AMPICILLIN

Posology Usual adult dosage (including elderly patients):

Septicaemia, endocarditis, osteomyelitis: 500 mg four to six times a day IM or IV for one to six weeks. Peritonitis, intra-abdominal sepsis: 500mg four times a day IM or IV.

Meningitis:

Adult dosage: 2 g six-hourly IV. Children dosage: 150 mg/kg daily IV in divided doses. Ampicillin may also be administered by other routes of conjunction with systemic therapy. Intraperitoneal: 500 mg daily in up to 10 ml water for injections.

Intrapleural: 500 mg daily in 5-10 ml water for injections. 5% procaine hydrochloride solution. Local use in abdominal surgery: 1 g sterile powder sprinkled into the wound extraperitoneally or into muscle layers to prevent wound infection post operatively.

Paediatric population Half adult routine dosage for children under 10 years. All recommended dosages are a guide only. In severe infections the above dosages may be increased. Renal Impairment In the presence of severe renal impairment (creatinine clearance <10ml/min) a reduction in dose or extension of dose interval should be considered.

In cases of dialysis, an additional dose should be administered after the procedure. 5 ml water for injections to 500mg vial contents.

Intravenous:

Dissolve 500 mg in 10 ml water for injections. Administer by slow injection (three to four minutes). Ampicillin may also be added to infusion fluids or injected, suitably diluted, into the drip tube over a period of three to four minutes.

Hypersensitivity reactions:

If any hypersensitivity reaction occurs, the treatment should be discontinued. Skin rash, pruritis and urticaria have been reported occasionally. The incidence is higher in patients suffering from infectious mononucleosis and acute or chronic leukaemia of lymphoid origin.

Purpura has also been reported. Rarely, skin reactions such as erythema multiforme and Stevens Johnson syndrome, and toxic epidermal necrolysis have been reported. 4) has been reported rarely.

Renal effects:

Interstitial nephritis can occur rarely.

Gastrointestinal reactions:

Effects include nausea, vomiting and diarrhoea. Pseudomembraneous colitis and haemorrhagic colitis has been reported rarely.

Hepatic effects:

As with other beta-lactam antibiotics, hepatitis and cholestatic jaundice have been reported rarely. As with most other antibiotics, a moderate and transient increase in transaminases has been reported.

Haematological effects:

As with other beta-lactams, haematological effects including transient leucopenia, transient thrombocytopenia and haemolytic anaemia have been reported rarely. Prolongation of bleeding time and prothrombin time has also been reported rarely.

Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Before initiating therapy with ampicillin, careful enquiry should be made concerning previous hypersensitivity reactions to beta-lactam antibiotics. Serious and occasionally fatal hypersensitivity reactions (anaphylaxis) have been reported in patients receiving beta-lactam antibiotics.

Although anaphylaxis is more frequent following parenteral therapy, it has occurred in patients on oral penicillins. These reactions are more likely to occur in individuals with a history of beta-lactam hypersensitivity. Ampicillin should be avoided if infectious mononucleosis and/or acute or chronic leukaemia of lymphoid origin are suspected.

The occurrence of a skin rash has been associated with these conditions following the administration of ampicillin. Prolonged use may occasionally result in overgrowth of non-susceptible organisms. 2). 7% of the WHO recommended maximum daily intake of 2 g sodium for an adult.

1. g. ampicillin, penicillins, cephalosporins) or excipients.