Ampicillin is a broad-spectrum antibiotic from the group of semisynthetic penicillins. It acts bactericidal, inhibiting the synthesis of the cell wall of microorganisms. It is destroyed by penicillinase. Acid resistant.
The following microorganisms are constantly sensitive to the drug:
Streptococci A, B, C, F, G, Str. pneumoniae not producing penicillinases; L. monocytogernes, Corynebacterium diphtheriae, Erysipelotrix rhusopathiae, Eikenella, N. meningitidis, Bordetella pertussis, Clostridium spp., Propioniobacterium acnes, Peptostreptococcus spp., Actinomyces spp., Leptospema,
not constantly sensitive: Enterococcus faecalis, E. Coli, Proteus mirabilis, Salmonella spp., Vibrio cholerae, H. Influenzae, N. gonorrhoeae, Fusobacterium spp., Prevotella.
Resistant to the preparation: Staphylococcus spp., B. catarrhalis, Klebsiella spp., Enterobacter spp., C. diversus, C. freundii, Proteus vulgaris, Providencia rettgeri, Morganella moranii, Y. enterocolitica., Pseudomonas spp., Acinetbacter spp. Xanthomonas spp., Flavobacterium spp., Alcaligenes spp., Nocardia spp., Campylobacter spp., Legionella pneumophila, Mycobacterium spp., Bacteroides spp., Mycoplasma spp., Chlamydia spp.
The drug is not destroyed in the acidic environment of the stomach, is well absorbed from the digestive tract. The highest plasma concentration is achieved approximately 1.5-2 hours after administration. It penetrates into the tissues and body fluids, is found in therapeutic concentrations in the pleural, peritoneal and synovial fluids, in bile. The drug crosses the placental barrier, excreted in breast milk. The half-life (T1/2) is about 1 hour, with anuria it increases to 12-20 hours. The main part is excreted from the body by the kidneys, and a very high concentration of an antibiotic is created in the urine. The drug does not accumulate during repeated injections, which makes it possible to use it in large doses and for a long time.
Indications for use
Bacterial infections: bronchitis, pneumonia, dysentery, salmonellosis, prolonged carriage of salmonella, cholecystitis, whooping cough, pyelonephritis, urethritis, endocarditis, infections of the skin and soft cells, gynecological infections, infections of the ear, throat, nose, odontogenic infections, meningitis, sepsis and other infections caused by drug-sensitive microorganisms.
Dosage and administration
The drug is taken 0.5-1 hours before a meal.
For moderate infections, the daily dose for adults is 2 to 3 g, for severe infections – 10 g, for meningitis – 14 g.: For children, the drug is prescribed in a daily dose of 50-100 mg / kg. For children under 1 year, this will be 0.25–0.75 g / day, from 1 year to 6 years – 0.75–1.5 g / day, from 6 years to 15 years – 1.5–2 g / day. The daily dose is divided into 2–4 doses, with meningitis 6–8 doses. An exception is gonococcal urethritis, in which 3.5 g is administered orally in a single dose. The duration of the course of treatment is usually 5-10 days, with acute pyelonephritis – 2 – 3 weeks, with chronic pyelonephritis – more than 6 months.
Allergic reactions (urticaria, erythema, Quincke’s edema, rhinitis, conjunctivitis; rarely – fever, joint pain, eosinophilia; extremely rare – anaphylactic shock).
Possible toxic effects on the central nervous system (when using high doses in patients with renal failure), dyspeptic symptoms (diarrhea, nausea, vomiting), candidiasis, intestinal dysbiosis.
Absolute: hypersensitivity to penicillin antibiotics, severe liver dysfunction, myasthenia gravis, children under 1-year-old, infectious diseases caused by strains insensitive to the drug, especially pseudomonads and staphylococci.
Relative: with caution, hypersensitivity to cephalosporins, the presence of a history of allergies, bronchial asthma, hay runny nose or urticaria, secondary infections with infectious mononucleosis, lymphocytic leukemia, pregnancy and lactation.
With simultaneous use with bacteriostatic antibiotics (tetracycline, chloramphenicol, erythromycin and others), mutual antagonism occurs. With aminoglycoside antibiotics, synergism in antimicrobial efficacy is observed.
The combined use of probenicide reduces the excretion of the drug in the urine and leads to an increase in its content in the blood serum, and with allopurinol, it slows down the metabolism of the drug and increases the incidence of skin rashes.
The drug in rare cases weakens the effect of oral contraceptives.
In case of allergic reactions, it is necessary to stop taking the drug and carry out desensitizing therapy. When using the drug in patients with sepsis, a bacteriolysis reaction is possible (Yarish-Herxheimer reaction). In debilitated patients with prolonged treatment, superinfection caused by drug-resistant microorganisms (yeast-like fungi, gram-negative microorganisms) may develop. It is advisable for these patients to prescribe B vitamins and vitamin C during treatment with the drug, and if necessary, prescribe nystatin or levorin.
In case of bronchial asthma, hay fever and other allergic diseases, if necessary, the drug is used with the simultaneous appointment of desensitizing agents.
With caution, the drug is prescribed to patients with renal failure in pregnant and lactating women. Systematic monitoring of kidney, liver and blood picture is needed.
The drug should be stored out of the reach of children and not used after the expiration date.
Symptoms: nausea, vomiting, diarrhea, disturbance of water-electrolyte balance (as a result of vomiting and diarrhea complications).
Treatment: gastric lavage, activated charcoal, salt lubricants, water-electrolyte balance, symptomatic therapy. It is excreted by hemodialysis.
Capsules of 250 mg and 500 mg blister packaging.
In a dry, dark place at a temperature of no higher than 25°C.
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