erythematous rashes).glandular fever (erythematous
rashes common)
SPECIFIC CAUTIONS
▶With intravenous useAccumulation of electrolytes
contained in parenteral preparations can occur with high
doses
lINTERACTIONS→Appendix 1 : penicillins
lSIDE-EFFECTSColitis haemorrhagic.purpura
lPREGNANCYNot known to be harmful.
lBREAST FEEDINGTrace amounts in milk, but appropriate
to use.
lRENAL IMPAIRMENT
▶With intravenous useAccumulation of electrolytes
contained in parenteral preparations can occur in patients
with renal failure.
Dose adjustmentsIf estimated glomerularfiltration rate
less than 10 mL/minute/ 1. 73 m^2 reduce dose or frequency;
rashes more common.
lDIRECTIONS FOR ADMINISTRATION
▶With oral useAdminister at least 30 minutes before food.
▶With intravenous useDisplacement value may be significant
when reconstituting injection, consult local guidelines.
Dilute intravenous injection to a concentration of
50 – 100 mg/mL. May be further diluted with glucose 5 %or
10 %orsodium chloride 0. 9 %or 0. 45 % for infusion. Give
over 30 minutes when using doses of greater than
50 mg/kg to avoid CNS toxicity including convulsions.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Ampicillin for bacterial
infectionwww.medicinesforchildren.org.uk/ampicillin-
bacterial-infectionlMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Oral suspension
CAUTIONARY AND ADVISORY LABELS9, 23
▶Ampicillin (Non-proprietary)
Ampicillin 25 mg per 1 mlAmpicillin 125 mg/ 5 ml oral suspension|
100 mlP£ 29. 86 DT = £ 29. 86
Ampicillin 50 mg per 1 mlAmpicillin 250 mg/ 5 ml oral suspension|
100 mlP£ 38. 86 DT = £ 38. 86
Capsule
CAUTIONARY AND ADVISORY LABELS9, 23
▶Ampicillin (Non-proprietary)
Ampicillin 250 mgAmpicillin 250 mg capsules| 28 capsuleP
£ 20. 50 DT = £ 20. 50
Ampicillin 500 mgAmpicillin 500 mg capsules| 28 capsuleP
£ 40. 30 DT = £ 40. 30
Powder for solution for injection
▶Ampicillin (Non-proprietary)
Ampicillin (as Ampicillin sodium) 500 mgAmpicillin 500 mg
powder for solution for injection vials| 10 vialP£ 78. 30 DT =
£ 78. 30
eiiiiF 336Co-fluampicil
lINDICATIONS AND DOSE
Mixed infections involving beta-lactamase-producing
staphylococci
▶BY MOUTH
▶Child 1 month–9 years: 125 / 125 mg every 6 hours
▶Child 10–17 years: 250 / 250 mg every 6 hours
▶BY INTRAMUSCULAR INJECTION, OR BY SLOW INTRAVENOUS
INJECTION, OR BY INTRAVENOUS INFUSION
▶Child 1 month–1 year: 62. 5 / 62. 5 mg every 6 hours
▶Child 2–9 years: 125 / 125 mg every 6 hours
▶Child 10–17 years: 250 / 250 mg every 6 hoursSevere mixed infections involving beta-lactamase-
producing staphylococci
▶BY MOUTH
▶Child 1 month–9 years: 250 / 250 mg every 6 hours
▶Child 10–17 years: 500 / 500 mg every 6 hours
▶BY INTRAMUSCULAR INJECTION, OR BY SLOW INTRAVENOUS
INJECTION, OR BY INTRAVENOUS INFUSION
▶Child 1 month–1 year: 125 / 125 mg every 6 hours
▶Child 2–9 years: 250 / 250 mg every 6 hours
▶Child 10–17 years: 500 / 500 mg every 6 hoursIMPORTANT SAFETY INFORMATION
HEPATIC DISORDERS
Cholestatic jaundice and hepatitis may occur very rarely,
up to two months after treatment withflucloxacillin has
been stopped. Administration for more than 2 weeks and
increasing age are risk factors. Healthcare professionals
are reminded that:
.flucloxacillin should not be used in patients with a
history of hepatic dysfunction associated with
flucloxacillin;
.flucloxacillin should be used with caution in patients
with hepatic impairment;
.careful enquiry should be made about hypersensitivity
reactions to beta-lactam antibacterials.lCAUTIONS
GENERAL CAUTIONSAcute lymphocytic leukaemia
(increased risk of erythematous rashes).chronic
lymphocytic leukaemia (increased risk of erythematous
rashes).cytomegalovirus infection (increased risk of
erythematous rashes).glandular fever (erythematous
rashes common)
SPECIFIC CAUTIONS
▶With intravenous useAccumulation of electrolytes
contained in parenteral preparations can occur with high
doses.risk of kernicterus in jaundiced neonates when high
doses given parenterally
lINTERACTIONS→Appendix 1 : penicillins
lSIDE-EFFECTSArthralgia.bronchospasm.coma.
dyspnoea.electrolyte imbalance.eosinophilia.erythema
nodosum.gastrointestinal disorder.hallucination.
Jarisch-Herxheimer reaction.myalgia.purpura non-
thrombocytopenic.vasculitis
lPREGNANCYNot known to be harmful.
lBREAST FEEDINGTrace amount in milk, but appropriate to
use.
lHEPATIC IMPAIRMENTUse with caution.
lRENAL IMPAIRMENT
▶With intravenous useAccumulation of electrolytes
contained in parenteral preparations can occur in patients
with renal failure.
Dose adjustmentsReduce dose or frequency if estimated
glomerularfiltration rate less than 10 mL/minute/ 1. 73 m^2 ;
rashes more common.
lEFFECT ON LABORATORY TESTSFalse-positive urinary
glucose (if tested for reducing substances).
lPRESCRIBING AND DISPENSING INFORMATIONDose
expressed as a combination of equal parts by mass of
flucloxacillin and ampicillin.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Oral suspension
CAUTIONARY AND ADVISORY LABELS9, 22
▶Co-fluampicil (Non-proprietary)
Ampicillin (as Ampicillin trihydrate) 25 mg per 1 ml, Flucloxacillin
(as Flucloxacillin magnesium) 25 mg per 1 mlCo-fluampicil
125 mg/ 125 mg/ 5 ml oral suspension| 100 mlP£ 23. 93 DT =
£ 23. 93342 Bacterial infection BNFC 2018 – 2019
Infection5