title: Sulbactam/ampicillin: in vitro spectrum, potency, and activity in models of acute infection.
abstract: More than 90% of community hospital-isolated strains of Staphylococcus (including methicillin-resistant isolates), Streptococcus, Haemophilus, Neisseria, Branhamella, Bacteroides, Escherichia coli, Klebsiella, Enterobacter aerogenes, Proteus, and Acinetobacter calcoaceticus were inhibited by the sulbactam/ampicillin (1:2) combination at concentrations of 8 micrograms/16 micrograms per ml. The peak serum level from a 15-min infusion of 1 g/2 g of sulbactam/ampicillin is more than seven times this 90% end point. Excellent bactericidal activity was demonstrated against ampicillin-resistant isolates. Ampicillin-resistant strains did not develop resistance to sulbactam/ampicillin when they were serially transferred in the presence of sublethal concentrations of the combination. In mice the combination was active against a variety of acute, fatal infections produced by ampicillin-resistant bacterial isolates, including methicillin-resistant strains of Staphylococcus aureus and mixed anaerobes. The in vitro and in vivo properties of sulbactam/ampicillin, coupled with its reliable pharmacokinetic performance, appear to make the combination ideally suited for the treatment of polymicrobial (aerobe-anaerobe) infections.
mesh_terms: D000208:Acute Disease; D000667:Ampicillin / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy*; D001439:Bacteroides / Q000187:drug effects; D004195:Disease Models, Animal; D004338:Drug Combinations / Q000494:pharmacology / Q000627:therapeutic use; D004357:Drug Synergism; D004755:Enterobacteriaceae / Q000187:drug effects; D006190:Haemophilus / Q000187:drug effects; D051379:Mice; D008826:Microbial Sensitivity Tests; D009346:Neisseriaceae / Q000187:drug effects; D010397:Penicillanic Acid / Q000494:pharmacology* / Q000627:therapeutic use; D013210:Staphylococcus / Q000187:drug effects; D013291:Streptococcus / Q000187:drug effects; D013407:Sulbactam
chemical_list: D004338:Drug Combinations; C035444:sultamicillin; D000667:Ampicillin; D010397:Penicillanic Acid; D013407:Sulbactam