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
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