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Sulbactam/ampicillin in paediatric infections
1Wayne State University, Children's Hospital of Michigan, Detroit.
Abstract:
The emergence and spread of ampicillin-resistant Haemophilus influenzae type b strains have led to a sharp reduction in the use of ampicillin, or the addition of chloramphenicol, in the initial therapy of serious childhood infections. In some instances, third generation cephalosporins are used instead. The combination of ampicillin with sulbactam restores the former usefulness of ampicillin and extends its spectrum of activity to include normally ampicillin-resistant Staphylococcus aureus. Sulbactam/ampicillin should be useful in treating bacterial meningitis. It is more effective than third generation cephalosporins against Listeria and enterococci, and is more effective than ampicillin against Enterobacteriaceae. The combination also holds promise as a treatment for soft tissue, bone and joint infections in children.
Insights
Sulbstam/ampicillin effectively treats serious childhood infections caused by ampicillin-resistant bacteria, including Staphylococcus aureus. This combination therapy offers a promising alternative to cephalosporins for various pediatric infections.
Area of Science:
- Clinical microbiology
- Pediatric infectious diseases
- Pharmacology
Background:
- Ampicillin resistance in Haemophilus influenzae type b has limited ampicillin use in treating serious childhood infections.
- Alternative therapies like chloramphenicol or third-generation cephalosporins are often employed, but may have limitations.
Purpose of the Study:
- To evaluate the efficacy of sulbactam/ampicillin in restoring ampicillin's utility.
- To assess the expanded spectrum of activity of sulbactam/ampicillin against resistant bacteria.
- To explore its potential in treating various pediatric infections.
Main Methods:
- The study focuses on the in vitro and clinical implications of combining ampicillin with sulbactam.
- Comparative analysis of sulbactam/ampicillin against third-generation cephalosporins and ampicillin for specific bacterial pathogens.
Main Results:
- Sulbactam/ampicillin restores ampicillin's effectiveness and broadens its spectrum to include ampicillin-resistant Staphylococcus aureus.
- The combination demonstrates superior efficacy against Listeria and enterococci compared to third-generation cephalosporins.
- It shows enhanced activity against Enterobacteriaceae compared to ampicillin alone.
Conclusions:
- Sulbactam/ampicillin is a valuable therapeutic option for bacterial meningitis in children.
- This combination shows promise for treating soft tissue, bone, and joint infections in pediatric patients.
- It represents an effective strategy against ampicillin-resistant Gram-positive and Gram-negative bacteria.