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Experience with ampicillin/sulbactam in severe infections
1Department of Pediatric Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey. gkanra@gen.hun.edu.tr
Abstract:
The emergence of beta-lactamase-mediated resistance to established beta-lactam antibiotics prompted the development of beta-lactamase inhibitors for co-administration. Ampicillin has been combined with sulbactam for both parenteral and oral (as the mutual pro-drug sultamicillin) administration. The combination is active in vitro against a wide variety of Gram-positive and Gram-negative pathogens, including aerobic and anaerobic organisms. In clinical trials, ampicillin/sulbactam has proved clinically and bacteriologically effective against a variety of frequently encountered pediatric infections, including mild-to-moderate upper respiratory tract infections (acute otitis media, sinusitis, pharyngitis, and tonsillitis), severe post-operative and intra-abdominal infections, periorbital infections (which, left untreated, can lead to blindness, brain abscess, or death), acute epiglottitis, bacterial meningitis, and brain abscess. Ampicillin/sulbactam has also proved effective in the prevention of post-operative surgical infections in pediatric patients. The clinical efficacy profile of ampicillin/sulbactam and sultamicillin, combined with their excellent tolerability profile, make these agents attractive options for the management of many life-threatening infections in pediatric patients.
Insights
Ampicillin combined with sulbactam, including its oral form sultamicillin, effectively treats various pediatric infections. This antibiotic combination shows high efficacy and tolerability for bacterial infections, including serious ones like meningitis.
Area of Science:
- Pharmacology and Infectious Diseases
- Microbiology and Antibiotic Resistance
Background:
- Beta-lactamase-mediated resistance necessitates the development of beta-lactamase inhibitors.
- Ampicillin/sulbactam and sultamicillin address resistance to traditional beta-lactam antibiotics.
Purpose of the Study:
- To evaluate the clinical efficacy and tolerability of ampicillin/sulbactam and sultamicillin in pediatric patients.
- To assess the effectiveness against a broad spectrum of bacterial pathogens and infections.
Main Methods:
- Review of in vitro activity against Gram-positive and Gram-negative pathogens (aerobic and anaerobic).
- Analysis of clinical trial data for various pediatric infections and post-operative prophylaxis.
Main Results:
- Ampicillin/sulbactam demonstrated in vitro activity against a wide range of bacteria.
- Clinical trials confirmed efficacy in treating pediatric upper respiratory, abdominal, periorbital, and CNS infections.
- Effective in preventing post-operative surgical infections in pediatric patients.
Conclusions:
- Ampicillin/sulbactam and sultamicillin are effective therapeutic options for numerous pediatric infections.
- The combination's favorable efficacy and tolerability profile support its use in managing severe pediatric infections.
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