Ampicillin/sulbactam in lower respiratory tract infections: a review.
The pathophysiology and microbiology of lower respiratory tract infections are outlined and diagnostic and therapeutic problems considered. The use of sulbactam/ampicillin in the treatment of these infections is evaluated. The two drugs have similar pharmacokinetic characteristics; predictable and dose-dependent peak serum concentrations of both agents are achieved after parenteral administration. More than 90% of strains of Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella sp, Escherichia coli, and Acinetobacter sp were inhibited by ampicillin/sulbactam concentrations of 16/8 micrograms/ml. Serum concentrations of ampicillin and sulbactam were 18 to 28 micrograms/ml and 13 micrograms/ml, respectively, after intramuscular administration of 1 gm/0.5 gm of ampicillin/sulbactam and 58 micrograms/ml and 30 micrograms/ml, respectively, after intravenous administration of the same dose. Good distribution of ampicillin/sulbactam into lung tissue, sputum, and bronchial fluid has been demonstrated. In over 2,250 patients treated with ampicillin/sulbactam, the rate of discontinuance of treatment because of side effects was less than 1%. Satisfactory clinical and bacteriologic outcome has been reported in over 80% of patients treated with ampicillin/sulbactam. The cost of ampicillin/sulbactam treatment is generally lower than that of other comparable antibiotic regimens.
Cunha
B A
BA
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York.
D000667:Ampicillin / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001419:Bacteria / Q000201:enzymology; D003365:Costs and Cost Analysis; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D008826:Microbial Sensitivity Tests; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D013407:Sulbactam / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001618:beta-Lactamases / Q000378:metabolism
C035444:sultamicillin; D000667:Ampicillin; D001618:beta-Lactamases; D013407:Sulbactam