Neonatal Drug Therapy Manual

Ampicillin

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Classification: 
Antibiotic (semi-synthetic penicillin)
Original Date: 
March 1993
Revised Date: 
January 2019
Indications: 
  • Infections due to most Gram (+) and Gram (-) aerobic cocci
  • Infections due to some Gram (+) aerobic and anaerobic bacilli and some spirochetes
Administration: 
  • IV direct: over 5 minutes.  Do not exceed infusion rate of 10 mg/kg/minute.
  • IV intermittent infusion: over 15 - 30 minutes.
  • Usual dilution: 125 mg/mL (CHEO) , 100 mg/mL (TOH)
Dosage: 

Age

      Sepsis 

Group B Streptococcal Meningitis

0-7 days:   2 kg

                   > 2 kg

100 mg/kg/day divided Q12H

150 mg/kg/day divided Q8H

Regardless of weight:
200 - 300 mg/kg/day divided Q8H

>7 days:   < 1.2 kg

                   1.2-2 kg

                     > 2 kg

100 mg/kg/day divided Q12H 

150 mg/kg/day divided Q8H

200 mg/kg/day divided Q6H

Regardless of weight:
300 mg/kg/day divided 4-6H*

* Doses up to 400 mg/kg/day have been used

Dosage adjustment required in renal impairment.  Refer to available references or clinical pharmacist for dosage adjustment.

Side Effects: 
  • CNS: excitation/seizure with very high doses
  • GI: diarrhea
  • Hematologic: thrombocytopenia, leukopenia, neutropenia, agranulocytosis
  • Local: may be irritating to veins
Parameters to Monitor: 
  • CBC with differential
  • Temperature
  • Injection site
Reconstitution and Stability: 

CHEO:

Ampicillin 500 mg

  • Add 4 mL SWFI
  • Final concentration: 125 mg/mL
  • Reconstituted vial stability: 1 hour at room temperature, 4 hours in fridge

 

 TOH:

Ampicillin 250 mg

  • Add 2.5 mL SWFI
  • Final concentration: 100 mg/mL
  • Reconstituted vial stability: 1 hour at room temperature, 4 hours in fridge 

 

Ampicillin 500 mg

  • Add 5 mL SWFI
  • Final concentration: 100 mg/mL
  • Reconstituted vial stability: 1 hour at room temperature, 4 hours in fridge
Compatibility: 

- Solutions Compatible: D5W, 0.9% NaCl

- Y-site Compatible: heparin, morphine, potassium chloride, SMOF

Incompatible: dopamine, epinephrine, gentamicin, midazolam, TPN, vancomycin

 

Notes: 

Contains 2.6 - 3.1 mmol Na/g (according to the brand).  May interfere with results of Clinitest (false positive result).

References: 

-Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 22nd Edition. Hudson: Lexi-Comp Inc.; 2015

-Trissel LA. Handbook on Injectable Drugs. 16th Edition. Bethesda: American Society of Health-System Pharmacists; 2011

- Lau E, Chen Jennifer. (Editors). Drug Handbook and Formulary - The Hospital for Sick Children. Toronto: Lexi-Comp Inc.; 2015

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.