NAME OF DRUG
ampicillin sodium

CLASSIFICATION

Antibiotic

ALTERNATE NAME

PENBRITIN, AMPICIN

INDICATIONS

• treatment of infections caused by susceptible strains of micro-organisms

RECONSTITUTION AND STABILITY

• powder is stable at room temperature
• reconstitute vial with appropriate volume of sterile water for injection:
      1000 mg vial - add 3.5 mL diluent - 250 mg/mL
      2000 mg via - add 6.8 mL diluent - 250 mg/mL
• use reconstituted solution in vial within 1 hour

COMPATIBILITY

• compatible with D5W, NS
• stable for 24 hours in NS and 4 hours in dextrose solutions at room temperature
• compatible via Y-site with acyclovir, clindamycin, cyclosporine, erythromycin, furosemide, heparin, hydromorphone, insulin regular, levofloxacin, magnesium sulphate, meperidine, metronidazole, morphine, MVI, pantoprazole, potassium chloride, ranitidine, vitamin K
• incompatible with most other drugs - IV lines with drug-containing solutions should be cleared with NS prior to and after ampicillin administration

ROUTES OF ADMINISTRATION

• IM - deeply into muscle
• IV direct - into a large vessel at a concentration of 100 mg/mL and a rate no greater than 100 mg/minute
• IV intermittent - dilute with 50-100 mL of solution

VH & HSC ADMINISTRATION POLICY

E - Direct IV route can be administered by nurses on general nursing units provided a venous access has been established, and according to policies and recommendations stated in this manual.

DOSAGE

Usual:

• 2,000-12,000mg (2-12 g)/day in equally divided doses every 4-6 hours
• Severe systemic infections: 8,000-14,000 mg (8-14 g)/day in equally divided doses every 4-6 hours

Children:

• 100-200 mg/kg/day in divided doses every 4-6 hours
• meningitis in children: 200 to 400 mg/kg/day IV in divided doses every 4 hours

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

• hypersensitivity reactions - immediate and delayed
• too rapid IV can produce convulsions or muscular irritability - maximum rate 100 mg/minute
• possibility of severe pain at injection site
• thrombophlebitis with long term use

IMPORTANT IMPLICATIONS

• ampicillin has been implicated in causing pseudomembranous colitis
• hyperuricemia or allopurinol may potentiate ampicillin rash
• serum concentrations are greatly elevated in patients with renal impairment
• contraindicated in patients with a history of serious allergic reactions to penicillin
• use with caution in patients with a history of allergic reactions to cephalosporins

Rev. May 2005