Ampicillin - instructions for use, dose, side effects, contraindications

Antibacterial broad spectrum antibacterial agent from the group of semisynthetic penicillins obtained by acetylation of 6-aminopenicillanic acid with an aminophenylacetic acid residue is acid-fast. Inhibits the peptidoglycan polymerase and transpeptidase, prevents the formation of peptide bonds and disrupts the late stages of the synthesis of the cell wall of the fissile microorganism, which leads to a decrease in the osmotic stability of the bacterial cell and causes its lysis. It is active against Gram-positive (alpha and beta-hemolytic streptococci, Streptococcus pneumoniae, Staphylococcus spp., Bacillus anthracis, Clostridium spp., most enterococci, incl. Enterococcus faecalis) and gram-negative (Haemophilus influenzae, Neisseria meningitidis, Proteus mirabilis, Pasteurella multocida many species Salmonella spp., Shigella spp., Escherichia coli) microorganisms, aerobic non-spore-forming bacteria (Listeria spp.).

He Effective against penicillinase-producing strains Staphylococcus spp., all strains Pseudomonas aeruginosa, most strains Klebsiella apr. and Enterobacter spp.

Pharmacokinetics:

Absorption after oral administration - fast, high, bioavailability - 40%; time to reach the maximum concentration with oral intake of 500 mg - 2 hours, the maximum concentration - 3-4 ng / ml. Connection with plasma proteins - 20%.

It is evenly distributed in the organs and tissues of the body, it is found in therapeutic concentrations in pleural, peritoneal, amniotic and synovial fluids, cerebrospinal fluid, contents of blisters, urine (high concentrations), intestinal mucosa, bones, gall bladder, lungs, female genital tract, bile , in a bronchial secretion (in the purulent bronchial secretion, the accumulation is weak), paranasal sinuses, middle ear fluid, saliva, fetal tissues. Poor penetrates the blood-brain barrier (permeability increases with inflammation).

It is excreted mainly by the kidneys (70-80%), and in the urine very high concentrations of the unchanged antibiotic are created; partially with bile, in nursing mothers - with milk. Do not cumulate. Removed during hemodialysis.

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

Contraindications:

Hypersensitivity (including to other penicillins, cephalosporins, carbapenems). infectious mononucleosis, lymphocytic leukemia. hepatic insufficiency, a history of the gastrointestinal tract (especially colitis associated with the use of antibiotics), lactation period, children's age (up to 4 years).

Carefully:Bronchial asthma, hay fever and other allergic diseases, renal insufficiency, bleeding in the anamnesis, pregnancy.

Dosing and Administration:

Inside adults - 0.25 g, 4 times a day for 0.5-1 h 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. With gonococcal urethritis - inside 3.5 g once.

With a mild infection in children, it is preferable to take a suspension.

Children over 4 years of age are prescribed 1-2 g per day, 3-4 years - 100-150 mg / kg. The daily dose is divided into 4-6 receptions.

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

Side effects:

Allergic reactions: possible - skin peeling, itching, hives, rhinitis, conjunctivitis, Quincke's edema, rarely - fever, arthralgia, eosinophilia, erythematous and maculopapular rash, exfoliative dermatitis, multiform exudative erythema, incl. Stevens-Johnson syndrome. reactions similar to serum sickness, in single cases anaphylactic shock.

From the digestive system: dysbacteriosis, gastritis, dry mouth. change in taste, abdominal pain, nausea, vomiting, diarrhea, stomatitis, glossitis, impaired liver function, moderate increase in the level of "liver" transaminases, pseudomembranous enterocolitis.

From the 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 resistance of the body), candidiasis of the vagina.

Overdose:

Symptoms: the manifestation of toxic effects on the central nervous system (especially in patients with renal insufficiency); nausea, vomiting, diarrhea, disturbance of water electrolyte balance (as a consequence of vomiting and diarrhea).

Treatment: gastric lavage Activated carbon, salt laxatives, preparations to maintain the water-electrolyte balance and symptomatic.

It is excreted by hemodialysis.

Interaction:

Antacids, glucosamine, laxatives, food slows down and reduces absorption; ascorbic acid increases absorption.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) - synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol. lincosamides, tetracyclines, sulfonamides) - antagonistic.

Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index); reduces the effectiveness of extrogen-containing oral contraceptives (additional methods of contraception must be used), drugs whose metabolism produces the steam-amino-benzoic acid, ethinyl estradiol (in the latter case increases the risk of bleeding "breakthrough").

Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, non-steroidal anti-inflammatory drugs; drugs that block tubular secretion increase the concentration (by reducing tubular secretion).

Allopurinol increases the risk of skin rash.

Reduces clearance and increases the toxicity of methotrexate.

Increases the absorption of digoxin.

Special instructions:

At course treatment it is necessary to monitor the status of the functions of the organs of hematopoiesis, liver and kidneys.

It is possible to develop superinfection due to the growth of insensitive microflora, which requires a corresponding change in antibacterial therapy.

In the treatment of patients with bacteremia (sepsis), the development of a bacteriolysis reaction (the Yarisch-Gerxheimer reaction) is possible.

In patients who are hypersensitive to penicillins, there may be cross-allergic reactions with cephalosporin antibiotics.

In the treatment of mild diarrhea against the background of course treatment, antidiarrheal drugs should be avoided, which reduce intestinal peristalsis; It is possible to use kaolin- or attapulgite-containing antidiarrhoeic agents.

Treatment should necessarily continue for another 48-72 hours after the disappearance of clinical signs of the disease.

When concomitantly using estrogen-containing oral contraceptives and ampicillin, other or additional methods of contraception should be used whenever possible.

Form release / dosage:

Tablets 250 mg.

Packaging:

For 10 tablets in a contour mesh box made of polyvinylchloride film and aluminum foil printed lacquered or in a contour mesh packaging from a polyvinyl chloride or imported film and paper with a polymer coating.

2 contour mesh packages with instructions for use are placed in a pack of cardboard for consumer packaging.

Storage conditions:

List B. In a dry place, at a temperature not exceeding 20 ⁰ Store in a place inaccessible to children.

Shelf life:

2 years.

After expiration date the drug should not be used.

Terms of leave from pharmacies:On prescription

Registration number:LSR-008110/08

Date of registration:14.10.2008 / 26.10.2015

Expiration Date:Unlimited

The owner of the registration certificate:AVEKSIMA, JSC AVEKSIMA, JSC Russia

Manufacturer: & nbsp

IRBITSK HFZ, OJSC Russia

Information update date: & nbsp21.08.2017

Illustrated instructions

Instructions

Ampicillin (Ampicillin)