Parenteral Manual

Ampicillin sodium

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

Alternate Name(s): 
PENBRITIN®, AMPICIN®
Classification: 
Antibiotic
Original Date: 
August 2005
Revised Date: 
October 2018
Indications: 
  • Semisynthetic penicillin for the treatment of infections due to susceptible bacteria
  • Endocarditis prophylaxis
Reconstitution and Stability: 

 

VIAL SIZE STERILE WATER FOR INJECTION REQUIRED FINAL CONCENTRATION
500 mg 4 mL 125 mg/mL
1000 mg 7.4 mL 125 mg/mL
  • Powder is stable at room temperature   
  • Reconstituted solution stable 1 hour at room temperature or 4 hours refrigerated                 
  • Solutions diluted in D5W stable for 1 hour only
Compatibility: 
  • Solutions Compatible: 0.9% NaCl, ringer's solution, D5W (but only for 1 hour)
  • Additives/Above Cassette Compatible : no information
  • Y-site Compatible:  potassium chloride (up to 40 mmol/L), morphine

Incompatible: TPN, Do not mix with aminoglycosides. Flush line well between administration of beta-lactams and aminoglycosides

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM YES, deeply into large muscle
Usual dilution: <250 mg/mL
IV Direct

Yes, into large vessel

Usual dilution: 125 mg/mL

Infusion rate:

Patient less than or equal to 10 kg: do not exceed 10 mg/kg/minute

Patient greater than 10 kg: Do not exceed 100 mg/minute
IV Intermittent Infusion

Yes

Usual dilution: 125 mg/mL

Infusion time: 15-30 minutes

 

Infusion rate:

Patient less than or equal to 10 kg: do not exceed 10 mg/kg/minute

Patient greater than 10 kg: Do not exceed 100 mg/minute
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • Usual: 100-200 mg/kg/day ÷ Q 6 hours (Maximum : 12 g/day)
  • Meningitis: 300-400 mg/kg/day ÷ Q 4 hours (Maximum : 12 g/day)
  • Q4H recommended for bacteremia, endocarditis, meningitis and osteomyelitis
  • Endocarditis prophylaxis: 50 mg/kg/dose (max 2 g) given 1 hour  before procedure

Adolescent/Adult:  

  • Usual adult dose 0.5  to 3 g Q 6 hours (Maximum : 14 g/day)
  • Endocarditis prophylaxis:  2 g given 1 hour before procedure

DOSAGE ADJUSTMENT IN RENAL IMPAIRMENT:

CrCl 10-30 mL/min: administer Q 6-12 hours CrCl < 10 mL/min: administer Q 12 hours

Potential hazards of parenteral administration: 
  • Hypersensitivity reactions - immediate and delayed 
  • Too rapid IV can produce convulsions or muscular irritability;  maximum rate 10 mg/kg/min to a max of 100 mg/minute
  • Possibility of severe pain at injection site  
  • Rash, pruritis, urticaria, nausea, vomiting, diarrhea                                            
Notes: 
  • With prolonged therapy, monitor renal, hepatic and hematologic function periodically
  • Hyperuricemia or allopurinol may potentiate ampicillin rash
  • Caution in patients allergic to penicillin or cephalosporins (may be cross-sensitive)
  • Contains 3.1 mmol sodium/g of ampicillin
  • False positive urinary glucose for Clinitest, Fehling, and Benedicts solution

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