Antimicrobials

• Treatment of bacteremia, endocarditis, meningitis, osteomyelitis, urinary tract infection, pneumonia 
• Prevention of intrapartum group B streptococcal infection in infants (alternative to Penicillin G)
• Prophylaxis of infective endocarditis associated with certain procedures

• The potential for allergic cross-reactivity exists among penicillins, cephalosporins and carbapenems
• Pregnancy: not expected to increase risk of major congenital malformations.
• Breastfeeding: considered safe during breastfeeding. Monitor nursing infant for GI symptoms.

• Nausea, abdominal pain, vomiting, diarrhea
• Skin rash (may be a unique reaction to ampicillin/amoxicillin – no cross-reactivity with beta-lactams – common in patients with infectious mononucleosis, CMV infection, or leukemia)
• Hypersensitivity reactions (beta-lactam type) including anaphylaxis
• Phlebitis at site of IV infusion
• Rarely: interstitial nephritis, blood dyscrasias, elevated liver enzymes, seizures (drug accumulation in renal insufficiency)

Usual Dosage:

• Bacteremia (with suspected/proven deep-seated infection), endocarditis, meningitis, osteomyelitis: 2 g IV q4h
• Urinary tract infection, pneumonia, bacteremia (without deep-seated infection): 2 g IV q6h

Note: Orders for oral ampicillin are automatically converted to amoxicillin

Renal Insufficiency:

• Intermittent Infusion: 1 g over 15 – 30 minutes; 2 g over 30 – 60 minutes
• Continuous Infusion: 2 g in NS IV q4h infused over 4h
• Please refer to IV drug monograph on pharmacy intranet page for additional administration information.