氨苄西林

用途

• Gram-positive infections
• Gram-negative infections
• Susceptible UTI's
• Susceptible soft tissue infections
• Pneumonia, systemic
• Meningitis, orthopedic infections
• Susceptible sepsis, bacteremia
• Neonatal sepsis
• Sepsis
• Susceptible UTI's
• To eliminate the leptospiremic phase of leptospirosis
• Routine infections
• CNS or serious bacterial infections
• Susceptible infections (Amazon parrots)

給藥方式

可能的副作用

• Gastrointestinal upset (anorexia, vomiting, diarrhea)
• Antibiotic-associated diarrhea and superinfections (alteration of gut flora)
• Hypersensitivity reactions (rashes, fever, eosinophilia, anaphylaxis)
• Neurotoxicity (ataxia, seizures) at very high doses or prolonged use
• Elevated liver enzymes (rare)
• Tachypnea, dyspnea, edema, and tachycardia (reported in dogs)

注意事項與禁忌

• Patients with a known hypersensitivity to penicillins
• Oral administration in patients with septicemia, shock, or grave illness (due to delayed/diminished GI absorption)
• Oral or parenteral use in small hindgut fermenters (rabbits, guinea pigs, chinchillas, hamsters) due to risk of fatal clostridial enterotoxemia
• > **Cross-Reactivity:** Use cautiously in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., cephalosporins, carbapenems), as cross-reactivity can occur. > **Species Warning:** Severe, potentially fatal enteritis and clostridial enterotoxemia can occur if administered to rabbits, guinea pigs, chinchillas, or hamsters. > **Laboratory Interference:** May cause false-positive urine glucose determinations when using cupric sulfate solutions (e.g., Clinitest). Glucose oxidase tests are unaffected.

藥物相互作用

• Bacteriostatic Antimicrobials (e.g., chloramphenicol, macrolides, tetracyclines): Potential in vitro antagonism; clinical significance is debated but concurrent use is traditionally discouraged.
• Methotrexate: Ampicillin may decrease the renal excretion of methotrexate, leading to increased levels and potential toxicity.
• Probenecid: Competitively blocks the tubular secretion of penicillins, increasing serum levels and prolonging half-life.
• Aminoglycosides (e.g., gentamicin, amikacin): In vitro inactivation of aminoglycosides if mixed in the same syringe or fluid bag. May also occur in vivo in patients with severe renal failure.
• Tetracycline: Antagonism of bactericidal effect due to bacteriostatic action
• Erythromycin: Antagonism of bactericidal effect due to bacteriostatic action
• Chloramphenicol: Antagonism of bactericidal effect due to bacteriostatic action
• Aminoglycosides: In vitro inactivation if mixed in the same syringe; however, exhibits synergistic antimicrobial effects when used concurrently in vivo

常見問題