Sulbactam/
ampicillin is a combination of a
beta-lactamase inhibitor with minimal intrinsic antibacterial activity (
sulbactam sodium), and an aminopenicillin (
ampicillin sodium). The addition of
sulbactam to
ampicillin has no effect on the chemical stability of
ampicillin in aqueous
solution, and the administration guidelines of the combination are the same as for
ampicillin alone.
Sulbactam acts primarily by irreversible inactivation of
beta-lactamases from most
beta-lactamase-producing organisms. The pharmacokinetics of
sulbactam are similar to those of
ampicillin with an elimination half-life of about one hour in most patients. One difference is that serum and tissue concentrations of
sulbactam are usually twice those of
ampicillin, at equivalent doses. The
sulbactam/
ampicillin combination has been approved for the treatment of adults with intraabdominal, skin and skin structure, and gynecological
infections due to
beta-lactamase-producing bacteria such as Staphylococcus aureus, Escherichia coli, and species of Klebsiella and Bacteroides. Clinical studies to date have also shown the combination to be effective for the treatment of
meningitis,
pneumonia,
gonorrhea, epiglottis,
urinary tract infections, cervical
adenitis, and as prophylaxis for abdominal and
gynecological surgeries. Many of these studies, however, have included small numbers of patients and/or had design flaws. Adverse effects have been minor with most being attributed to the
ampicillin component.
Sulbactam/
ampicillin compares favorably with other
antibiotic regimens in terms of acquisition costs and ease of administration.