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Drug Name: Unasyn (ampicillin-sulbactam)

Click on the titles below for drug details

  • Beta-lactam - Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs). The addition of sulbactam, a beta-lactamase inhibitor, to ampicillin extends the spectrum of ampicillin to include some beta-lactamase-producing organisms.
  • Bactericidal
  • IV (rarely IM)
  • Meningitis or severe rhinosinusitis infections: 100 mg/kg/dose q6 hours (max: 2000mg/dose)
  • Other infection indications: 75 mg/kg/dose q6 hours (max: 2000mg/dose)
  • Patients with abnormal renal function (<30 mL/minute/1.73 m2) require renal dosing adjustment, generally extending the dosing interval. Talk to your friendly pharmacist.
  • Spectrum of Activity - Sulbactam is a beta lactamase inhibitor. Ampicillin Sulbactam has the same coverage as ampicillin but has the additional coverage of bacteria that produce beta lactamase, including MSSA, anaerobes, gram-negatives (non-resistant Enterobacterales, Pasteurella multocida, Eikenella corrodens, Haemophilus influenzae)
  • Does NOT cover MRSA or Pseudomonas aeruginosa
  • Indications:
    • Dental infections
    • Retropharyngeal and peritonsillar infections
    • Preseptal and orbital cellulitis (not MRSA)
    • Skin and soft tissues infections (not MRSA)
    • Bites (humans, dogs, cats)
    • Urinary tract infections
    • Recurrent acute otitis media or concern for H. influenzae infection (otitis-conjunctivitis syndrome)
    • Failed otitis media or pneumonia treatment with amoxicillin
  • Allergy to amoxicillin
  • Diarrhea, upset stomach, or vomiting
  • Headache
  • Allergic reaction
  • Ampicillin-sulbactam is readily distributed throughout the body, but has poor penetration into cerebrospinal fluid with uninflamed meninges.
  • Ampicillin-sulbactam may cause diarrhea which typically improves after completing the antibiotic.
  • Ampicillin rash occurs in 5% to 10% of children and is a generalized dull red, maculopapular rash. Rash does not necessarily mean the patient has an allergy but should be carefully monitored for signs of difficulty breathing, significant itching, persistent vomiting.