Clinical Pharmacology of Ampicillin in Infants and Children - Abstract
Ampicillin is an aminopenicillin and is more active than penicillin G. Ampicillin is destroyed by ?-lactamase and is co-formulated with sulbactam an inhibitor of ?-lactamase. Ampicillin is bactericidal and it is active against meningococci, Listeria monocytogenes, enterococci, and the co-administration with sulbactam markedly expands the spectrum of activity against Haemophilus influenzae, Escherichia coli, Proteus, and Bacillus fragilis. Ampicillin may be administered intravenously and orally and the intravenous dose is 50 mg twice-daily and thrice-daily in preterm and term infants, respectively. The oral dose in children ranges from 125 to 500 mg 4 times-daily and increases with the chid age. Ampicillin has been found efficacy and safe in infants and children but may cause adverse-effects. In infants, the ampicillin elimination half-life ranges between 2.4 to 5.0 hours and decreases with infant maturation and in children it is about 0.8 hours. Ampicillin interacts with drugs, the treatment and the trials with ampicillin have been extensively studied in infants and children. This antibiotic freely crosses the human placenta but poorly migrates into the breast-milk. Ampicillin penetrates into the cerebrospinal fluid in significant amounts and treated meningitis caused by different pathogens generally co-administered with other antibiotics, particularly with chloramphenicol, but cefotaxime or cefuroxime sterilized the cerebrospinal fluid more rapidly. The aim of this study is to review the ampicillin dosing, efficacy and safety, effects, adverse-effects, tissue concentration, pharmacokinetics, interaction with drugs, treatment, trials, placental transfer, migration into breast-milk, penetration into the cerebrospinal fluid, and treatment of bacterial meningitis in infants and children.