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Vfend renal dosing for cipro

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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for solution

  • 1.5g (ampicillin 1g/sulbactam 0.5g)
  • 3g (ampicillin 2g/sulbactam 1g)
  • 15g (ampicillin 10g/sulbactam 5g)

more...

Gynecologic Infections

1.5 g (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) IV/IM q6hr; not to exceed 12 g/day

Intra-Abdominal Infections

1.5 g (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) IV/IM q6hr; not to exceed 12 g/day

Skin & Skin Structure Infections

1.5 g (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) IV/IM q6hr; not to exceed 12 g/day

Orbital Cellulitis

3 g (2 g ampicillin + 1 g sulbactam) IV q6hr

Pelvic Inflammatory Disease

3 g (2 g ampicillin + 1 g sulbactam) IV q6hr

Pneumonia

Aspiration or community acquired: 1.5 g (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) IV q6hr for 5 or more days

Hospital acquired: 3 g IV q6hr for 5 or more days

Urinary Tract Infections

Pyelonephritis: 3 g (2 g ampicillin + 1 g sulbactam) IV q6hr for 14 days

Acute Bacterial Rhinosinusitis (Off-label)

Severe infection requiring hospitalization

1.5 g (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) IV q6hr for 5-7 days

Endocarditis (Off-label)

Enterococcus infection resistant to penicillin/susceptible to aminoglycosides: 3 g (2 g ampicillin + 1 g sulbactam) IV q6hr for 6 weeks if not aminoglycoside resistant; >6 weeks if aminoglycoside resistant

HACEK infection: 3 g (2 g ampicillin + 1 g sulbactam) IV q6hr for 4 weeks

Dosing Modifications

Renal impairment

  • CrCl 5-14 mL/min/1.73 m²: 1.5 g (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) IV q24hr
  • CrCl 15-29 mL/min/1.73 m²: 3 g (2 g ampicillin + 1 g sulbactam) IV q12hr
  • CrCl ≥ 30 mL/min/1.73 m²: No dose adjustment necessary

Dosage Forms & Strengths

powder for solution

  • 1.5g (ampicillin 1g/sulbactam 0.5g)
  • 3g (ampicillin 2g/sulbactam 1g) 
  • 15g (ampicillin 10g/sulbactam 5g)

more...

Skin Infections

>1 year (<40 kg): 200 mg/kg/day IV divided q6hr; not to exceed 14 days of therapy 

>1 year (>40 kg): 1.5 g (1 g ampicillin + 0.5 g sulbactam) to 3 g (2 g ampicillin + 1 g sulbactam) q6hr; not to exceed 12 g/day

Epiglottitis

Children and adolescents: 100-200 mg ampicillin/kg/day IV divided q6hr 

Mild/Moderate Infection

>1 month-1 year: 100-150 mg ampicillin/kg/day IV/IM divided q6hr 

>1 year: 100-200 mg ampicillin/kg/day IV/IM divided q6hr

Meningitis/Severe Infections

>1 month-1 year: 200-300 mg ampicillin/kg/day IV/IM divided q6hr 

>1 year: 200-400 mg ampicillin/kg/day IV/IM divided q6hr

Peritonsillar and Retropharyngeal Abscess

Children and adolescents: 200 mg ampicillin/kg/day IV divided q6hr 

Interactions

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Adverse Effects

>10%

IM injection site pain (16%)

1-10%

Diarrhea (3%)

IV injection site pain (3%)

Thrombophlebitis (3%)

Rash ( < 2%)

<1%

Abdominal distention

Black, "hairy" tongue

Candidiasis

Chest pain

Chills

Dysuria

Edema

Epistaxis

Erythema

Fatigue

Flatulence

Glossitis

Headache

Itching

Malaise

Mucosal bleeding

Nausea

Pseudomembranous colitis

Seizure

Tightness in throat

Thrombocytopenia

Urine retention

Vomiting

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Warnings

Contraindications

Hypersensitivity to drug or components

Patients with previous history of cholestatic jaundice/hepatic dysfunction associated with ampicillin sulbactam

Cautions

Use caution in patients with allergy to cephalosporins and carbapenems

Adjust dose in renal failure

Prolonged use is associated with fungal or bacterial superinfection

Hepatic dysfunction, including hepatitis and cholestatic jaundice reported; hepatic toxicity is usually reversible; however, deaths have occurred; monitor hepatic function at regular intervals in patients with hepatic impairment

A generalized dull red maculopapular rash may occur in 5-10% of children 3-14 days after initiating therapy; carefully evaluate the rash to differentiate a nonallergic ampicillin rash from a hypersensitivity reaction; it normally begins on the trunk and spreads over most of the body; it may be most intense at pressure areas, elbows, and knees

Hepatotoxicity reported; monitor hepatic function at regular intervals in patients with hepatic impairment

A high percentage of patients with infectious mononucleosis have developed rash during therapy; therapy is not recommended in these patients

May cause severe skin reactions, such as toxic epidermal necrolysis (TEN), Stevens- Johnson syndrome (SJS), dermatitis exfoliative, erythema multiforme, and acute generalized exanthematous pustulosis (AGEP); if patients develop skin rash monitor closely and discontinued therapy if lesions progress

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Pregnancy & Lactation

Pregnancy category: B

Lactation: Excreted in breast milk; use caution

Pregnancy Categories

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Pharmacology

Mechanism of Action

Drug combination of beta-lactamase inhibitor with ampicillin; interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms; alternative to amoxicillin when unable to take medication orally; covers skin, enteric flora, and anaerobes; not ideal for nosocomial pathogens.

Absorption

Ampicillin

  • Bioavailability: 30-40%
  • Peak plasma time: 1-2 hr (oral)

Distribution

Ampicillin

  • Protein bound: 15-25%
  • Blister and tissue fluids, bile, and CSF with inflamed meninges

Sulbactam

  • Protein bound: 38%
  • Bile, blister, and tissue fluids

Metabolism

Ampicillin and sulbactam

  • Liver

Elimination

Ampicillin

  • Half-life: 1-1.8 hr (normal renal function); 7-20 hr (anuria/end-stage renal disease)
  • Excretion: Urine (90% within 24 hr)

Sulbactam

  • Half-life: 1-1.3 hr
  • Excretion: Urine (75-85%)

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Administration

IV Incompatibilities vfend renal dosing for cipro

Additive: Aminoglycosides, ciprofloxacin

Y-site: Aminoglycosides, amiodarone, amphotericin B cholesteryl sulfate, ciprofloxacin, cisatracurium(?), diltiazem(?), idarubicin, nicardipine, ondansetron, sargramostim

IV Compatibilities

Solution: NS

Additive: Aztreonam

Y-site: Amifostine, aztreonam, bivalirudin, cefepime, dexmedetomidine, docetaxel, enalaprilat, etoposide PO4, famotidine, fenoldopam, filgrastim, fluconazole, fludarabine, gatifloxacin, gemcitabine, granisetron, heparin, Hextend, insulin, linezolid, meperidine, morphine, paclitaxel, remifentanil, tacrolimus, teniposide, theophylline, thiotepa, vancomycin

IV/IM Preparation

Reconstitute with SWI or 0.5% or 2% lidocaine injection (IM) to obtain a 250 mg ampicillin-125 mg sulbactam/mL solution

IM: Use within 1 hr after preparation

IV: Further dilute to 3-45 mg/mL with appropriate diluent

Use NS for IV piggyback

IV: Use within 8 hr after preparation

IV/IM Administration

Administer around-the-clock to promote less variation in peak and trough serum levels

Slow IV injection over at least 10-15 min or infusion over 15-30 min

IM: Deep into large muscle mass

Storage

Store intact vials <30°C

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Patient Handout

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Formulary

FormularyPatient Discounts

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Create Your List of Plans

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Plans
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