Ampicillin sulbactam: Difference between revisions

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{{Drugbox
__NOTOC__
| type              = combo
{{Ampicillin sulbactam}}
| component1        = Ampicillin
{{CMG}}
| class1            = [[Penicillin]] [[antibiotic]]
| component2        = Sulbactam
| class2            = [[Beta-lactamase inhibitor]]
| CAS_number        =
| ATC_prefix        = J01
| ATC_suffix        = CR01
| PubChem          = 656676
| DrugBank          =
| pregnancy_AU      =  <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US      =  <!-- A / B            / C / D / X -->
| pregnancy_category= 
| legal_AU          =  <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
| legal_CA          =  <!--            / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK          =  <!-- GSL        / P      / POM / CD / Class A, B, C -->
| legal_US          =  <!-- OTC                  / Rx-only  / Schedule I, II, III, IV, V -->
| legal_status      =
| routes_of_administration =
}}
{{SI}}


==Overview==
Ampicillin/sulbactam, the combination of [[ampicillin]] with [[sulbactam]] (an irreversible [[beta-lactamase inhibitor|beta-lactamase inhibitor]]), has an antimicrobial spectrum  similar to that of [[amoxicillin]]-[[clavulanic acid|clavulanate]] that includes [[methicillin]]-sensitive strains of [[Staphylococcus aureus]], [[Enterobacteriaceae]] (but not resistant strains of [[Escherichia coli]] or [[Pseudomonas aeruginosa]]), and [[anaerobe]]s. The agent has been used effectively to treat polymicrobial intra-abdominal and pelvic infections. It may also be used for soft tissue infections secondary to human or animal bites.<ref name="Lode-2008">{{Cite journal | last1 = Lode | first1 = HM. | title = Rational antibiotic therapy and the position of ampicillin/sulbactam. | journal = Int J Antimicrob Agents | volume = 32 | issue = 1 | pages = 10-28 | month = Jul | year = 2008 | doi = 10.1016/j.ijantimicag.2008.02.004 | PMID = 18539004 }}</ref>


'''Ampicillin/sulbactam''' is a combination of the common [[penicillin]]-derived [[antibiotic]] [[ampicillin]] and [[sulbactam]], an [[Enzyme inhibitor|inhibitor]] of [[bacteria]]l [[beta-lactamase]]. Two different forms of the drug exist. The first, developed in [[1987]] and marketed in the United States under the tradename '''Unasyn''', is an [[intravenous]] antibiotic. The second, an oral form called [[sultamicillin]], is marketed under the trade name '''Ampictam''' outside of the United States. Ampicillin/sulbactam is used to treat [[infection]]s caused by bacteria resistant to [[beta-lactam antibiotic]]s. Sulbactam blocks the [[enzyme]] which breaks down ampicillin and thereby allows ampicillin to attack and kill the bacteria.
==Category==
Aminopenicillin


{| class="wikitable" style="text-align:center"
==US Brand Names==
| [[Image:Ampicillin-2D-skeletal.png|200px]] || [[Image:Sulbactam.svg|100px]] || [[Image:Sultamicillin schematic.svg|220px]]
Unasyn<sup>®</sup>
|-
| [[Skeletal formula]] of [[ampicillin]] || Skeletal formula of [[sulbactam]] || Skeletal formula of [[sultamicillin]], highlighting ampicillin in blue and sulbactam in orange
|}


Ampicillin/sulbactam is also used when the cause of an infection is not known ([[empiric therapy]]). [[peritonitis|Intra-abdominal infections]], skin infections, [[pneumonia]], and [[gynecology|gynecologic infections]]. It is active against a wide range of bacterial groups, including ''[[Staphylococcus aureus]]'', ''[[Enterobacteriaceae]]'', and [[anaerobic bacteria]]. Importantly, it is not active against ''[[Pseudomonas aeruginosa]]'' and should not be used alone when infection with this organism is suspected or known.
==FDA Package Insert==
'''[[Ampicillin sulbactam description|Description]]'''
'''| [[Ampicillin sulbactam clinical pharmacology|Clinical Pharmacology]]'''
'''| [[Ampicillin sulbactam microbiology|Microbiology]]'''
'''| [[Ampicillin sulbactam indications and usage|Indications and Usage]]'''
'''| [[Ampicillin sulbactam contraindications|Contraindications]]'''
'''| [[Ampicillin sulbactam warnings|Warnings]]'''
'''| [[Ampicillin sulbactam precautions|Precautions]]'''
'''| [[Ampicillin sulbactam adverse reactions|Adverse Reactions]]'''
'''| [[Ampicillin sulbactam overdosage|Overdosage]]'''
'''| [[Ampicillin sulbactam clinical studies|Clinical Studies]]'''
'''| [[Ampicillin sulbactam dosage and administration|Dosage and Administration]]'''
'''| [[Ampicillin sulbactam compatibility reconstitution and stability|Compatibility, Reconstitution, and Stability]]'''
'''| [[Ampicillin sulbactam directions for use|Directions For Use]]'''
'''| [[Ampicillin sulbactam how supplied|How Supplied]]'''
'''| [[Ampicillin sulbactam other size packages available|Other Size Packages Available]]'''


{{PenicillinAntiBiotics}}
==Mechanisms of Action==
[[Category: Beta-lactam antibiotics]]
Ampicillin inhibits bacterial cell wall synthesis by binding to [[penicillin]]-binding proteins which in turn inhibits the transpeptidation (cross-linking) of [[peptidoglycan]]. Thus, cell wall assembly is interrupted and bacteria are lyzed by [[autolysins]] and murein [[hydrolase]]s. Sulbactam irreversibly inhibit [[plasmid]]-mediated [[beta-lactamases]]which are frequently accountable for [[drug resistance]]. In addition, sulbactam has modest activity ''in vitro'' against strains of [[Acinetobacter baumannii]].<ref name="Higgins-2004">{{Cite journal | last1 = Higgins | first1 = PG. | last2 = Wisplinghoff | first2 = H. | last3 = Stefanik | first3 = D. | last4 = Seifert | first4 = H. | title = In vitro activities of the beta-lactamase inhibitors clavulanic acid, sulbactam, and tazobactam alone or in combination with beta-lactams against epidemiologically characterized multidrug-resistant Acinetobacter baumannii strains. | journal = Antimicrob Agents Chemother | volume = 48 | issue = 5 | pages = 1586-92 | month = May | year = 2004 | doi = | PMID = 15105109}}</ref> The presence of sulbactam in the formulation extends the spectrum of ampicillin to include beta-lactamase producing strains.


[[Category:Combination antibiotics]]
==References==
{{Reflist|2}}


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Revision as of 17:04, 16 December 2013

Ampicillin/Sulbactam
UNASYN® FDA Package Insert
Description
Clinical Pharmacology
Microbiology
Indications and Usage
Contraindications
Warnings
Precautions
Adverse Reactions
Overdosage
Clinical Studies
Dosage and Administration
Compatibility, Reconstitution, and Stability
Directions For Use
How Supplied
Other Size Packages Available
Labels and Packages

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Ampicillin/sulbactam, the combination of ampicillin with sulbactam (an irreversible beta-lactamase inhibitor), has an antimicrobial spectrum similar to that of amoxicillin-clavulanate that includes methicillin-sensitive strains of Staphylococcus aureus, Enterobacteriaceae (but not resistant strains of Escherichia coli or Pseudomonas aeruginosa), and anaerobes. The agent has been used effectively to treat polymicrobial intra-abdominal and pelvic infections. It may also be used for soft tissue infections secondary to human or animal bites.[1]

Category

Aminopenicillin

US Brand Names

Unasyn®

FDA Package Insert

Description | Clinical Pharmacology | Microbiology | Indications and Usage | Contraindications | Warnings | Precautions | Adverse Reactions | Overdosage | Clinical Studies | Dosage and Administration | Compatibility, Reconstitution, and Stability | Directions For Use | How Supplied | Other Size Packages Available

Mechanisms of Action

Ampicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins which in turn inhibits the transpeptidation (cross-linking) of peptidoglycan. Thus, cell wall assembly is interrupted and bacteria are lyzed by autolysins and murein hydrolases. Sulbactam irreversibly inhibit plasmid-mediated beta-lactamaseswhich are frequently accountable for drug resistance. In addition, sulbactam has modest activity in vitro against strains of Acinetobacter baumannii.[2] The presence of sulbactam in the formulation extends the spectrum of ampicillin to include beta-lactamase producing strains.

References

  1. ↑ Lode, HM. (2008). "Rational antibiotic therapy and the position of ampicillin/sulbactam". Int J Antimicrob Agents. 32 (1): 10–28. doi:10.1016/j.ijantimicag.2008.02.004. PMID 18539004. Unknown parameter |month= ignored (help)
  2. ↑ Higgins, PG.; Wisplinghoff, H.; Stefanik, D.; Seifert, H. (2004). "In vitro activities of the beta-lactamase inhibitors clavulanic acid, sulbactam, and tazobactam alone or in combination with beta-lactams against epidemiologically characterized multidrug-resistant Acinetobacter baumannii strains". Antimicrob Agents Chemother. 48 (5): 1586–92. PMID 15105109. Unknown parameter |month= ignored (help)
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