Antibacterial drugs

Ampicillin sodium and sulbactam sodium is used parenterally for the treatment of skin and skin structure, intra-abdominal, and gynecologic infections caused by susceptible bacteria. The drug also has been used parenterally for the treatment of other infections, including respiratory tract infections caused by susceptible bacteria.

Ampicillin shares the uses of other aminopenicillins and is used principally for the treatment of infections caused by susceptible gram-negative bacteria (e.g., Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Salmonella). Ampicillin also is used for the treatment of infections caused by susceptible gram-positive bacteria (e.g., Streptococcus pneumoniae, enterococci, nonpenicillinase-producing staphylococci, Listeria); however, like other aminopenicillins, ampicillin generally should not be used for the treatment of streptococcal or staphylococcal infections when a natural penicillin would be effective.

Amoxicillin and clavulanate potassium is used orally for the treatment of lower respiratory tract infections, otitis media, sinusitis, skin and skin structure infections, and urinary tract infections caused by susceptible organisms. Amoxicillin and clavulanate potassium also has been used orally for the treatment of chancroid and gonorrhea caused by susceptible organisms. Amoxicillin and clavulanate potassium has been effective when used orally in adults and children for the treatment of abscesses, cellulitis, and impetigo caused by susceptible penicillinase-producing and nonpenicillinase-producing Staphylococcus aureus and S. epidermidis, Streptococcus pyogenes (group A b-hemolytic streptococci), or Corynebacterium. Results of several controlled studies indicate that amoxicillin and clavulanate potassium is as effective as cefaclor in the treatment of these infections.

Amoxicillin is used for the treatment of acute otitis media (AOM) caused by S. pneumoniae, H. influenzae, or M. catarrhalis. Amoxicillin usually is considered the drug of first choice for initial treatment of AOM, unless the infection is suspected of being caused by b-lactamase-producing bacteria resistant to the drug, in which case amoxicillin and clavulanate potassium is recommended.

Penicillin V potassium is used for the treatment of mild to moderately severe infections caused by organisms susceptible to low concentrations of the drug or for prophylaxis of certain streptococcal infections. For specific information on the uses of penicillin V potassium, see Uses in the Natural Penicillins General Statement 8:12.16.04.

Penicillin G procaine is used only for the treatment of moderately severe infections caused by organisms susceptible to low concentrations of penicillin G or as follow-up therapy to IM or IV penicillin G potassium or sodium. When high penicillin G concentrations are required, IM or IV penicillin G potassium or sodium should be used. For specific information on the uses of penicillin G procaine, see Uses in the Natural Penicillins General Statement 8:12.16.04. Penicillin G procaine is administered by deep IM injection.

Penicillin G potassium is administered by IM injection or by continuous or intermittent IV infusion. The drug has also been administered orally and by intrapleural, intra-articular, and other local instillations.

IM penicillin G benzathine is used only for the treatment of mild to moderately severe infections caused by organisms susceptible to low concentrations of penicillin G, for prophylaxis of infections caused by these organisms, or as follow-up therapy to IM or IV penicillin G potassium or sodium. When high concentrations of penicillin G are required, parenteral penicillin G potassium or sodium should be used. For specific information on the uses of penicillin G benzathine, see Uses in the Natural Penicillins General Statement 8:12.16.04.

Based on Spectra of Activity Penicillins are natural or semisynthetic antibiotics produced by or derived from certain species of the fungus Penicillium. The drugs are b-lactam antibiotics structurally and pharmacologically related to other b-lactam antibiotics including cephalosporins and cephamycins.

Dosage of troleandomycin is expressed in terms of oleandomycin. The usual adult dosage is 250-500 mg every 6 hours. The usual dosage in children is 125-250 mg every 6 hours. Alternatively, children may receive 6.6-11 mg/kg every 6 hours.