氨苄西林钠;Ampicillin sodium

【分类】抗生素/β-内酰胺类/青霉素类

【别名】氨苄青、广谱青霉素、安比西林、安比林、苄那消

【外文名】Ampicillin，Acillin，BRL-1341，Doktacillin，Eurocillin，Pamecil

【作用与用途】属广谱抗菌素，对大多数G+菌的抗菌作用不及青霉素G，对阴性杆菌的作用超过青霉素。作用机制同青霉素。但肠球菌对本品较为敏感，对G-杆菌作用较卡那霉素，庆大霉素弱，与四环素相仿，对伤寒杆菌，大肠杆菌的抗菌作用较强，绿脓杆菌和金葡菌对本品耐药.主要用于治疗敏感细菌所致的败血症，尿路感染，肺部感染，胆道感染等；治疗伤寒、副伤寒疗效与氯霉素相仿。本品在脑膜炎症时，脑脊液浓度较高，也适用于治疗由肺炎球菌、脑膜炎双球菌及流感杆菌引起的脑膜炎。与其他半合成青霉素类、氨基糖甙类及氯霉素等合用可增强疗效。

【适应证】用以治疗敏感的G+菌和流感杆菌、伤寒杆菌、淋球菌、脑膜炎球菌、大肠杆菌等G所致的呼吸道感染、胃肠道感染、尿路感染、软组织感染、脑膜炎、败血症、心内膜炎等。

【用法及用量】肌内或静注。成人，肌内注射剂量为每日2～4g，分4次给予；静脉给药剂量每日4～12g，分2～4次，每日最高剂量为16g。小儿，肌注剂量为每日按体重50～100mg/kg，分4次；静脉给药剂量每日按体重100～200mg/kg，分2～4次，每日最高剂量为按体重300mg/kg。口服，成人每日2～4g，分4次服用；小儿每日按体重50～100mg/kg，分4次服用。

【不良反应】1.与青霉素有交叉过敏反应，可发生包括过敏性休克在内的各型过敏反应。2.有恶心、轻度腹泻及皮疹。肾功能重度损害伴心功能不全者，静滴本品钠盐可诱发心力衰竭，宜注意。3.本品皮疹反应高于其他青霉素类抗生素；4.抗生素关联性肠炎：腹泻发生率约5%；5.SGOT升高；6.其他反应如大剂量可发生惊厥、血液系统异常等。

【注意事项】不良反应与青霉素相仿，以过敏反应较为多见。传染性单核细胞增多症、巨细胞病毒感染、淋巴细胞白血病、淋巴瘤等病人应用本品时易发生皮疹。因此，本品不能用于这些病人。大剂量氨苄西林静脉给药可发生抽搐等神经系统毒性症状。

【药物相互作用】1.与丙磺舒合用可提高本品血浓度。2.与头孢菌素等合用对耐酶的金黄色葡萄球菌引起的感染有较好的协同作用，但不能放在同一容器中。3.不能与维生素C、B合用。4.稳定性因葡萄糖、果糖的存在而降低，所以用0.9%N.S最好。

Ampicillin Sodium Injection
About your treatment
Your doctor has ordered ampicillin, an antibiotic, to help treat your infection. The drug will be either injected into a large muscle (such as your buttock or hip) or added to an intravenous fluid that will drip through a needle or catheter placed in your vein for about 30 minutes, four to six times a day.

Ampicillin eliminates bacteria that cause many kinds of infection, including pneumonia; meningitis; and urinary tract, gastrointestinal tract, skin, bone, joint, blood, and heart valve infections. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.

Precautions
Before administering ampicillin,
tell your doctor and pharmacist if you are allergic to ampicillin, penicillin, cephalosporins [e.g., cefaclor (Ceclor), cefadroxil (Duricef), or cephalexin (Keflex)], or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other antibiotics, allopurinol (Lopurin), anticoagulants ('blood thinners') such as warfarin (Coumadin), atenolol (Tenormin), oral contraceptives, probenecid (Benemid), rifampin (Rifadin), sulfasalazine, and vitamins.
tell your doctor if you have or have ever had kidney or liver disease, allergies, asthma, blood disease, colitis, stomach problems, or hay fever.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ampicillin, call your doctor.
if you have diabetes and regularly check your urine for sugar, use Clinistix or TesTape. Do not use Clinitest tablets because ampicillin may cause false positive results.

Administering your medication
Before you administer ampicillin, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Side effects 
Ampicillin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
upset stomach
diarrhea
vomiting
mild skin rash

If you experience any of the following symptoms, call your health care provider immediately:
severe skin rash
itching
hives
difficulty breathing or swallowing
wheezing
unusual bleeding or bruising
headache
dizziness
seizures
sore mouth or throat

Storing your medication 
Your health care provider probably will give you a several-day supply of ampicillin at a time. If you are receiving ampicillin intravenously (in your vein), you probably will be told to store it in the refrigerator or freezer.
Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature.
If you are told to store additional ampicillin in the freezer, always move a 24-hour supply to the refrigerator for the next day's use.
Do not refreeze medications.

If you are receiving ampicillin intramuscularly (in your muscle), your health care provider will tell you how to store it properly.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

In case of emergency/overdose 
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Signs of infection
If you are receiving ampicillin in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:
tenderness
warmth
irritation
drainage
redness
swelling
pain