Ampicillin is indicated in the treatment of infections caused by susceptible strains of the designated organism listed below:

• Infections of the Genitourinary Tract Including Gonorrhea: E. coli, P. mirabilis, enterococci, Shigella, S. typhosa and other Salmonella, and nonpenicillinase-producing N. gononhoeae.
• Infections of the Respiratory Tract: Nonpenicillinase-producing H. influenzae and staphylococci, and streptococci including streptococcus pneumoniae.
• Infections of the Gastrointestinal Tract: Shigella, S. typhosa and other Salmonella, E. coli, P. mirabilis, and enterococci.
• Meningitis: O. Meningitides.

Bacteriology studies to determine the causative organisms and their sensetivity to ampicillin should be performed. Therapy may be instituted prior to the results of susceptibility testing.

Intra-articular:

Supplement in systemic therapy for treatment of susceptible infections-

• Adult: 500 mg daily.
• Child: <10 yr Half of adult routine dosage.

Intraperitoneal:

Supplement in systemic therapy for treatment of susceptible infections-

• Adult: 500 mg daily.
• Child: <10 yr Half of adult routine dosage.

Intrapleural:

Supplement in systemic therapy for treatment of susceptible infections-

• Adult: 500 mg daily.
• Child: <10 yr Half of adult routine dosage

Intravenous:

Meningitis-

• Adult: 2 gm 6 hrly.
• Child: 150 mg/kg daily in divided doses.

Intrapartum prophylaxis against group B Streptoccocal infection in neonates-

• Adult: Initially, 2 gm via IV inj followed by 1 gm 4 hrly until delivery.

Oral:

Biliary tract infections, Bronchitis, Endocarditis, Gastroenteritis, Listeriosis, Otitis media, Perinatal streptococcal infections, Peritonitis-

• Adult: 0.25-1 gm 6 hrly.
• Child: <10 yr Half of adult routine dosage.

Typhoid and paratyphoid fever-

• Adult: 1-2 gm 6 hrly for 2 wk in acute infections, and 4-12 wk in carriers.

Uncomplicated gonorrhoea-

• Adult: 2 gm with 1 gm of probenecid as single dose, recommended to be repeated in female patients.

Urinary tract infections-

• Adult: 500 mg 8 hrly.

Parenteral:

Susceptible infections-

• Adult: 500 mg 6 hrly, via IM or slow IV inj over 3-5 min or by infusion.
• Child: <10 yr Half of adult routine dosage.

Septicaemia-

• Adult: 150-200 mg/kg daily. Initiate with IV admin for at least 3 days, then continue with IM inj 3-4 hrly. Continue treatment for at least 48-72 hr after the patient has become asymptomatic or when there is evidence of bacterial eradication. Recommended treatment duration for infections caused by group-A β-haemolytic streptococci: At least 10-days, to prevent occurrence of acute rheumatic fever or acute glomerulonephritis.
• Child: Same as adult dose.

Should be taken on an empty stomach. Take 1 hr before or 2 hr after meals.

Hypersensitivity to ampicillin and other penicillins.

Nausea, vomiting, diarrhoea, erythematous maculo-papular rashes, sore mouth, black/hairy tongue, rash, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, fever, joint pains, serum sickness-like symptoms, haemolytic anaemia, thrombocytopenia, leucopenia, neutropenia, coagulation disorders, prolonged bleeding time and prothrombin time, CNS toxicity (e.g. convulsions); paraesthesia, nephropathy, interstitial nephritis, hepatitis, cholestatic jaundice, moderate and transient increase in transaminases, Anaphylaxis, Clostridium difficile-associated diarrhoea (CDAD).

Overdose Effects

Symptoms: Nausea, vomiting and diarrhoea.

Management: Symptomatic and supportive treatment. May be removed from the circulation by haemodialysis.

Pregnancy & Lactation

Pregnancy Category B. Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Precautions & Warnings

Patient with history of β-lactam allergy. During renal impairment, Pregnancy and lactation.

Use in Special Populations

Renal Impairment: CrCl<10: Dose reduction or increase in dose interval.