Ampicillin
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Trade Name
Principen (historical brand name); generic ampicillin
Classification
Penicillin antibiotic; aminopenicillin, beta-lactam
Dosage/Route
- * Dosage:
- – Capsules: 250 mg, 500 mg
- – Suspension: 125 mg/5 mL, 250 mg/5 mL
- – IV/IM: 250 mg, 500 mg, 1 g, 2 g vials
- * Route: Oral (PO), intravenous (IV), intramuscular (IM)
Usual Dosage
- * Adults:
- – PO: 250-500 mg every 6 hours (QID); max 4 g/day
- – IV/IM: 500 mg-2 g every 4-6 hours; max 12 g/day
- * Children:
- – PO: 50-100 mg/kg/day divided q6h
- – IV/IM: 100-200 mg/kg/day divided q4-6h
- * Duration: 7-14 days (e.g., 10 days for strep)
Mechanism of Action
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, disrupting peptidoglycan cross-linking. Bactericidal against susceptible gram-positive (e.g., Streptococcus) and some gram-negative bacteria (e.g., E. coli, H. influenzae); broader spectrum than penicillin G
Side Effects & Adverse Effects
- * Side Effects: Nausea, diarrhea, rash
- * Adverse Effects:
- – Hypersensitivity (rash, anaphylaxis; boxed warning for penicillin allergy)
- – Clostridioides difficile-associated diarrhea (CDAD)
- – Injection site reaction (IM/IV; phlebitis)
- – Rare: Seizures (high IV doses), hematologic effects
Nursing Management (Implications & Teachings)
- * Implications:
- – Assess for penicillin allergy (anaphylaxis risk) before first dose
- – Monitor renal function (adjust dose if CrCl <50 mL/min), diarrhea (CDAD)
- – IV: Infuse over 30-60 min; reconstitute per label (e.g., 10 mL water for 500 mg)
- – PO: Give on empty stomach (1 hr before/2 hr after meals)
- * Teachings:
- – Finish full course; don’t skip doses
- – Report hives, swelling, or bloody diarrhea
- – Take PO with water, shake suspension well
- – Store reconstituted IV in fridge if delayed (stable 24 hr)
Indication for This Patient
* Bacterial infections:
- – Respiratory (e.g., pneumonia, sinusitis)
- – UTI (e.g., E. coli)
- – Meningitis (e.g., Listeria, with other drugs)
- – Endocarditis prophylaxis (susceptible organisms)
Time
- * Timing: PO: Every 6 hours; IV/IM: Every 4-6 hours
- * Onset: Symptom relief in 1-3 days
- * Duration: 7-14 days (infection-specific)
