Ampicillin and Sulbactam

Ampicillin and Sulbactam Brand Name– Unasyn

What is Ampicillin and Sulbactam

Unasyn(R) is a parenteral antibiotic that combines ampicillin with sulbactam, a beta-lactamase inhibitor.

The antimicrobial coverage of Unasyn is similar to the oral agent Augmentin(R) (see Amoxicillin; Clavulanic Acid monograph). Sulbactam alone has weak antibacterial activity.

In combination with sulbactam, ampicillin’s spectrum is broadened to include many beta-lactamase-producing organisms.

Unasyn is used mainly to treat infections such as moderate to severe intra-abdominal infections, gynecologic infections, and skin and soft-tissue infection caused by susceptible organisms. It is not indicated for meningitis.

Unasyn was approved by the FDA in December 1986 and came off patent in 1999.

Indications

1. Acinetobacter calcoaceticus
2. Acinetobacter sp.
3. Actinomyces sp.
4. Bacillus anthracis
5. Bacteroides fragilis
6. Bacteroides funduliformis
7. Bacteroides sp.
8. Bifidobacterium sp.
9. bone and joint infections
10. Bordetella pertussis
11. Borrelia burgdorferi
12. Brucella sp.
13. cellulitis
14. Clostridium perfringens
15. Clostridium sp.
16. Clostridium tetani
17. community-acquired pneumonia
18. Corynebacterium diphtheriae
19. Corynebacterium xerosis
20. diabetic foot ulcer
21. Eikenella corrodens
22. endocarditis
23. Enterococcus faecalis
24. epiglottitis
25. Erysipelothrix rhusiopathiae
26. Escherichia coli
27. Eubacterium sp.
28. Fusobacterium sp.
29. Gardnerella vaginalis
30. gynecologic infections
31. Haemophilus ducreyi
32. Haemophilus influenzae (beta-lactamase negative)
33. Haemophilus influenzae (beta-lactamase positive)
34. Helicobacter pylori
35. infectious arthritis
36. intraabdominal infections
37. Klebsiella granulomatis
38. Klebsiella pneumoniae
39. Klebsiella sp.
40. Lactobacillus sp.
41. Leptospira sp.
42. Listeria monocytogenes
43. Moraxella catarrhalis
44. Morganella morganii
45. Neisseria gonorrhoeae
46. Neisseria meningitidis
47. osteomyelitis
48. Pasteurella multocida
49. pelvic inflammatory disease (PID)
50. Peptococcus sp.
51. Peptostreptococcus sp.
52. peritonitis
53. pleural empyema
54. pneumonia
55. Porphyromonas sp.
56. Prevotella sp.
57. Propionibacterium sp.
58. Proteus mirabilis
59. Proteus vulgaris
60. Providencia rettgeri
61. Providencia stuartii
62. pyelonephritis
63. Salmonella sp.
64. Salmonella typhi
65. Shigella sp.
66. sialadenitis
67. sinusitis
68. skin and skin structure infections
69. Staphylococcus aureus (MSSA)
70. Staphylococcus epidermidis
71. Staphylococcus saprophyticus
72. Streptococcus agalactiae (group B streptococci)
73. Streptococcus dysgalactiae
74. Streptococcus pneumoniae
75. Streptococcus pyogenes (group A beta-hemolytic streptococci)
76. surgical infection prophylaxis
77. Treponema pallidum
78. urinary tract infection (UTI)
79. Viridans streptococci

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. agranulocytosis
4. anaphylactic shock
5. anaphylactoid reactions
6. angioedema
7. azotemia
8. candidiasis
9. chest pain (unspecified)
10. chills
11. cholestasis
12. diarrhea
13. dizziness
14. dyspepsia
15. dyspnea
16. dysuria
17. edema
18. elevated hepatic enzymes
19. epistaxis
20. erythema
21. erythema multiforme
22. exfoliative dermatitis
23. fatigue
24. flatulence
25. gastritis
26. glossitis
27. headache
28. hemolytic anemia
29. hepatitis
30. hyperbilirubinemia
31. hypoalbuminemia
32. injection site reaction
33. interstitial nephritis
34. jaundice
35. lymphocytosis
36. malaise
37. melena
38. nausea
39. phlebitis
40. pruritus
41. pseudomembranous colitis
42. rash
43. seizures
44. Stevens-Johnson syndrome
45. stomatitis
46. superinfection
47. tongue discoloration
48. toxic epidermal necrolysis
49. urinary retention
50. urticaria
51. vomiting

Monitoring Parameters

• serum creatinine/BUN

Contraindications

• asthma
• breast-feeding
• carbapenem hypersensitivity
• cephalosporin hypersensitivity
• cholestasis
• dialysis
• diarrhea
• eczema
• geriatric
• GI disease
• hepatic disease
• hepatitis
• inflammatory bowel disease
• jaundice
• mononucleosis
• penicillin hypersensitivity
• pregnancy
• pseudomembranous colitis
• renal failure
• renal impairment
• serious rash
• sexually transmitted disease
• ulcerative colitis
• urticaria

Interactions

• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Allopurinol
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atenolol
• Atenolol; Chlorthalidone
• Carbidopa; Levodopa; Entacapone
• Choline Salicylate; Magnesium Salicylate
• Colchicine; Probenecid
• Dexlansoprazole
• Dichlorphenamide
• Dienogest; Estradiol valerate
• Digoxin
• Drospirenone
• Drospirenone; Estradiol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Elagolix; Estradiol; Norethindrone acetate
• Entacapone
• Erythromycin; Sulfisoxazole
• Esomeprazole
• Esomeprazole; Naproxen
• Estradiol; Levonorgestrel
• Estradiol; Norethindrone
• Estradiol; Norgestimate
• Ethacrynic Acid
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Furosemide
• Indomethacin
• Lansoprazole
• Lansoprazole; Naproxen
• Lesinurad; Allopurinol
• Leuprolide; Norethindrone
• Levonorgestrel
• Magnesium Salicylate
• Mestranol; Norethindrone
• Methotrexate
• Norethindrone
• Norgestrel
• Omeprazole
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Oral Contraceptives
• Pantoprazole
• Probenecid
• Proton pump inhibitors
• Pyrimethamine; Sulfadoxine
• Rabeprazole
• Salsalate
• Segesterone Acetate; Ethinyl Estradiol
• Sodium Benzoate; Sodium Phenylacetate
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Sulfadiazine
• Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
• Sulfasalazine
• Sulfisoxazole
• Sulfonamides
• Tetracyclines
• Typhoid Vaccine
• Warfarin