Clinical Pharmacology of Ampicillin

Abstract

Ampicillin is active against gram-negative and gram-positive organisms. Ampicillin is a β-lactam antibiotic and β-lactam ring is destroyed by β-lactamases thus ampicillin is co-formulated with sulbactam an inhibitor of β-lactamases. Ampicillin has been found efficacy and safe in treatment of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis and ampicillin/sulbactam has been found efficacy and safe in treatment of multidrug-resistant Acinetobacter baumannii. Ampicillin treats sinusitis, otitis media, acute exacerbations of chronic bronchitis, epiglottitis, and bacterial meningitis and ampicillin/sulbactam treats upper respiratory-tract and skin infections, and many life-threatening infections. Ampicillin and sulbactam penetrates into body-tissues. Ampicillin and sulbactam elimination half-life is 1.41 and 1.73 hours, respectively, in healthy subjects, but the half-life of ampicillin and sulbactam is increased in patients with acute kidney injury undergoing dialysis. The prophylaxis with ampicillin/sulbactam prevents infections in patients undergoing surgery and the treatment with ampicillin or ampicillin/sulbactam has been studied. Ampicillin penetrates into cerebrospinal fluid in significant amounts and ampicillin treats the bacterial meningitis caused by Haemophilus influenzae type b and Haemophilus meningitis but ampicillin may become resistant to Streptococcus aureus, Klebsiella, Pseudomonas, Salmonella enterica serotype Typhimurium, and Shigella dysenteriae. Ampicillin freely crosses the human placenta and migrates into breast-milk is significant amounts. The aim of this study is to review ampicillin and ampicillin/sulbactam efficacy and safety, ampicillin and sulbactam penetration into body-tissues, ampicillin and sulbactam pharmacokinetics, ampicillin/sulbactam prophylaxis and treatment, treatment of bacterial meningitis with ampicillin, ampicillin transfer across the human placenta, ampicillin migration into the breast-milk, and ampicillin resistance.