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

Semisynthetic penicillin, a broad spectrum of action, bactericidin. Acid-resistant. Suppresses the synthesis of the bacterial cell wall. It is active against Gram-positive (alpha and beta-hemolytic streptococci, Streptococcus pneumoniae, Staphylococcus spp., Bacillus anthracis, Clostridium spp., moderately active against the majority Enterococcus spp., in t.ch. Enterococcus faecalis), Listeria spp., and gram-negative (Haemophilus influenzae, Neisseria meningitidis, Neisseria gonorrhoeae, Proteus mirabilis, Yersinia multocida (formerly Pasteurella), many species Salmonella spp., Shigella spp., Escherichia coli) microorganisms, aerobic non-spore-forming bacteria.

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

Pharmacokinetics:

Absorption after ingestion is rapid, high. Admission simultaneously with food reduces absorption of the drug. Bioavailability - 40%. The time to reach the maximum concentration with oral intake of 500 mg is 2 hours, the maximum concentration is 3-4 μg / ml. Communication 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 bronchial secretion (in the purulent bronchial secretion, the accumulation is weak), paranasal sinuses, middle ear fluid (with its inflammation), saliva, fetal tissues. Poorly penetrates the blood-brain barrier (permeability increases with inflammation - meninges).

It is excreted mainly by the kidneys (70-80%), 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 pathogens: 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, cervicitis, skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatoses); infections of the musculoskeletal system; pasteurellosis, listeriosis, gastrointestinal tract infections (typhoid and paratyphoid, dysentery, salmonellosis, salmonella carcinoma).

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), children's age (up to 4 years).

Carefully:

Bronchial asthma, pollinosis and other allergic diseases, renal insufficiency, bleeding in the anamnesis.

Pregnancy and lactation:

It is possible to use the drug during pregnancy according to the indications in those cases,when the benefit to the mother exceeds the potential risk to the fetus. Ampicillin is excreted in breast milk in low concentrations. If you need to use the drug during breastfeeding, you should decide whether to stop it.

Dosing and Administration:

Directions for use: inside 0.5 to 1 hour before meals with a small amount of water. The dosage regimen is set individually, depending on the severity of the course and localization of the infection, the sensitivity of the pathogen to the drug.

Adults - 0.25 g (250 mg) 4 times a day; if necessary, increase the dose to 3 g / day. With infections of the gastrointestinal tract and organs of the genitourinary system: 0.5 g (500 mg) 4 times a day.

With gonococcal urethritis - inside 3.5 g once.

Children over 4 years of age are prescribed 1-2 g per day. 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: skin peeling, itching, urticaria, rhinitis, conjunctivitis, angioedema, fever, arthralgia, eosinophilia, erythematous and maculopapular rash, exfoliative dermatitis, multiform exudative erythema (incl.Stevens-Johnson syndrome), reactions similar to serum sickness, anaphylactic shock.

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

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: non-allergic ampicillin rash, interstitial nephritis, nephropathy, superinfection (especially in patients with chronic diseases or reduced resistance of the body), vaginal candidiasis.

Overdose:

Symptoms: manifestations 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, medicines to maintain the water-electrolyte balance and symptomatic. It is excreted by hemodialysis.

Interaction:

Antacids, glucosamine, laxative drugs, food and aminoglycosides (with enteral administration) slow down and reduce absorption; ascorbic acid increases absorption.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect; bacteriostatic medicinal products (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 estrogen-containing oral contraceptives (it is necessary to use additional methods of contraception), drugs that metabolize parahaminobenzoic acid, ethinyl estradiol (in the latter case, the risk of bleeding "breakthrough" increases).

Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, non-steroidal anti-inflammatory drugs and other drugs that block tubular secretion, increase the concentration of ampicillin in the plasma (by reducing tubular secretion).

Allopurinol increases the risk of skin rash.

Reduces clearance and increases the toxicity of methotrexate.

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.

When appointing patients with sepsis, the development of a bacteriolysis reaction (the Yarisch-Gerxheimer reaction) is possible.

In patients who have increased sensitivity to penicillins, there may be cross-allergic reactions with other beta-lactam antibiotics.

In the treatment of mild diarrhea, which occurs against the background of course treatment, anti-diarrheal drugs should be avoided, which reduce intestinal peristalsis; You can use kaolin - or attapulgite-containing antidiarrhoeal drugs, the withdrawal of the drug is indicated. With severe diarrhea, you should see a doctor.

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

Effect on the ability to drive transp. cf. and fur:

During treatment, it is not recommended to manage vehicles, mechanisms, and also to engage in activities requiring rapidity of psychomotor reactions.

Form release / dosage:

Tablets 250 mg.

Packaging:

For 10 tablets in a contour mesh box made of polyvinylchloride film and aluminum foil printed lacquered.

2,3,4 or 5 contour mesh packages together with the instruction for use are placed in a pack of cardboard.

Storage conditions:

In a dry place, at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life:

2 years. Do not use after the expiration date printed on the package.

Terms of leave from pharmacies:On prescription

Registration number:LS-001124

Date of registration:23.09.2011

Expiration Date:Unlimited

The owner of the registration certificate:DALHIMFARM, OJSC DALHIMFARM, OJSC Russia

Manufacturer: & nbsp

DALHIMFARM, OJSC Russia

Information update date: & nbsp21.08.2017

Illustrated instructions

Instructions

Ampicillin (Ampicillin)