AMPICILLIN CAPSULES BP 250mg
AMPICILLIN is a semisynthetic antibiotic with a broad spectrum of bactericidal activity against many gram-positive and gram-negative micro-organisms. Ampicillin is chemically designated as D(-)-∝ aminobenzyl penicillin trihydrate.
Ampicillin is available as:
Containing Ampicillin Trihydrate BP equivalent to 250mg and 500mg Ampicillin
b) ORAL SUSPENSION
Containing Ampicillin Trihydrate BP equivalent to 125mg/5ml and 250mg/5ml Ampicillin, on reconstitution.
Containing Ampicillin Sodium BP equivalent to 500mg and1.0g Ampicillin.
Ampicillin is stable in the presence of gastric acid and is rapidly absorbed after oral administration. It is rapidly absorbed after intramuscular injection and produces considerably high serum levels after one hour.
It acts through the inhibitions of biosynthesis of cell-wall mucopeptides. In vitro studies have demonstrated the susceptibility of most strains of gram positive bacteria since it does not resist destruction by pencilinase, it is not effective against penicillinase-producing bacteria. Serratia, Pseudomonas aeruginosa, Proteus vulgaris, Citobacter and most strains of Klebsiella and Enterobacter are resistant.
- Infections of respiratory tract due to S.pneumoniae, S.pyogenes and most strains of H.influenzae.
- Meningitis due to N.meningitidis, S.penumoniae, H.influenzae & Listeria mono cytogenes.
- Infections of Urinary Tract caused by E.coil, P.mirabils, Enterococci, Shigella, S.typhosa and other Salmonella species.
- Bacterial endocarditis caused by Streptococcus viridans or Enterococci.
- Prophylaxix of bacterial endocardits.
- Prophylaxix of surgical infections.
A history of allergic reaction to any of the penicillns and infections caused by penicillnase producing organisms are contraindication.
Before initiating therapy with any penicillin, careful enquiry should be made concerning previous hypersensitivity reactions to Penicillins, Cephalosporins and other allergens. Serious and occasionally fatal hypersensitivity (anaphlactiod) reactions have been reported in patients on Penicillin therapy. These reactions are more frequent after parenteral administration. There have been reports of individuals with a history of Penicillin hypersensitivity who have experienced severe reaction when treated with Cephalosporins. If an allergic reaction occurs, appropriate therapy should be instituted and discontinuance of Ampicillin therapy considered. Serious anaphylactoid reactions require immediate emergency treatment with Epinephrine, oxygen, intravenous steroids, and airway management, including intubation, should also be administered as indicated.
USAGE IN PREGNANCY
Safety for use in pregnancy has not been established.
As with any potent drug, periodic assessment of renal, hepatic and hematopoietic function should be made during prolonged therapy. The possibility of superinfections with mycotic or bacterial pathogens should be kept in mind during therapy. If superinfections occur (ususally involving Enterobacter, Pseudomonas or Candida), the drug should be discontinued. Lesion of syphilis should be thoroughly investigated and appropriatedly treated.
As with other Penicillins, it may be expected that untoward reactions will be essentially limited to sensitivity phenomena. They are more likely to occur in individuals who have previously demonstrated hypersensitivity to Penicillins and in those with a history of allergy, asthma, hay fever or urticaria. The following adverse reactions have been reported as associated with the use of Penicillins:
Gastrointestinal: glossitis, stomatitis, nausea, vomiting, diarrhoea, enterocolitis, and pseudomembranous colitis. These reactions are usually associated with oral dosage forms of the drug.
Hypersensitivity: occurance of an etythematous, mildly pruritic; maculopapular skin rash have been reported.
When administered concurrently, the following drugs may interact with Ampicillin:
- Allopurinol may increase possibility of hypersensitivity reactions.
- Chloramphenicol, Tetracyclines, Sulphonamides and Macrolide antibiotics may interfere with bactericidal efficacy of Penicillins.
- Oral contraceptives may be less effective and increased breakthrough bleeding may occur.
- Probenecid may decrease renal tubular secretion of Ampicillin, resulting in its increased blood levels and/or Ampicillin toxicity.
DOSAGE AND ADMINISTRATION
CAPSULES and SUSPENSION to be administered orally.
Adults: 250mg-500mg four times daily.
Children: 125mg-250mg four times daily.
INJECTIONS for intramuscular and intravenous administration.
Children: 25mg-50mg/kg body weight in divided doses if necessary.