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Guidelines For The Use of Ampicillin: Recommended Neonatal Dose, Route, and Interval

This document provides guidelines for using ampicillin including recommended dosing for neonates of 50 mg/kg IV over 30 minutes with higher meningitic doses of 100 mg/kg. Dosing intervals vary based on postnatal age and weight. Ampicillin is useful against group B streptococcus, Listeria, and E. coli and is commonly used with aminoglycosides for sepsis and meningitis. Possible adverse reactions include oral candidiasis, GI upset, hepatic impairment, and hypersensitivity reactions. Precautions include dosage adjustment for renal impairment and administration over 15 minutes to avoid seizures.

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807 views2 pages

Guidelines For The Use of Ampicillin: Recommended Neonatal Dose, Route, and Interval

This document provides guidelines for using ampicillin including recommended dosing for neonates of 50 mg/kg IV over 30 minutes with higher meningitic doses of 100 mg/kg. Dosing intervals vary based on postnatal age and weight. Ampicillin is useful against group B streptococcus, Listeria, and E. coli and is commonly used with aminoglycosides for sepsis and meningitis. Possible adverse reactions include oral candidiasis, GI upset, hepatic impairment, and hypersensitivity reactions. Precautions include dosage adjustment for renal impairment and administration over 15 minutes to avoid seizures.

Uploaded by

Pathan Nasrin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Guidelines for the Use of Ampicillin

Recommended Neonatal Dose, Route, and Interval

50 mg/kg/dose by IV over 30 minutes


Meningitic doses: 100 mg/kg/dose
UTI Prophylaxis: 25 mg/kg/day divided q12 hours

Dosing Intervals:

Postnatal Age Weight Interval


(Days) (kg) (Hours)

<7 <2 12
>2 8
>7 <2 8
>2 6

Chief Indications

1. Broad spectrum antibiotic useful against group B streptococcus, Listeria monocytogenes, and
susceptible E. coli species
2. Most commonly used in combination with aminoglycosides for sepsis and meningitis
3. UTI Prophylaxis

Possible Adverse Reactions:

1. Oral or diaper rash candidiasis


2. GI upset - vomiting, diarrhea
3. Hepatic impairment with long term use
4. Hypersensitivity reaction - maculopapular rash, urticaria rash, hemolytic anemia, thrombocytopenia,
or fever (not commonly seen in the neonatal period)
5. Very large doses may cause CNS excitation or convulsions
6. Pseudomembranous enterocolitis

Contraindications & Precautions

1. Dosage adjustment may be necessary in patients with severe renal impairment


2. Hypersensitivity to penicillin derivatives

Nursing Implications

1. Give only after blood culture drawn


2. Observe for signs of adverse reactions - "ampicillin rash" usually seen after 5 - 14 days of
treatment, and incidence is higher in patients with other viral infections
3. Monitor renal, hepatic, hematopoietic functions
4. Administer IV over a minimum of 15 minutes to avoid the possibility of seizures.
Standard NICU administration time is 30 minutes.

Special Considerations and Calculations

1. NOT to be mixed with any other drug


2. Adjust dose as indicated for renal dysfunction
3. Peak: 30-60 min.; half-life: 2-4 hrs.
4. Reconstituted solution must be used within 1 hour of mixing due to increased risk of
microbial contamination and loss of potency of ampicillin due to the higher concentration
used when compounded at bedside.
5. Administer aminoglycosides at least 1 hour after the start of ampicillin due to the concern
of blunting the peak concentration of aminoglycosides due to a drug interaction.
6. Not compatible with any dextrose containing solution, including parenteral nutrition
solutions
7. Reconstitute with sterile water for IM or IV use. Follow manufacturer’s instructions for
reconstitution and further dilute to a standard concentration of 50mg/mL per the NICU
guidelines.

References:
1. Neofax 2009
2. The Johns Hopkins Harriet Lane Harriet Lane Handbook, 17th Edition, Mosby Co. 2005

Reviewed/Revised: 6/2010 by

Samir Alabsi, MD
Kelli DeVore, Pharm. D, BCPS
Rebecca Willson MSN, NNP-BC
 

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