Criteria & Principles
- Ampicillin/sulbactam lacks activity against Pseudomonas, MRSA, and AmpC GNRs
Usual Dose & Administration
Usual Adult Dose
1.5-3 g q6h
Adjustment of Dose & Administration
Indication-Specific Adjustment
| Indication | CrCl (mL/min) | |||
| >30 | 15-30 | <15, IHD | CRRT | |
|
Infections caused by: Carbapenem-Resistant Acinetobacter (CRAB)* |
9 g IV q8h over 4 hours |
6g IV q8h over 4 hours |
6g IV q12h over 4 hours | 9 g IV q8h over 4 hours |
|
Infections caused by: Acinetobacter spp, mild CRAB, or CRAB with intolerance to higher dosing |
3g q4h | 3g q6h |
3g q8h |
3g q6h |
|
Severe infections including: Diabetic foot ulcers Lower respiratory tract infections Endocarditis (HACEK organisms, Enterococcus) Osteomyelitis Orbital cellulitis |
3g q6h | 3g q12h |
3g q24h (give dose after dialysis on dialysis days) |
3g q8h |
|
Acute bacterial sinusitis Community-acquired aspiration pneumonia Cellulitis (non-purulent) UTI (complicated) |
1.5g q6h | 1.5g q12h |
1.5g q24h (give dose after dialysis on dialysis days) |
1.5g q8h |
*Higher doses ampicilin/sulbactam (i.e. 6 and 9 grams) are formulated in 250 mL of NS; use caution in patients with heart failure due to high sodium content
General Notes
- Up-to-date cost information, click here
- IV antimicrobials outpatient (OPAT) dosing, click here
- Obesity dosing weight recommendations here
- Helpful drug-drug interaction check website here
- When dosing guidance is provided it is important to note the following:
Fixed (ie non weight-based) doses in adults are historically based on a 70 kg patient. Specific disease states or individual patients may warrant dosages that differ from the above recommendations. Since product-specific criteria for dose adjustment based on creatinine clearance exist, consult product information regarding specific recommendations for dosage adjustment based on estimated creatinine clearance.