Use of ampicillin/sulbactam and sultamicillin in pediatric infections: a re-evaluation.
Ampicillin/sulbactam is an effective solution to the emergence of beta-lactamase-mediated resistance among common pediatric pathogens, and is a widely recognized treatment option for a variety of pediatric infections. Recent antimicrobial surveillance data confirm the continued susceptibility of many Gram-positive and Gram-negative aerobes and anaerobes to ampicillin/sulbactam. Pharmacokinetic studies have demonstrated high drug concentrations at a variety of infection sites, including cerebrospinal fluid and bone. Furthermore, clinical studies have shown that ampicillin/sulbactam, administered intravenously, intramuscularly or orally (as the mutual prodrug sultamicillin), is clinically and bacteriologically effective against upper and lower respiratory tract infections, urinary tract infections, skin, bone and soft-tissue infections, and meningitis, and provides effective surgical prophylaxis. Sultamicillin has an excellent tolerability profile, which is associated with a low rate of treatment discontinuation. Accordingly, ampicillin/sulbactam and sultamicillin should be considered first-choice options for the management of a variety of pediatric infections.
Dajani
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Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, MI, USA. adnan.dajani@wayne.edu
D000667:Ampicillin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004361:Drug Tolerance; D006801:Humans; D016920:Meningitis, Bacterial / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000188:drug therapy; D013407:Sulbactam / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000188:drug therapy
C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam