Ampicillin Sodium and Sulbactam Sodium and Obesity

• Generic Name: ampicillin / sulbactam
• Dosage Forms: n.a.
• Other Brand Names: Unasyn, Unasyn ADD-Vantage

Treatment of bone and joint infections (including osteomyelitis and/or septic arthritis) caused by susceptible β-lactamase-producing bacteria.

Treatment of intra-abdominal infections caused by susceptible β-lactamase-producing Escherichia coli, Klebsiella (including K. pneumoniae), Bacteroides (including B. fragilis), or Enterobacter.

May be as effective as multiple-drug regimens for treatment of less severe intra-abdominal infections, but an aminoglycoside probably should be used concomitantly for empiric therapy in more serious intra-abdominal infections, including hospital-acquired infections, pending results of in vitro susceptibility tests.

Treatment of serious gynecologic infections (e.g., endometritis, postpartum endomyometritis, posthysterectomy pelvic cellulitis, vaginal cuff abscess, salpingitis, tubo-ovarian abscess, pelvic peritonitis or abscess, surgical wound sepsis) caused by susceptible β-lactamase-producing E. coli or Bacteroides (including B. fragilis).

Treatment of pelvic inflammatory disease (PID). When a parenteral regimen is indicated for PID, CDC and others recommend a regimen of IV ampicillin and sulbactam and IV doxycycline as an alternative since it provides good coverage against C. trachomatis, N. gonorrhoeae, and anaerobes and is effective for tubo-ovarian abscess.

Treatment of lower respiratory tract infections (including pneumonia, bronchitis, acute exacerbations of chronic bronchitis, bronchiectasis) caused by susceptible Staphylococcus, Streptococcus, Haemophilus influenzae, H. parainfluenzae, Moraxella catarrhalis, E. coli, Klebsiella, or Proteus mirabilis.

Has been used for treatment of respiratory tract infections (e.g., pneumonia, tracheobronchitis) or bacteremia caused by Acinetobacter resistant to imipenem and other anti-infectives. Imipenem or meropenem with or without an aminoglycoside usually are recommended for treatment of infections caused by susceptible Acinetobacter.

Treatment of skin and skin structure infections (e.g., wound infections, cellulitis, ulcers, abscesses, furunculosis) caused by susceptible β-lactamase-producing S. aureus, Enterobacter, E. coli, Klebsiella (including K. pneumoniae), P. mirabilis, Bacteroides (including B. fragilis), or Acinetobacter.

Also has been used for treatment of skin and skin structure infections caused by susceptible S. epidermidis, S. warneri, Enterococcus faecalis, Citrobacter, or Morganella morganii.

Empiric treatment of animal or human bites. Active against most likely bite pathogens, including anaerobes, Staphylococcus, Eikenella corrodens, Pasteurella multocida.

Alternative for treatment of infections caused by P. multocida or E. corrodens.

Has been used for treatment of uncomplicated gonorrhea caused by susceptible Neisseria gonorrhoeae. However, penicillins, including ampicillin sodium and sulbactam sodium, are not included in current CDC recommendations for treatment of gonorrhea.

Alternative for treatment of meningitis caused by susceptible N. meningitidis, H. influenzae, or S. pneumoniae. Other drugs generally preferred and some clinicians strongly discourage use of ampicillin and sulbactam in CNS infections. Treatment failures reported when used for treatment of meningitis caused by K. pneumoniae.

Perioperative prophylaxis to reduce the incidence of infections in patients undergoing contaminated or potentially contaminated surgery (e.g., GI or biliary tract surgery, vaginal or abdominal hysterectomy, transurethral prostatectomy). Other anti-infectives with narrower spectra of activity (e.g., cephalosporins) generally preferred when prophylaxis is indicated in such procedures.