Antimicrobials
Ampicillin

Ampicillin

Low
N/A
See below under General Info

Dosing

General Information

Hospital Formulary Status Yes (parenteral inj)

In-Hospital Cost will be updated

PharmaCare Formulary Status Yes (PO solid, parenteral inj)

SA None

PharmaCare Coverage 250mg PO - $0.4561/cap 500mg PO - $0.8646/cap 250mg powder for soln/inj - $2.2140/vial 500mg powder for soln/inj - $2.3220/vial 1g powder for soln/inj - $3.8880/vial 2g powder for soln/inj - $7.7760/vial

Outpatient Cost 250mg PO - $0.51-0.56/cap 500mg PO - $0.90-0.97/cap 250mg powder for soln/inj - $2.22-2.44/vial 500mg powder for soln/inj - $2.32-2.55/vial 1g powder for soln/inj- $3.89-4.28/vial 2g powder for soln/inj - $7.78-8.56/vial

Pathogen directed therapy for CNS, intravascular, intraabdominal, urinary and other infections especially enterococcus and listeria

Acute liver injury (mainly with IV)

  • usually mild and self-limiting
  • involves cholestatic hepatitis and elevations in ALT, AST and alkaline phosphatase
  • onset: can occur after stopping drug
  • recovery: slow in some cholestatic instances (2-6 months)
  • liver failure is rare

Neutropenia (mainly with IV)

  • associated with immune-mediated destruction of polymorphonuclear leukocytes
  • sx: abrupt onset of fever, rash, and eosinophilia
  • can occur at doses of 40-250mg/kg/day PO and IV

Thrombocytopenia (mainly with IV)

  • acute immune-mediated
  • usually platelet count normalizes within 2 weeks after discontinuation

Allergic interstitial nephritis (mainly with IV)

  • sx: acute and often severe renal failure, with active urinary sediment (hematuria, proteinuria, and pyuria) but no red cell casts
  • usually signs of hypersensitivity are present (fever, peripheral eosinophilia, eosinophiluria and rash)
  • several cases of cross-sensitivity between beta-lactam antibiotics

Pulmonary infiltrate with eosinophilia (PIE) syndrome (mainly with IV)

  • sx: abrupt onset of fever, chills, dyspnea, pulmonary infiltrates and peripheral eosinophilia
  • can occur at doses of 0.5g/dose q6h in children

CNS toxicity (mainly with IV)

  • sx: seizures, encephalopathy
  • has less convulsant properties than penicillin

Infusion-related reactions (IV)

  • sx: painful, inflamed vein or phlebitis after infusion

Allergic reaction (PO and IV)

  • IgE-mediated
  • sx: pruritus, flushing, urticaria, angioedema, wheezing, laryngeal edema, hypotension, and/or anaphylaxis
  • sx usually appear within 4 hrs of administration but may begin within mins

Serum sickness (PO and IV)

  • late allergic reaction
  • sx: fever, rash, adenopathy, arthritis and glomerulonephritis
  • associated with circulating immune complexes

Rash (PO and IV)

  • includes morbilliform rash, erythema multiforme, SJS, exfoliative dermatitis, toxic epidermal necrolysis and vasculitis
  • sx: photosensitivity, skin lesions, mucosal membrane ulceration, erythema, scaling, palpable purpura and/or positive Nikolsky's sign

Note: EBV-related rash - not an allergy

  • morbilliform rash, occurring 48 hrs to weeks after initial amoxicillin exposure in patients with Epstein Barr Virus, does not appear to be a true drug allergy

Allopurinol, methotrexate, mycophenolate, warfarin, some vaccines

Antimicrobial class: Aminopenicillin

Pregnancy category: B

Average serum half life: 1.0 hr

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic