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ampicillin/sulbactam (Rx)Brand and Other Names:Unasyn

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 1.5g (ampicillin 1g/sulbactam 0.5g)
  • 3g (ampicillin 2g/sulbactam 1g)

powder for solution

  • 15g (ampicillin 10g/sulbactam 5g)
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Gynecological Infections

1.5g (1g ampicillin + 0.5g sulbactam) to 3g (2g ampicillin + 1g sulbactam) IV/IM q6hr

Intra-Abdominal Infections

1.5g (1g ampicillin + 0.5g sulbactam) to 3g (2g ampicillin + 1g sulbactam) IV/IM q6hr

Skin & Skin Structure Infections

1.5g (1g ampicillin + 0.5g sulbactam) to 3g (2g ampicillin + 1g sulbactam) IV/IM q6hr

Renal Impairment

CrCl 15-29 mL/min: administer q12hr

CrCl 5-14 mL/min: administer q24hr

Other Indications & Uses

Beta-lactamase-producing: S. aureus, E. coli, Klebsiella spp, P. mirabilis, Bacteroides fragilis, Enterobacter spp, Acinetobacter calcoaceticus

Dosages based on total drug content (amp+sulb)

Dosage Forms & Strengths

injectable solution

  • 1.5g (ampicillin 1g/sulbactam 0.5g)
  • 3g (ampicillin 2g/sulbactam 1g)

powder for solution

  • 15g (ampicillin 10g/sulbactam 5g)
more...

Skin Infections

>1 year old: 200 mg/kg/day IV divided q6hr 

Mild/Moderate Infection

>1 month old- 1 year old: 100-150 mg/kg/day IV/IM divided q6hr 

>1 year old: 100-200 mg/kg/day IV/IM divided q6hr

Meningitis/Severe Infections

>1 month old-1 year old: 200-300 mg/kg/day divided q6hr IV/IM 

>1 year old: 200-400 mg/kg/day divided q6hr IV/IM

Other Information

Dosages based on ampicillin dosing

>40 kg: Same as adult

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Interactions

Interaction Checker

ampicillin/sulbactam and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            IM injection site pain (16%)

            1-10%

            Diarrhea (3%)

            IV injection site pain (3%)

            Thrombophlebitis (3%)

            Rash ( < 2%)

            <1%

            Abdominal distention

            Black "hairy" tongue

            Candidiasis

            Chest pain

            Chillls

            Dysuria

            Edema

            Epistaxis

            Erythema

            Fatigue

            Flatulence

            Glossitis

            Headache

            Itching

            Malaise

            Mucosal bleeding

            Nausea

            Pseudomembranous colitis

            Seizure

            Tightness in throat

            Thrombocytopenia

            Urine retention

            Vomiting

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            Warnings

            Contraindications

            Allergy to penicillins

            Infectious mononucleosis

            Cautions

            Allergy to cephalosporins, carbapenems

            Adjust dose in renal failure; evaluate rash and differentiate from hypersensitivity reaction

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Half-Life: 1.2-1.5 hr

            Protein Bound: 38%

            Distribution: bile, blister & tissue fluids

            Metabolism: liver

            Excretion: urine

            Mechanism of Action

            Drug combination of beta-lactamase inhibitor with ampicillin. Interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms. Alternative to amoxicillin when unable to take medication orally. Covers skin, enteric flora, and anaerobes. Not ideal for nosocomial pathogens.

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            Administration

            IV Incompatibilities

            Additive: aminoglycosides, ciprofloxacin

            Y-site: aminoglycosides, amiodarone, amphotercin B cholesteryl sulfate, ciprofloxacin, cisatracurium(?), diltiazem(?), idarubicin, nicardipine, ondansetron, sargramostim

            IV Compatibilities

            Solution: NS

            Additive: aztreonam

            Y-site: amifostine, aztreonam, bivalirudin, cefepime, dexmedetomidine, docetaxel, enalaprilat, etoposide PO4, famotidine, fenoldopam, filgrastim, fluconazole, fludarabine, gatifloxacin, gemcitabine, granisetron, heparin, Hextend, insulin, linezolid, meperidine, morphine, paclitaxel, remifentanil, tacrolimus, teniposide, theophylline, thiotepa, vancomycin

            IV/IM Preparation

            Reconstitute with SWI or 0.5% or 2% lidocaine injection (IM) to obtain a 250 mg amp-125 mg sulb/mL soln

            IM: use within 1 hr after preparation

            IV: further dilute to 3-45 mg/mL w/ appropriate diluent

            Use NS for IV piggyback

            IV: use within 8 hr after preparation

            IV/IM Administration

            Administer around-the-clock to promote less variation in peak & trough serum levels

            Slow IV injection over at least 10-15 min or infusion over 15-30 min

            IM: deep into large muscle mass

            Storage

            Store intact vials <30&degC

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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