Ampicillin trihydrate - instructions for use, reviews, analogs and forms of release (tablets 250 mg, powder for the preparation of suspension, injections in ampoules for injections) drugs for the treatment of infections in adults, children and pregnancy
In this article, you can read the instructions for using the drug Ampicillin. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Ampicillin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Ampicillin in the presence of existing structural analogues.Use for the treatment of angina and other infectious diseases in adults, children, as well as during pregnancy and lactation.
Ampicillin - antibacterial bactericide of a broad spectrum of action from the group of semisynthetic penicillins, acid-fast. Inhibits the peptidoglycan polymerase and transpeptidase, prevents the formation of peptide bonds and disrupts the late stages of the synthesis of the cell wall of the fissile microorganism, which leads to a decrease in the osmotic stability of the bacterial cell and causes its lysis.
It is active against Gram-positive and Gram-negative microorganisms, aerobic non-spore-forming bacteria (Listeria spp.).
It is effective against penicillinase-producing strains of Staphylococcus spp., All strains of Pseudomonas aeruginosa, most strains of Klebsiella spp. and Enterobacter spp.
Composition
Ampicillin (in the form of trihydrate) + auxiliary substances.
Pharmacokinetics
Absorption after ingestion - fast, high, bioavailability - 40%. It is evenly distributed in the organs and tissues of the body, it is found in therapeutic concentrations in pleural, peritoneal, amniotic and synovial fluids, cerebrospinal fluid, contents of blisters,urine (high concentrations), intestinal mucosa, bones, gall bladder, lungs, female genital tract, bile, bronchial secretion (in the purulent bronchial secretion weak accumulation), paranasal sinuses, middle ear fluid, saliva, fetal tissues. Poor penetrates the blood-brain barrier (permeability increases with inflammation).
It is excreted mainly by the kidneys (70-80%), and in the urine very high concentrations of the unchanged antibiotic are created; partially with bile, in nursing mothers - with milk.
Do not cumulate. Removed during hemodialysis.
Indications
Bacterial infections caused by sensitive microflora:
- respiratory tract and ENT organs (sinusitis, tonsillitis, pharyngitis, otitis media, bronchitis, pneumonia, lung abscess);
- infection of the kidneys and urinary tract (pyelonephritis, pyelitis, cystitis, urethritis);
- infection of the biliary system (cholangitis, cholecystitis);
- chlamydial infections in pregnant women (with erythromycin intolerance);
- cervicitis;
- infections of the skin and soft tissues: erysipelas, impetigo, secondarily infected dermatoses;
- infections of the musculoskeletal system;
- pasteurellosis;
- listeriosis;
- infections of the digestive tract (typhoid and paratyphoid, dysentery, salmonellosis, salmonella, peritonitis);
- endocarditis (prevention and treatment);
- meningitis;
- bacterial septicemia.
Forms of release
Tablets 250 mg.
Powder or granules for the preparation of a suspension for oral administration.
Powder for the preparation of solution for intravenous and intramuscular injection (injections in ampoules for injection).
Capsules 250 mg and 500 mg.
Instructions for use and dosage
Inside, adults - 250 mg 4 times a day for 0.5-1 h before meals with a small amount of water; if necessary, increase the dose to 3 g per day.
Infections of the gastrointestinal tract and organs of the genitourinary system - 500 mg 4 times a day.
With gonococcal urethritis - inside 3.5 g once.
Suspension is recommended for children with a mild course of infections: newborns with 1 month - 150 mg / kg body weight per day; up to 1 year - at the rate of 100 mg / kg of body weight per day; from 1 to 4 years - 100-150 mg / kg of body weight per day; Children over 4 years of age are prescribed 1-2 g per day. The daily dose is divided into 4-6 receptions.
The duration of treatment depends on the severity of the disease (from 5-10 days to 2-3 weeks, and in chronic processes - for several months).
Tablets are taken orally regardless of food intake.
Preparation of the suspension: in the vial add water to the risks and shake well.The prepared suspension is stable at room temperature for 14 days. Before each use, the suspension must be shaken. 5 ml of the prepared suspension (1 measuring spoon) contain 250 mg of ampicillin.
With parenteral administration (intramuscularly, intravenously, intravenously, or intravenously drip (dropper)), the single dose for adults is 250-500 mg, the daily dose is 1-3 g; In severe infections, the daily dose can be increased to 10 g or more.
Newborn children are prescribed in a daily dose of 100 mg / kg, children of other age groups - 50 mg / kg. In severe infection, these doses can be doubled.
The daily dose is divided into 4-6 injections with an interval of 4-6 hours. The duration of the / m administration is 7-14 days. The duration of IV application is 5-7 days, with the subsequent transition (if necessary) to the / m introduction.
Solution for the / m introduction is prepared by adding to the contents of the bottle 2 ml of water for injection.
For intravenous administration of a single dose of the drug (not more than 2 g) is dissolved in 5-10 ml of water for injection or isotonic sodium chloride solution and injected slowly for 3-5 minutes (1-2 g for 10-15 minutes) . With a single dose exceeding 2 g, the drug is administered intravenously drip.To do this, a single dose of the drug (2-4 g) is dissolved in 7.5-15 ml of water for injection, then the resulting solution is added to 125-250 ml of isotonic sodium chloride solution or 5-10% glucose solution and injected at a rate of 60-80 cap. / min. When i / v drop introduction to children as a solvent used 5-10% glucose solution (30-50 ml, depending on age).
The solutions are used immediately after preparation.
Side effect
- skin peeling;
- itching;
- hives;
- rhinitis;
- conjunctivitis;
- angioedema;
- fever;
- anaphylactic shock;
- dysbiosis;
- stomatitis;
- gastritis;
- dry mouth;
- change in taste;
- abdominal pain;
- vomiting, nausea;
- diarrhea;
- pseudomembranous enterocolitis;
- aggressiveness;
- anxiety;
- confusion of consciousness;
- behavior change;
- depression;
- convulsions (with high-dose therapy);
- leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia;
- interstitial nephritis;
- nephropathy;
- superinfection (especially in patients with chronic diseases or reduced resistance of the body);
- candidiasis of the vagina.
Contraindications
- Infectious mononucleosis;
- lymphocytic leukemia;
- liver failure;
- Gastrointestinal disease in history (especially colitis, associated with the use of antibiotics);
- lactation period;
- children's age (up to 1 month);
- increased sensitivity (including to other penicillins, cephalosporins, carbapenems).
Application in pregnancy and lactation
With caution apply the drug during pregnancy. Contraindicated during lactation.
special instructions
At course treatment it is necessary to monitor the status of the functions of the organs of hematopoiesis, liver and kidneys.
It is possible to develop superinfection due to the growth of insensitive microflora, which requires a corresponding change in antibacterial therapy.
In the treatment of patients with bacteremia (sepsis), the development of a bacteriolysis reaction (the Yarisch-Gerxheimer reaction) is possible.
In patients who have increased sensitivity to penicillins, there may be cross-allergic reactions with other beta-lactam antibiotics.
In the treatment of mild diarrhea against the background of course treatment, antidiarrheal drugs should be avoided, which reduce intestinal peristalsis; you can use kaolin- or attapulgite-containing antidiarrheal agents, the drug cancellation. With severe diarrhea, you should see a doctor.
Treatment should necessarily continue for another 48-72 hours after the disappearance of clinical signs of the disease.
Drug Interactions
Antacids, glucosamine, laxatives, food slow down and reduce absorption; Ascorbic acid increases absorption.
Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) - synergistic action; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) antagonistic.
Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index); reduces the effectiveness of estrogen-containing oral contraceptives (it is necessary to use additional methods of contraception), drugs, in the process of metabolism of which forms para-aminobenzoic acid, ethinyl estradiol (in the latter case, the risk of development of bleeding breakthroughs increases).
Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, nonsteroidal anti-inflammatory drugs, drugs that block tubular secretion, increase the concentration of ampicillin in the plasma (by lowering the tubular secretion).
Allopurinol increases the risk of skin rash.
Reduces clearance and increases the toxicity of methotrexate.
Increases the absorption of digoxin.
Analogues of the drug Ampicillin
Structural analogs for the active substance:
- Ampicillin AMP-KID;
- Ampicillin AMP-Forte;
- Ampicillin Innotek;
- Ampicillin sodium;
- Ampicillin-AKOS;
- Ampicillin-Ferein;
- Ampicillin sodium salt;
- Ampicillin sodium salt is sterile;
- Ampicillin trihydrate;
- Zetsil;
- Penodyl;
- Pentrexyl;
- Stendacillin.
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