, 250 mg, 500 mg, 1 gm, 2 gm vials
Actions Â
A broad-spectrum semisynthetic aminopenicillin, is highly bactericidal even at low concentrations, but is inactivated by penicillinase (beta-lactamase).
Therapeutic effects
Active against gram-positive microorganisms such as alpha- and beta-Hemolytic streptococci, Diplococcus pneumoniae, non-penicillinase producing Staphylococci, and Listeria. Major advantage over penicillin G is enhanced action against most strains of Enterococci and several gram-negative strains including Escherichia coli, Neisseria gonorrhoeae, N. meningitidis, Haemophilus influenzae, Proteus mirabilis, Salmonella (including typhosa), and Shigella. Inactive against Mycoplasma, rickettsiae, fungi, and viruses.
Uses Â
Infections of GU, respiratory, and GI tracts and skin and soft tissues; also gonococcal infections, bacterial meningitis, otitis media, sinusitis, and septicemia and for prophylaxis of bacterial endocarditis. Used parenterally only for moderately severe to severe infections.
Route & Dosage Â
Systemic Infections
adult:  PO 250–500 mg q6 h
IV/IM 250 mg–2 g q6h
child:  PO 25–50 mg/kg/d divided q6h
IV/IM 25–100 mg/kg/d divided q6h
neonate:  IV/IM <=7 d & <=2000 g, 50 mg/kg/d divided q12h; <=7 d & >2000 g, 75 mg/kg/d divided q8h; >7 d, 50–100 mg/kg/d dividedq6–12 h
Meningitis
adultchild:  IV 150–200 mg/kg/d divided q4–6 h
neonate:  IV/IM <=7 d & <=2000 g, 100 mg/kg/d divided q12 h; <=7 d & >2000 g, 150 mg/kg/d divided q8h; >7 d, 100–200 mg/kg/d divided q6–12h
Gonorrhea
adult:Â Â POÂ 3.5 g with 1 g probenecid times 1
IV/IM 500 mg q8–12h
Administration
Oral
- Give with a full glass of water on an empty stomach (at least 1 h before or 2 h after meals) for maximum absorption. Food hampers rate and extent of oral absorption.
Intramuscular
- Â Reconstitute each vial by adding the indicated amount of sterile water for injection or bacteriostatic water for injection (1.2 mL to 125 mg; 1 mL to 250 mg; 1.8 mL to 500 mg; 3.5 mL to 1 g; 6.8 ml to 2 g). All reconstituted vials yield 250 mg/mL except the 125 mg vial which yields 125 mg/mL. Administer within 1 h of preparation.
- Withdraw the ordered dose and inject deep IM into a large muscle.
Intravenous  Â
- Verify correct IV concentration and rate of infusion with physician for administration to neonates, infants, and children.
PREPARE direct: /intermittent: Reconstitute each 500 mg or less with at least 5 mL of sterile water for injection. Final concentration must be <=30 mg/mL; thus may be further diluted in 50 mL or more of NS, D5W, D5/NS, D5W /0.45NS, or RL. • Stability of solution varies with diluent and concentration of solution. Solution in NS are stable for up to 8 h at room temperature; other solutions should be infused within 2–4 h of preparation. Give direct IV within 1 h of preparation. • Wear disposable gloves when handling drug repeatedly; contact dermatitis occurs frequently in sensitized individuals.
ADMINISTER direct: /intermittent: Slowly over at least 15 min. • With solutions of 100 mL or more, set rate according to amount of solution, but no faster than direct IV rate. • Convulsions may be induced by too rapid administration.
Incompatibilities Solution / Additive: Any dextrose-containing solution, including parenteral nutrition solutions.  Y-site: Clindamycin, erythromycin, aminoglycosides, lidocaine, verapamil.
Store capsules and unopened vials at 15°–30° C (59°–86° F) unless otherwise directed. Keep oral preparations tightly covered.
Adverse effects
BodyWhole: Similar to those for penicillin G. Hypersensitivity (pruritus, urticaria, eosinophilia, hemolytic anemia, interstitial nephritis, anaphylactoid reaction); superinfections.
CNS:Convulsive seizures with high doses.
GI:Diarrhea, nausea, vomiting, pseudomembranous colitis.
other:Severe pain (following IM); phlebitis (following IV);
Skin:Rash.
Nursing implicationsÂ
Assessment & Drug Effects
- Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy.
- Lab tests: Baseline C&S tests prior to initiation of therapy; start drug pending results. Baseline and periodic assessments of renal, hepatic, and hematologic functions, particularly during prolonged or high-dose therapy.
- Note: Sodium content of drug must be considered in patients on sodium restriction.
- Inspect skin daily and instruct patient to do the same. The appearance of a rash should be carefully evaluated to differentiate a nonallergenic ampicillin rash from a hypersensitivity reaction. Report rash promptly to physician.
- Note: Incidence of ampicillin rash is higher in patients with infectious mononucleosis or other viral infections, Salmonella infections, lymphocytic leukemia, or hyperuricemia or in patients taking allopurinol.
- Take medication around the clock; do not to miss a dose; continue taking medication until it is all gone (usually 10 d) unless otherwise directed by physician or pharmacist.
Patient & Family Education
- Note: Ampicillin rash is believed to be nonallergenic and therefore its appearance is not an absolute contraindication to future therapy.
- Report diarrhea to physician; do not self-medicate. Give a detailed report to the physician regarding onset, duration, character of stools, associated symptoms, temperature and weight loss (if any) to help rule out the possibility of drug-induced, potentially fatal pseudomembranous colitis .
- Report S&S of superinfection (onset of black, hairy tongue; oral lesions or soreness; rectal or vaginal itching; vaginal discharge; loose, foul-smelling stools; or unusual odor to urine).
- Notify physician if no improvement is noted within a few days after therapy is started.
- Do not breast feed while taking this drug without consulting physician.