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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › BETA-LACTAM ANTIBACTERIALS, PENICILLINS › Penicillins with extended spectrum
sulbenicillin
J01CA16
Forms & Strengths
- Injectable powder for reconstitution: 1 g, 2 g, 4 g per vial
Adult Dosing
- Systemic infections: 2 g to 4 g intravenously or intramuscularly every 6 to 8 hours
- Severe or life-threatening infections: Up to 12 g to 16 g daily in divided doses
Pediatric Dosing
- Neonates and infants: 100 mg/kg to 200 mg/kg daily divided every 6 to 12 hours
- Children: 100 mg/kg to 300 mg/kg daily divided every 6 hours
Indications
- Treatment of serious infections caused by susceptible Gram-negative bacilli (including Pseudomonas aeruginosa, Proteus species, and Escherichia coli)
- Respiratory tract infections
- Urinary tract infections
- Septicemia
- Intra-abdominal infections
Mechanism of Action
- Binds to penicillin-binding proteins (PBPs) located on the bacterial cell wall
- Inhibits bacterial cell wall synthesis leading to cell lysis and death
- Broad-spectrum antipseudomonal penicillin with activity against select Gram-negative and Gram-positive organisms
Contraindications
- Known hypersensitivity to sulbenicillin, penicillins, or other beta-lactam antibiotics
- History of penicillin-associated cholestatic jaundice or hepatic dysfunction
Adverse Reactions
- Hypersensitivity reactions (rash, urticaria, pruritus, anaphylaxis)
- Gastrointestinal disturbances (diarrhea, nausea, vomiting, pseudomembranous colitis)
- Hematologic effects (eosinophilia, leukopenia, thrombocytopenia, hemolytic anemia with prolonged high doses)
- Neurological toxicity (seizures or encephalopathy, particularly in renal impairment)
- Local reactions (pain, thrombophlebitis at injection site)
- Electrolyte disturbances (hypernatremia or hypokalemia due to high sodium load in formulations)
Drug Interactions
- Probenecid decreases renal tubular secretion of sulbenicillin, increasing and prolonging serum concentrations
- Aminoglycosides may exhibit synergistic bactericidal activity but are physically incompatible and should not be mixed in the same IV line
- Bacteriostatic antibiotics (e.g., chloramphenicol, erythromycin, tetracyclines) may antagonize the bactericidal activity of penicillins
- Anticoagulants (e.g., warfarin) may have increased bleeding risk due to potential additive effects on platelet function at high doses
Curated Content: Needs Vetting Before Put to Clinical Use