Ampicillin

INTRODUCTION

Indications

Treatment of the following infections: Skin and skin structure infections; Soft-tissue infections; Otitis media, Sinusitis; Respiratory infections; Genitourinary infections; Meningitis; Septicemia; Endocarditis prophylaxis. Unlabeled Use: Prevention of infection in certain high-risk patients undergoing cesarean section.

Action

Binds to bacterial cell wall, resulting in cell death. Therapeutic Effects: Bactericidal action; spectrum is broader than penicillin. Spectrum: Active against Streptococci, Nonpenicillinase-producing staphylococci, Listeria, Pneumococci, Enterococci, Haemophilus influenzae, Escherichia coli, Enterobacter, Klebsiella, Proteus mirabilis, Neisseria meningitidis, N. gonorrhoeae, Shigella, Salmonella.

Adverse Reactions/Side Effects

CNS: SEIZURES (HIGH DOSES). GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, nausea, vomiting. Derm: rashes, urticaria. Hemat: blood dyscrasias. Misc: ALLERGIC REACTIONS. INCLUDING ANAPHYLAXIS AND SERUM SICKNESS, superinfection.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Watch for seizures; notify physician immediately if patient develops or increases seizure activity.

• Monitor signs of pseudomembranous colitis, including diarrhea, abdominal pain, fever, pus or mucus in stool, and other severe or prolonged GI problems (nausea, vomiting, heartburn). Notify physician or nursing staff immediately of these signs.

• Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

• Assess muscle aches and joint pain (arthralgia) that may be caused by serum sickness. Notify physician if these symptoms seem to be drug related rather than caused by musculoskeletal injury, or if muscle and joint pain are accompanied by allergic-like reactions (fever, rashes, etc.)

• Monitor signs of blood dyscrasias such as eosinophilia (fatigue, weakness, myalgia) and leukopenia (fever, sore throat, signs of infection). Report these signs to the physician.

Interventions

• Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Use universal precautions or isolation procedures as indicated for specific patients.

Patient/Client-Related Instruction

• Instruct patient to notify physician immediately of signs of superinfection, including black, furry overgrowth on tongue, vaginal itching or discharge, and loose or foul-smelling stools.

• Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged skin problems (rash, itching) or GI problems (nausea, vomiting, diarrhea).

Pharmacokinetics

Absorption: Moderately absorbed from the duodenum (30–50%).

Distribution: Diffuses readily into body tissues and fluids. CSF penetration is increased in the presence of inflamed meninges. Crosses the placenta; enters breast milk in small amounts.

Metabolism and Excretion: Variably metabolized by the liver (12–50%). Renal excretion is variable (25–60% after oral dosing; 50–85% ...