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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › BETA-LACTAM ANTIBACTERIALS, PENICILLINS › Combinations of penicillins, incl. beta-lactamase inhibitors
sultamicillin
J01CR04
Forms & Strengths
- Oral Tablets: 375 mg (ampicillin 220 mg / sulbactam 147 mg)
- Oral Suspension: 250 mg/5 mL
Adult Dosing
- 375 mg to 750 mg orally twice daily
- Duration of therapy typically 5 to 14 days depending on infection severity
Pediatric Dosing
- Children > 1 year: 25 to 50 mg/kg/day orally divided into two doses
- Not routinely recommended in neonates and young infants due to immature renal function
Indications
- Upper respiratory tract infections (including sinusitis, otitis media, tonsillitis)
- Lower respiratory tract infections (including pneumonia, bronchitis)
- Skin and soft tissue infections
- Urinary tract infections caused by beta-lactamase-producing strains
Mechanism of Action
- Prodrug of ampicillin and sulbactam linked via a methylene group
- Ampicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins
- Sulbactam irreversibly inhibits beta-lactamases, protecting ampicillin from enzymatic degradation
Contraindications
- Hypersensitivity to ampicillin, sulbactam, or any penicillin class antibiotics
- History of penicillin-associated cholestatic jaundice or hepatic dysfunction
Adverse Reactions
- Diarrhea / loose stools (most common)
- Nausea and vomiting
- Rash, urticaria, pruritus
- Transient elevations in serum transaminases
- Clostridioides difficile-associated diarrhea
Drug Interactions
- Allopurinol increases the incidence of skin rashes
- Probenecid decreases renal tubular secretion of ampicillin and sulbactam, increasing blood levels
- May reduce the efficacy of oral contraceptives
- May prolong bleeding time when co-administered with anticoagulants
Curated Content: Needs Vetting Before Put to Clinical Use