Clinical and pharmacological group: & nbsp

Penicillins

Included in the formulation
  • Ampicillin
    powder w / m in / in 
    KRASFARMA, JSC     Russia
  • Ampicillin
    powder w / m 
  • Ampicillin
    pills inwards 
  • Ampicillin
    pills inwards 
    AVEKSIMA, JSC     Russia
  • Ampicillin
    pills inwards 
    DALHIMFARM, OJSC     Russia
  • Ampicillin
    pills inwards 
    UPDATE OF PFC, CJSC     Russia
  • Ampicillin
    powder w / m in / in 
    ABOLMED, LLC     Russia
  • Ampicillin
    pills inwards 
    BELMEDPREPARATY, RUP     Republic of Belarus
  • Ampicillin
    pills inwards 
  • Ampicillin
    powder w / m in / in 
    BIOSINTEZ, PAO     Russia
  • Ampicillin
    powder w / m 
    KRASFARMA, JSC     Russia
  • Ampicillin
    powder w / m in / in 
    SYNTHESIS, OJSC     Russia
  • Ampicillin
    powder w / m 
    SYNTHESIS, OJSC     Russia
  • Ampicillin
    pills inwards 
    SYNTHESIS, OJSC     Russia
  • Ampicillin-AKOS
    lyophilizate w / m in / in 
    SYNTHESIS, OJSC     Russia
  • Ampicillin-Ferein
    powder w / m in / in 
    BRYNTSALOV-A, CJSC     Russia
  • Ampicillin sodium salt-Vial
    powder w / m in / in 
    VIAL, LLC     Russia
  • Ampicillin trihydrate
    pills inwards 
  • Ampicillin trihydrate
    pills inwards 
    BIOCHEMIST, OJSC     Russia
  • Ampicillin trihydrate
    pills inwards 
    URALBIOFARM, OJSC     Russia
  • Ampicillin trihydrate
    pills inwards 
    BIOSINTEZ, PAO     Russia
  • Ampicillin trihydrate
    pills inwards 
  • АТХ:

    J.01.C.A   Penicillins of a wide spectrum of action

    J.01.C.A.01   Ampicillin

    Pharmacodynamics:

    It causes bacterial lysis, affecting the synthesis of the cell wall by inhibiting the transpeptidase necessary for the formation of peptide bonds between the structural elements of the bacterial wall.

    It is active against: alpha and beta-hemolytic streptococci, Streptococcus pneumoniae, Staphylococcus spp., Bacillus anthracis, Clostridium spp.

    Moderately active against most enterococci and Gram-negative microorganisms: Haemophilus influenzae, Neisseria meningitidis, Neisseria gonorrhoeae, Proteus mirabilis, Yersinia multocida (Pasteurella), Salmonella spp., Shigella spp., Bordetella spp., Escherichia coli), aerobic non-spore-forming bacteria.

    It is not effective against penicillinase-forming strains Staphylococcus spp., all strains Pseudomonas aeruginosa, most strains Klebsiella spp. and Enterobacter spp., Proteus vulgaris (indolipositive).

    Pharmacokinetics:

    When ingested, 30-40% of the drug is absorbed from the gastrointestinal tract, eating reduces the bioavailability in half, which determines the preference for parenteral forms; the maximum concentration is observed after 1.5-2 hours. Poor penetration through blood-brain barrier, with inflammation of meninges permeability him increases. Virtually does not undergo biotransformation and is excreted by the kidneys in unchanged form (in the urine high concentrations of antibiotic). Partially excreted with bile, in nursing mothers - with milk. Do not cumulate.

    Indications:

    Infections of the respiratory tract and ENT organs: otitis media, acute rhinitis with purulent discharge, bronchitis, pneumonia, sinusitis, tonsillitis, pharyngitis, lung abscess.

    Infections of the kidneys and urinary tract: cystitis, urethritis, pyelonephritis.

    Gonorrhea.

    Infections of the musculoskeletal system.

    Infections of the gastrointestinal tract: salmonella, salmonella, typhoid and paratyphoid, shigellosis.

    Infections of the biliary system: cholangitis, cholecystitis.

    Peritonitis.

    Infections of the skin and soft tissues: erysipelas, impetigo, secondary-infected dermatoses (often caused by golden staphylococci, only 13% are sensitive to ampicillin).

    Infectious endocarditis: prevention and treatment.

    Meningitis.

    Bacterial septicemia, sepsis.

    Pasteurellosis and listeriosis.

    I.A00-A09.A05.9   Bacterial food poisoning, unspecified

    I.A30-A49.A37   Whooping cough

    I.A30-A49.A39   Meningococcal infection

    I.A30-A49.A41.9   Septicemia, unspecified

    VI.G00-G09.G00   Bacterial meningitis, not elsewhere classified

    IX.I30-I52.I33   Acute and subacute endocarditis

    X.J00-J06.J06.8   Other acute upper respiratory tract infections of multiple localization

    XIV.N30-N39.N39.0   Urinary tract infection without established localization

    Contraindications:

    Individual intolerance, including other penicillins, cephalosporins, carbapenems.

    Infectious mononucleosis.

    Lymphocytic leukemia.

    Liver failure.

    Diseases of the gastrointestinal tract in the anamnesis (especially colitis associated with the use of antibiotics).

    Lactation.

    Children's age (up to 1 month).

    Carefully:

    Bronchial asthma; fromfever and other allergic diseases; kidney failure; hemorrhages in the anamnesis; pregnancy.

    Pregnancy and lactation:

    Recommendations FDA Category B. Passes through the placenta in low concentrations. In studies on animals in doses that are many times higher than the doses for humans, it did not adversely affect the course of pregnancy and fetus. Penetrates into breast milk. Although significant problems are not documented, it can cause diarrhea, sensitization, candidiasis and skin rash in a child.

    Dosing and Administration:

    Respiratory tract infections and ENT organs: otitis media (acute otitis media in children - 100 mg / kg per day, 250 mg / m2 body surface per day, 4 times a day - the effect of antibacterial therapy is moderate; ORZ of the upper respiratory tract, acute rhinitis with purulent discharge: children up to 2 years - 125 mg 4 times a day, the effect of antibacterial therapy is moderate, the use is not recommended), bronchitis (exacerbation of chronic obstructive bronchitis: adults inside the capsule for 0.5-1 g every 6 hours, 3-4 days), pneumonia (in children, in children under 5 years - intramuscularly 100 mg / kg per day 4 times a day), sinusitis (250 mg 4 times a day, 7 days), tonsillitis, pharyngitis , lung abscess.

    Infections of the kidneys and the urinary tract (in pregnant - in / 2 grams every 4 hours in combination with gentamicin; 500 mg orally two times a day, 5 days - many modes of application of antibiotics effective to select a suitable mode insufficient data; 500 mg every 4 times a day), pyelonephritis (w / 1g every 6 hours - 3 days, followed by 500 mg oral 4 times a day in combination with gentamicin), pyelitis, cystitis (500 mg four times a day, 10 days), urethritis - 0.5 g 4 times a day.

    Gonorrhea (500 mg 4 times a day, 5 days in combination with probenecid, once 3.5 g in combination with probenecid) - inside 3.5 g once or in / m 0.5 g 2 times for one day; with gonorrheal uncomplicated urethritis - once 0.5 g.

    Infections of the musculoskeletal system (purulent arthritis in children, gonococcal arthritis: orally 3.5 g / day in combination with probenecid, then 2 g / day for 7 days).

    Infections of the gastrointestinal tract: salmonellosis (with easy flow does not affect the outcome of treatment), children - 100 mg / kg per day, 5 days, salmonella, typhoid (1 g every 6 hours, 10 days, children - first in / in , then orally 100 mg / kg per day, 7 days) and paratyphoid, shigellosis (500 mg 4 times a day, 5 days).

    Infections of the biliary system: cholangitis (iv 500 mg 4 times a day in combination with metronidazole and ceftazidime, iv or 4 g / day in combination with gentamycin), cholecystitis (500 mg 4 times a day, 5 days; see "Cholangitis").

    Peritonitis (intravenously 2 g 2 times a day in combination with nonimmitsicin, metronidazole).

    Infections of the skin and soft tissues (oral 500 mg 4 times a day, 5-10 days): erysipelas, impetigo (newborns - inside 50 mg 4 times a day), secondarily infected dermatoses (more often caused by golden staphylococci, only 13% are sensitive to ampicillin).

    Infection endocarditis: prophylaxis (in cardiac surgery - 1 g during surgery and then every 6 hours for 48 hours in combination with cloxacillin, in combination with aminoglycosides) and treatment.

    Meningitis - acute bacterial meningitis in children with the inability to use cephalosporins of the third generation (ceftriaxone, cefotaxime), variants: iv in 160-400 mg / kg per day 4 times a day in combination with chloramphenicol (iv 25-100 mg / kg every 6 hours), in some cases after 5 days - switching to oral therapy; in / in combination with chloramphenicol (first dose of chloramphenicol 50 mg / kg, then 25 mg / kg every 6 hours), a loading dose of ampicillin is 75 mg / kg, then 50 mg / kg every 4 hours for 10 days , with meningococcal meningitis - 7 days) - 14 g / day, multiplicity of 6-8 times a day.

    Bacterial septicemia, sepsis (intramuscularly, intravenously in combination with aminoglycosides, 0.5-3 g 4 times a day, 7-11 days, this scheme is inferior in clinical efficacy and safety of monotherapy with modern beta-lactam drugs of a wide spectrum of action).

    Listeriosis (first-line drug - IV in high doses, course not less than 2 weeks) - in / m or IV at 50 mg / kg every 6 hours. Inside adults - 0.25 g 4 times a day for 0, 5-1 h before meals with a little water; if necessary 3 g / day. Intramuscularly and intravenously, adults with infections of moderate severity 0.25-0.5 g every 6-8 hours; with severe infections 1-2 g 3-4 times a day.Course 5-10 days for 2-3 weeks, with chronic processes - a few months.

    Side effects:

    Nervous system and sensory organs: headache, tremor, convulsions (in the treatment of high doses).

    Blood: leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia.

    Allergic reactions, dysbiosis.

    Overdose:

    When an overdose is observed toxic effect on CNS (especially in patients with renal insufficiency), as well as nausea, vomiting, diarrhea and, as a consequence, a violation of the water-electrolyte balance. For treatment appointed gastric lavage, enterosorbents, salt laxatives, maintenance of water-electrolyte balance, symptomatic therapy. It is excreted by hemodialysis.

    Interaction:

    Ampicillin is incompatible with aminoglycosides.

    With simultaneous use with allopurinol increases the likelihood of an allergic rash.

    When treating ampicillin and using Estrogen-containing oral medications are recommended additional methods of contraception (condoms, spermicides).

    Ampicillin enhances the effect of oral anticoagulants, antibiotics aminoglycoside series.

    In the appointment of bactericidal antibiotics (cephalosporins, Vancomycin, rifampicin, aminoglycosides) - synergism with bacteriostatic (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonism.

    Simultaneous use with diuretics, allopurinol, probenecid, tubular secretion blockers, NSAIDs, phenylbutazone increases concentration of ampicillin.

    Special instructions:

    It is necessary to monitor the status of the function of the organs of hematopoiesis, kidneys and liver.

    The therapy lasts for 2-3 days after the disappearance of the symptoms of the disease.

    Perhaps the development of superinfection due to the growth of insensitive to the drug microflora. In this case, the drug should be urgently discontinued and the treatment adjusted.

    Therapy of sepsis may be complicated by the development of a bacteriolysis reaction (the Yarisch-Gerxheimer reaction).

    With increased sensitivity to penicillins, allergic reactions with other beta-lactam antibiotics are possible.

    In the treatment of mild diarrhea against the background of course therapy should avoid antidiarrheal drugs, reducing peristalsis of the intestine.

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