Ampicillin

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take this medicine with a full glass of water.

Take ampicillin on an empty stomach, at least 30 minutes before or 2 hours after a meal.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not share this medicine with another person, even if they have the same symptoms you have.

If you are being treated for gonorrhea, your doctor may also have you tested for syphilis, another sexually transmitted disease.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Ampicillin will not treat a viral infection such as the flu or a common cold.

This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using ampicillin.

Store at room temperature away from moisture, heat, and light.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Usual Adult Dose for Bacterial Infection:

The manufacturer recommends:
Parenteral:
-Infections of the respiratory tract and soft tissues: 250 to 500 mg IM or IV every 6 hours
-Infections of the gastrointestinal and genitourinary tracts (including Neisseria gonorrhoeae infections in females): 500 mg IM or IV every 6 hours
-Urethritis in males due to N gonorrhoeae: 500 mg IM or IV every 8 to 12 hours for 2 doses
-Bacterial meningitis: 150 to 200 mg/kg/day in equally divided doses every 3 to 4 hours; may start with IV drip therapy and continue with IM injections
-Septicemia: 150 to 200 mg/kg/day; start with IV administration for at least 3 days and continue with IM route every 3 to 4 hours

Oral:
-Genitourinary or gastrointestinal tract infections (other than gonorrhea): 500 mg orally every 6 hours
-Gonorrhea: 3.5 g orally as a single dose (plus probenecid 1 g)
-Respiratory tract infections: 250 mg orally every 6 hours

Approved indications:
-Parenteral: Respiratory tract Infections, bacterial meningitis, septicemia, endocarditis, urinary tract infections, gastrointestinal infections
-Oral: Genitourinary tract infections (including gonorrhea), respiratory tract infections, gastrointestinal tract infections, and meningitis

Some experts recommend:
Parenteral: 1 to 2 g IM or IV every 4 to 6 hours or 50 to 250 mg/kg/day IM or IV in divided doses
Maximum dose: 12 g/day

Oral: 250 to 500 mg orally every 6 hours

Usual Adult Dose for Endocarditis:

The manufacturer gives no specific dosing instructions.

Approved indications:
-Parenteral: Endocarditis due to susceptible gram-positive organisms including Streptococcus species, penicillin G-susceptible staphylococci, and enterococci

American Heart Association (AHA) recommendations for patients with normal renal function:
Native valve or prosthetic valve infections due to susceptible enterococci: Ampicillin 2 g IV every 4 hours plus gentamicin or streptomycin (if gentamicin resistant)

Duration of therapy:
-Native valve: 4 weeks (symptoms for less than 3 months) or 6 weeks (symptoms for at least 3 months)
-Prosthetic valve: At least 6 weeks

Native valve or prosthetic valve infections due to Enterococcus faecalis strains resistant to penicillin, aminoglycoside, and vancomycin: Ampicillin 2 g IV every 4 hours plus imipenem-cilastatin or ceftriaxone
Duration of therapy: At least 8 weeks

Infections due to susceptible strains of Escherichia coli or Proteus mirabilis: Ampicillin 2 g IV every 4 hours plus an aminoglycoside (usually gentamicin)

Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

(Not approved by FDA)

AHA recommendations: 2 g IM or IV as a single dose 30 to 60 minutes before procedure

Comments:
-Recommended for patients unable to take oral medication.
-Antibiotic prophylaxis may be used for dental procedures (involving manipulation of gingival tissues or periapical region of teeth or perforation of oral mucosa), respiratory tract procedures, or procedures on infected skin, skin structures, or musculoskeletal tissue only for patients with the highest risk of infective endocarditis.

Usual Adult Dose for Meningitis:

The manufacturer recommends: 150 to 200 mg/kg/day IV in equally divided doses every 3 to 4 hours

Comments:
-Therapy may be started with IV administration and continued with IM injections.

Approved indications:
-Parenteral: Bacterial meningitis due to E coli, group B streptococci, and other gram-negative bacteria (Listeria monocytogenes, N meningitidis)
-Oral: Meningitis due to N meningitidis

Some experts recommend:
IV: 200 mg/kg/day IV in equally divided doses every 4 hours, in combination with other parenteral antibiotics
Maximum dose: 12 g/day

Intrathecal or intraventricular: 10 to 50 mg/day in addition to IV antibiotics

Usual Adult Dose for Septicemia:

The manufacturer recommends: 150 to 200 mg/kg/day

Comments:
-Start with IV administration for at least 3 days and continue with the IM route every 3 to 4 hours

Approved indications:
-Parenteral: Septicemia due to susceptible gram-positive organisms including Streptococcus species, penicillin G-susceptible staphylococci, and enterococci; gram-negative sepsis due to E coli, P mirabilis, and Salmonella species

Some experts recommend: 1 to 2 g IV every 3 to 4 hours, in combination with other antibiotics

Usual Adult Dose for Gastroenteritis:

The manufacturer recommends: 500 mg orally or IM or IV every 6 hours

Comments:
-Severe, chronic, or stubborn infections may require larger doses.

Approved indications:
-Parenteral: Gastrointestinal infections due to Salmonella species (including S typhi) and Shigella species
-Oral: Gastrointestinal tract infections due to Shigella, Salmonella species (including S typhi), E coli, P mirabilis, and enterococci

Some experts recommend: 250 to 500 mg orally every 6 hours

Usual Adult Dose for Intraabdominal Infection:

The manufacturer recommends: 500 mg orally or IM or IV every 6 hours

Comments:
-Severe, chronic, or stubborn infections may require larger doses.

Approved indications:
-Parenteral: Gastrointestinal infections due to Salmonella species (including S typhi) and Shigella species
-Oral: Gastrointestinal tract infections due to Shigella, Salmonella species (including S typhi), E coli, P mirabilis, and enterococci

Some experts recommend: 1 to 2 g IV every 4 to 6 hours in combination with other antibiotics, depending on the nature and severity of the infection
Duration of therapy: 10 to 14 days

Usual Adult Dose for Skin or Soft Tissue Infection:

The manufacturer recommends: 250 to 500 mg IM or IV every 6 hours
Some experts recommend: 250 to 500 mg orally every 6 hours or 1 to 2 g IV every 4 to 6 hours, depending on the nature and severity of the infection

Usual Adult Dose for Pharyngitis:

The manufacturer recommends:
Parenteral: 250 to 500 mg IM or IV every 6 hours
Oral: 250 mg orally every 6 hours

Approved indications:
Parenteral: Respiratory tract infections due to Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Group A beta-hemolytic streptococci
Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Some experts recommend: 500 mg orally or 1 to 2 g IM or IV every 6 hours, depending on the nature and severity of the infection

Usual Adult Dose for Sinusitis:

The manufacturer recommends:
Parenteral: 250 to 500 mg IM or IV every 6 hours
Oral: 250 mg orally every 6 hours

Approved indications:
Parenteral: Respiratory tract infections due to Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Group A beta-hemolytic streptococci
Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Some experts recommend: 500 mg orally or 1 to 2 g IM or IV every 6 hours, depending on the nature and severity of the infection

Usual Adult Dose for Upper Respiratory Tract Infection:

The manufacturer recommends:
Parenteral: 250 to 500 mg IM or IV every 6 hours
Oral: 250 mg orally every 6 hours

Approved indications:
Parenteral: Respiratory tract infections due to Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Group A beta-hemolytic streptococci
Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Some experts recommend: 500 mg orally or 1 to 2 g IM or IV every 6 hours, depending on the nature and severity of the infection

Usual Adult Dose for Pneumonia:

The manufacturer recommends:
Parenteral: 250 to 500 mg IM or IV every 6 hours
Oral: 250 mg orally every 6 hours

Approved indications:
Parenteral: Respiratory tract infections due to S pneumoniae, S aureus, H influenzae, and Group A beta-hemolytic streptococci
Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Some experts recommend:
Beta-lactamase negative, penicillin-susceptible: 1 to 2 g IV every 4 to 6 hours, in combination with other antibiotic(s) depending on the nature and severity of the infection

Usual Adult Dose for Bronchitis:

The manufacturer recommends:
Parenteral: 250 to 500 mg IM or IV every 6 hours
Oral: 250 mg orally every 6 hours

Approved indications:
Parenteral: Respiratory tract infections due to S pneumoniae, S aureus, H influenzae, and Group A beta-hemolytic streptococci
Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Some experts recommend:
Bacterial exacerbations of chronic bronchitis: 250 to 500 mg orally every 6 hours for 5 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Urinary Tract Infection:

The manufacturer recommends: 500 mg orally or IM or IV every 6 hours

Comments:
-Severe, chronic, or stubborn infections may require larger doses.

Approved indications:
-Parenteral: Urinary tract infections due to sensitive strains of E coli and P mirabilis
-Oral: Genitourinary tract infections due to E coli, P mirabilis, enterococci, Shigella, Salmonella species (including S typhi)

Some experts recommend:
Mild, uncomplicated: 250 to 500 mg orally every 6 hours
Severe, complicated: 500 mg to 2 g IV every 4 to 6 hours with or without other antibiotics, depending on the nature and severity of the infection

Usual Adult Dose for Pyelonephritis:

The manufacturer recommends: 500 mg orally or IM or IV every 6 hours

Comments:
-Severe, chronic, or stubborn infections may require larger doses.

Approved indications:
-Parenteral: Urinary tract infections due to sensitive strains of E coli and P mirabilis
-Oral: Genitourinary tract infections due to E coli, P mirabilis, enterococci, Shigella, Salmonella species (including S typhi)

Some experts recommend: 500 mg to 2 g IM or IV every 4 to 6 hours with or without other antibiotics, depending on the nature and severity of the infection
Duration of therapy: 2 to 3 weeks

Usual Adult Dose for Shigellosis:

The manufacturer recommends: 500 mg orally or IM or IV every 6 hours

Comments:
-Severe, chronic, or stubborn infections may require larger doses.

Approved indications: Gastrointestinal tract infections due to Shigella species

Some experts recommend: 500 mg orally every 6 hours for 5 days

Usual Adult Dose for Typhoid Fever:

The manufacturer recommends: 500 mg orally or IM or IV every 6 hours

Comments:
-Severe, chronic, or stubborn infections may require larger doses.

Approved indications: Gastrointestinal tract infections due to Salmonella species (including S typhi)

Some experts recommend:
Severe, fully susceptible: 25 mg/kg IM or IV every 6 hours for 10 to 14 days
Carrier state: 1.5 g orally or IV with probenecid 500 mg every 6 hours for 6 weeks

Comments:
-Fluoroquinolones or amoxicillin are considered the drugs of choice.

Usual Adult Dose for Prevention of Perinatal Group B Streptococcal Disease:

(Not approved by FDA)

Centers for Disease Control and Prevention (CDC) recommendations: 2 g IV initial dose, then 1 g IV every 4 hours until delivery

Comments:
-Ampicillin is recommended as an alternative to penicillin G.

Usual Adult Dose for Surgical Prophylaxis:

(Not approved by FDA)

Liver transplant: Ampicillin 1 g IV plus cefotaxime 1 g IV at induction of anesthesia, then every 6 hours during procedure and for 48 hours after final surgical closure

Usual Adult Dose for Leptospirosis:

(Not approved by FDA)

Some experts recommend:
Mild: 500 to 750 mg orally every 6 hours
Moderate to severe: 0.5 to 1 g IV every 6 hours

Usual Adult Dose for Peritonitis:

(Not approved by FDA)

Some experts recommend:
CAPD-associated peritonitis: 250 to 500 mg orally twice a day and/or 100 to 125 mg/L exchange intraperitoneally, with or without other antibiotics depending on the nature and severity of the infection
Secondary: 1 to 2 g IV every 4 to 6 hours in combination with other antibiotics, depending on the nature and severity of the infection
Duration of therapy: 10 to 14 days

Usual Adult Dose for Otitis Media:

(Not approved by FDA)

Some experts recommend: 500 mg orally or 1 to 2 g IM or IV every 6 hours, depending on the nature and severity of the infection

Usual Pediatric Dose for Bacterial Infection:

American Academy of Pediatrics (AAP) General Dosing Recommendations for Susceptible Infections:
Neonates:
7 days or less, 2000 g or less: 50 mg/kg IM or IV every 12 hours
7 days or less, greater than 2000 g: 50 mg/kg IM or IV every 8 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

1 month or older:
Mild to moderate infections:
Parenteral: 25 to 37.5 mg/kg IM or IV every 6 hours
Oral: 12.5 to 25 mg/kg orally every 6 hours
Maximum dose: 4 g/day

Severe infections: 50 to 100 mg/kg IM or IV every 6 hours
Maximum dose: 12 g/day

The Manufacturer Recommends:
Parenteral:
-Infections of the respiratory tract and soft tissues:
Less than 40 kg: 25 to 50 mg/kg/day IM or IV in equally divided doses every 6 to 8 hours
40 kg or more: 250 to 500 mg IM or IV every 6 hours

-Infections of the gastrointestinal and genitourinary tracts (including N gonorrhoeae infections in females):
Less than 40 kg: 50 mg/kg/day IM or IV in equally divided doses every 6 to 8 hours
40 kg or more: 500 mg IM or IV every 6 hours

-Bacterial meningitis:
Children: 150 to 200 mg/kg/day in equally divided doses every 3 to 4 hours; may start with IV drip therapy and continue with IM injections

-Septicemia:
Children: 150 to 200 mg/kg/day; start with IV administration for at least 3 days and continue with IM route every 3 to 4 hours

Oral:
-Genitourinary or gastrointestinal tract infections:
20 kg or less: 25 mg/kg orally every 6 hours
Greater than 20 kg: 500 mg orally every 6 hours

-Respiratory tract infections:
20 kg or less: 50 mg/kg/day orally in equally divided doses every 6 to 8 hours
Greater than 20 kg: 250 mg orally every 6 hours

Comments:
-Pediatric doses should not exceed recommended adult doses.

Approved indications:
-Parenteral: Respiratory tract Infections, bacterial meningitis, septicemia, endocarditis, urinary tract infections, gastrointestinal infections
-Oral: Genitourinary tract infections (including gonorrhea), respiratory tract infections, gastrointestinal tract infections, and meningitis

Usual Pediatric Dose for Bacteremia:

AAP Recommendations:
Group B streptococcal bacteremia (presumed or proven):
Neonates:
7 days or younger, 2000 g or less: 100 mg/kg IM or IV every 12 hours
7 days or younger, greater than 2000 g: 50 mg/kg IM or IV every 8 hours or 100 mg/kg IM or IV every 12 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

Duration of therapy: At least 10 days for treatment of bacteremia without defined focus

The Manufacturer Recommends:
Children: 150 to 200 mg/kg/day

Comments:
-Start with IV administration for at least 3 days and continue with the IM route every 3 to 4 hours

Approved indications:
-Parenteral: Septicemia due to susceptible gram-positive organisms including Streptococcus species, penicillin G-susceptible staphylococci, and enterococci; gram-negative sepsis due to E coli, P mirabilis, and Salmonella species

Usual Pediatric Dose for Septicemia:

AAP Recommendations:
Group B streptococcal bacteremia (presumed or proven):
Neonates:
7 days or younger, 2000 g or less: 100 mg/kg IM or IV every 12 hours
7 days or younger, greater than 2000 g: 50 mg/kg IM or IV every 8 hours or 100 mg/kg IM or IV every 12 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

Duration of therapy: At least 10 days for treatment of bacteremia without defined focus

The Manufacturer Recommends:
Children: 150 to 200 mg/kg/day

Comments:
-Start with IV administration for at least 3 days and continue with the IM route every 3 to 4 hours

Approved indications:
-Parenteral: Septicemia due to susceptible gram-positive organisms including Streptococcus species, penicillin G-susceptible staphylococci, and enterococci; gram-negative sepsis due to E coli, P mirabilis, and Salmonella species

Usual Pediatric Dose for Meningitis:

AAP Recommendations:
Neonates:
Group B streptococcal meningitis:
7 days or younger: 50 to 100 mg/kg IV every 8 hours; some experts recommend 75 mg/kg IV every 6 hours
Older than 7 days: 50 to 75 mg/kg IV every 6 hours

Duration of therapy: At least 14 days (if uncomplicated)

Infants, children, adolescents: 50 to 100 mg/kg IV every 6 hours
Maximum dose: 12 g/day

The Manufacturer Recommends:
Children: 150 to 200 mg/kg/day IV in equally divided doses every 3 to 4 hours

Comments:
-Therapy may be started with IV administration and continued with IM injections.

Approved indications:
-Parenteral: Bacterial meningitis due to E coli, group B streptococci, and other gram-negative bacteria (L monocytogenes, N meningitidis)
-Oral: Meningitis due to N meningitidis

Usual Pediatric Dose for Endocarditis:

The manufacturer gives no specific dosing instructions.

Approved indications:
-Parenteral: Endocarditis due to susceptible gram-positive organisms including Streptococcus species, penicillin G-susceptible staphylococci, and enterococci

AHA Recommendations for Patients with Normal Renal Function (dosage should not exceed adult dose):
Native valve or prosthetic valve infections due to susceptible enterococci: Ampicillin 300 mg/kg/day IV in equally divided doses every 4 to 6 hours plus gentamicin or streptomycin (if gentamicin resistant)
Maximum dose: 12 g/day

Duration of therapy:
-Native valve: 4 weeks (symptoms for less than 3 months) or 6 weeks (symptoms for at least 3 months)
-Prosthetic valve: At least 6 weeks

Native valve or prosthetic valve infections due to E faecalis strains resistant to penicillin, aminoglycoside, and vancomycin: Ampicillin 300 mg/kg/day IV in equally divided doses every 4 to 6 hours plus imipenem-cilastatin or ceftriaxone
Duration of therapy: At least 8 weeks

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:

(Not approved by FDA)

AHA Recommendations:
Children: 50 mg/kg IM or IV as a single dose 30 to 60 minutes before procedure

Comments:
-Recommended for patients unable to take oral medication.
-Antibiotic prophylaxis may be used for dental procedures (involving manipulation of gingival tissues or periapical region of teeth or perforation of oral mucosa), respiratory tract procedures, or procedures on infected skin, skin structures, or musculoskeletal tissue only for patients with the highest risk of infective endocarditis.

Usual Pediatric Dose for Upper Respiratory Tract Infection:

AAP General Dosing Recommendations for Susceptible Infections:
Neonates:
7 days or less, 2000 g or less: 50 mg/kg IM or IV every 12 hours
7 days or less, greater than 2000 g: 50 mg/kg IM or IV every 8 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

1 month or older:
Mild to moderate infections:
Parenteral: 25 to 37.5 mg/kg IM or IV every 6 hours
Oral: 12.5 to 25 mg/kg orally every 6 hours
Maximum dose: 4 g/day

Severe infections: 50 to 100 mg/kg IM or IV every 6 hours
Maximum dose: 12 g/day

The Manufacturer Recommends:
Parenteral:
Less than 40 kg: 25 to 50 mg/kg/day IM or IV in equally divided doses every 6 to 8 hours
40 kg or more: 250 to 500 mg IM or IV every 6 hours

Oral:
20 kg or less: 50 mg/kg/day orally in equally divided doses every 6 to 8 hours
Greater than 20 kg: 250 mg orally every 6 hours

Comments:
-Pediatric doses should not exceed recommended adult doses.

Approved indications:
-Parenteral: Respiratory tract infections due to S pneumoniae, S aureus (penicillinase and nonpenicillinase-producing), H influenzae, and group A beta-hemolytic streptococci
-Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Usual Pediatric Dose for Pneumonia:

AAP General Dosing Recommendations for Susceptible Infections:
Neonates:
7 days or less, 2000 g or less: 50 mg/kg IM or IV every 12 hours
7 days or less, greater than 2000 g: 50 mg/kg IM or IV every 8 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

1 month or older:
Mild to moderate infections:
Parenteral: 25 to 37.5 mg/kg IM or IV every 6 hours
Oral: 12.5 to 25 mg/kg orally every 6 hours
Maximum dose: 4 g/day

Severe infections: 50 to 100 mg/kg IM or IV every 6 hours
Maximum dose: 12 g/day

Infectious Diseases Society of America (IDSA) and Pediatric Infectious Diseases Society (PIDS) Recommendations:
Community-acquired pneumonia:
Older than 3 months:
Empiric therapy, S pneumoniae (MICs for penicillin 2 mcg/mL or greater), or H influenzae (beta-lactamase negative) in fully immunized patients: 37.5 to 50 mg/kg IV every 6 hours
Group A Streptococcus: 50 mg/kg IV every 6 hours
S pneumoniae resistant to penicillin (MICs 4 mcg/mL or greater): 75 to 100 mg/kg IV every 6 hours; recommended as alternate therapy

The Manufacturer Recommends:
Parenteral:
Less than 40 kg: 25 to 50 mg/kg/day IM or IV in equally divided doses every 6 to 8 hours
40 kg or more: 250 to 500 mg IM or IV every 6 hours

Oral:
20 kg or less: 50 mg/kg/day orally in equally divided doses every 6 to 8 hours
Greater than 20 kg: 250 mg orally every 6 hours

Comments:
-Pediatric doses should not exceed recommended adult doses.

Approved indications:
-Parenteral: Respiratory tract infections due to S pneumoniae, S aureus (penicillinase and nonpenicillinase-producing), H influenzae, and group A beta-hemolytic streptococci
-Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Usual Pediatric Dose for Skin or Soft Tissue Infection:

AAP General Dosing Recommendations for Susceptible Infections:
Neonates:
7 days or less, 2000 g or less: 50 mg/kg IM or IV every 12 hours
7 days or less, greater than 2000 g: 50 mg/kg IM or IV every 8 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

1 month or older:
Mild to moderate infections:
Parenteral: 25 to 37.5 mg/kg IM or IV every 6 hours
Oral: 12.5 to 25 mg/kg orally every 6 hours
Maximum dose: 4 g/day

Severe infections: 50 to 100 mg/kg IM or IV every 6 hours
Maximum dose: 12 g/day

The Manufacturer Recommends:
Parenteral:
Less than 40 kg: 25 to 50 mg/kg/day IM or IV in equally divided doses every 6 to 8 hours
40 kg or more: 250 to 500 mg IM or IV every 6 hours

Comments:
-Pediatric doses should not exceed recommended adult doses.

Usual Pediatric Dose for Urinary Tract Infection:

AAP General Dosing Recommendations for Susceptible Infections:
Neonates:
7 days or less, 2000 g or less: 50 mg/kg IM or IV every 12 hours
7 days or less, greater than 2000 g: 50 mg/kg IM or IV every 8 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

1 month or older:
Mild to moderate infections:
Parenteral: 25 to 37.5 mg/kg IM or IV every 6 hours
Oral: 12.5 to 25 mg/kg orally every 6 hours
Maximum dose: 4 g/day

Severe infections: 50 to 100 mg/kg IM or IV every 6 hours
Maximum dose: 12 g/day

The Manufacturer Recommends:
Parenteral:
Less than 40 kg: 50 mg/kg/day IM or IV in equally divided doses every 6 to 8 hours
40 kg or more: 500 mg IM or IV every 6 hours

Oral:
20 kg or less: 25 mg/kg orally every 6 hours
Greater than 20 kg: 500 mg orally every 6 hours

Comments:
-Pediatric doses should not exceed recommended adult doses.
-Severe, chronic, or stubborn infections may require larger doses.

Approved indications:
-Parenteral: Urinary tract infections due to sensitive strains of E coli and P mirabilis
-Oral: Genitourinary tract infections due to E coli, P mirabilis, enterococci, Shigella, Salmonella species (including S typhi)

Usual Pediatric Dose for Surgical Prophylaxis:

(Not approved by FDA)

Some experts recommend:
Liver transplant:
1 month or older: Ampicillin 50 mg/kg IV plus cefotaxime 50 mg/kg IV at induction of anesthesia and every 6 hours for 48 hours after final surgical closure

Contraindications

• Known hypersensitivity to any penicillin.1 2

Warnings/Precautions

Warnings

Possible emergence and overgrowth of nonsusceptible bacteria or fungi.1 2 Discontinue and institute appropriate therapy if superinfection occurs.1 2

Treatment with anti-infectives may permit overgrowth of clostridia.1 Consider Clostridium difficile-associated diarrhea and colitis (antibiotic-associated pseudomembranous colitis) if diarrhea develops and manage accordingly.1

Some mild cases of C. difficile-associated diarrhea and colitis may respond to discontinuance alone.1 Manage moderate to severe cases with fluid, electrolyte, and protein supplementation; appropriate anti-infective therapy (e.g., oral metronidazole or vancomycin) recommended if colitis is severe.1

Sensitivity Reactions

Serious and occasionally fatal hypersensitivity reactions, including anaphylaxis, reported with penicillins.1 2 9

Prior to initiation of therapy, make careful inquiry regarding previous hypersensitivity reactions to penicillins, cephalosporins, or other drugs.1 2 Partial cross-allergenicity occurs among penicillins and other β-lactam antibiotics including cephalosporins and cephamycins.1 2

If a severe hypersensitivity reaction occurs, discontinue immediately and institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, maintenance of an adequate airway and oxygen).1 2

General Precautions

To reduce development of drug-resistant bacteria and maintain effectiveness of ampicillin and other antibacterials, use only for treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.

When selecting or modifying anti-infective therapy, use results of culture and in vitro susceptibility testing.1 2 In the absence of such data, consider local epidemiology and susceptibility patterns when selecting anti-infectives for empiric therapy.1 2

Possible increased risk of rash in patients with mononucleosis; use in these patients not recommended.

Because of increasing prevalence of ampicillin-resistant H. influenzae,5 the drug should not be used alone for empiric treatment of serious infections (e.g., meningitis, pneumonia) when H. influenzae may be involved.5 9

Periodically assess organ system functions, including renal, hepatic, and hematopoietic, during prolonged therapy.1 2

Powder for injection contains 2.9 mEq of sodium per g of ampicillin.2

Specific Populations

Category B.1 2

Distributed into milk.1 2 9 Use with caution.1 2

Renal clearance of ampicillin may be delayed in neonates and young infants because of incompletely developed renal function.1 9 Use lowest effective dosage.1

Dosage adjustments necessary in renal impairment.9 (See Renal Impairment under Dosage and Administration.)

Common Adverse Effects

GI effects (diarrhea, nausea), rash.

Storage

Oral

Tight container at 15–30°C; avoid excessive heat.1

Tight container at 15–30°C.1 After reconstitution, discard after 7 days if stored at room temperature or after 14 days if refrigerated.1

Parenteral

Solutions for IM injection or IV injection or infusion should be used within 1 hour after reconstitution and should not be frozen.2

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

• It is used to treat bacterial infections.

Use Ampicillin as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• It is given as a shot into a muscle or as an infusion into a vein over a period of time.
• It is given as a shot into a vein.

What do I do if I miss a dose?

• Call your doctor to find out what to do.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Feeling very tired or weak.
• Any unexplained bruising or bleeding.
• Fever or chills.
• Sore throat.
• Black, hairy tongue.
• Mouth irritation or mouth sores.
• It is common to have diarrhea when taking this medicine. Rarely, a very bad form of diarrhea called Clostridium difficile (C diff)–associated diarrhea (CDAD) may occur. Sometimes, this has led to a deadly bowel problem (colitis). CDAD may happen while you are taking Ampicillin or within a few months after you stop taking it. Call your doctor right away if you have stomach pain or cramps, very loose or watery stools, or bloody stools. Do not try to treat loose stools without first checking with your doctor.

Ampicillin for Injection, USP the monosodium salt of [2S-[2α,5α,6β(S*)]]-6-[(aminophenylacetyl)amino]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid, is a synthetic penicillin. It is an antibacterial agent with a broad spectrum of bactericidal activity against both penicillin-susceptible Gram-positive organisms and many common Gram-negative pathogens.

Ampicillin for Injection, USP is a white to cream-tinged, crystalline powder. The reconstituted solution is clear, colorless and free from visible particulates.

Each vial of Ampicillin for Injection, USP contains Ampicillin sodium equivalent to 125 mg, 250 mg, 500 mg, 1 gram or 2 grams Ampicillin. Ampicillin for Injection, USP contains 65.8 mg [2.9 mEq] sodium per gram Ampicillin.

It has the following molecular structure:

The molecular formula is C16H18N3NaO4S, and the molecular weight is 371.39. The pH range of the reconstituted solution is 8 to 10.

Ampicillin for Injection, USP diffuses readily into most body tissues and fluids. However, penetration into the cerebrospinal fluid and brain occurs only when the meninges are inflamed. Ampicillin is excreted largely unchanged in the urine and its excretion can be delayed by concurrent administration of probenecid. Due to maturational changes in renal function, Ampicillin half-life decreases as postmenstrual age (a sum of gestational age and postnatal age) increases for infants with postnatal age of less than 28 days. The active form appears in the bile in higher concentrations than those found in serum. Ampicillin is the least serum-bound of all the penicillins, averaging about 20% compared to approximately 60 to 90% for other penicillins. Ampicillin for Injection, USP is well-tolerated by most patients and has been given in doses of 2 grams daily for many weeks without adverse reactions.

Microbiology

While in vitro studies have demonstrated the susceptibility of most strains of the following organisms, clinical efficacy for infections other than those included in the INDICATIONS AND USAGE section has not been demonstrated.

Antibacterial Activity

The following bacteria have been shown in in vitro studies to be susceptible to Ampicillin for Injection, USP:

Gram-positive Bacteria

Hemolytic and nonhemolytic streptococci

Streptococcus pneumoniae

Nonpenicillinase-producing staphylococci

Clostridium spp.

B. anthracis

Listeria monocytogenes

Most strains of enterococci.

Gram-negative Bacteria

H. influenzae

N. gonorrhoeae

N. meningitidis

Proteus mirabilis

Many strains of Salmonella, Shigella, and E. coli.

Ampicillin does not resist destruction by penicillinase.

Diffusion Techniques

Quantitative methods that require measurement of zone diameters provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. One such standardized procedure1,2 that has been recommended for use with disks to test the susceptibility of microorganisms to Ampicillin, uses the 10 mcg Ampicillin disk. Interpretation involves correlation of the diameter obtained in the disk test with the minimum inhibitory concentration (MIC) for Ampicillin. Reports from the laboratory providing results of the standard single-disk susceptibility test with a 10 mcg Ampicillin disk should be interpreted according to the criteria provided in Table 1.

Dilution Techniques

Quantitative methods that are used to determine minimum inhibitory concentrations (MICs) provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. One such standardized procedure1,3 uses a standardized dilution method (broth or agar) or equivalent with Ampicillin powder. The MIC values obtained should be interpreted according to the criteria provided in Table 1.

Non-meningitidis S. pneumoniae isolates may be considered susceptible to Ampicillin if the isolate has a penicillin MIC of ≤0.06 mcg/mL.

Susceptibility of staphylococci to Ampicillin may be deduced from testing only penicillin and either cefoxitin or oxacillin.

A report of “Susceptible”(S) indicates that the pathogen is likely to be inhibited by usually achievable concentrations of the antimicrobial compound in the blood. A report of “Intermediate” (I) indicates that the result should be considered equivocal, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of the drug can be used. This category also provides a buffer zone that prevents small uncontrolled technical factors from causing major discrepancies in interpretation. A report of “Resistant” (R) indicates that the pathogen is not likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable; other therapy should be selected.

Quality Control

Standardized susceptibility test procedures require the use of laboratory control microorganisms1,2,3.

The 10 mcg Ampicillin disk and the standard Ampicillin powder should provide respectively the following zone diameters and MIC values in these laboratory test quality control strains:

General

The possibility of superinfections with mycotic organisms or bacterial pathogens should be kept in mind during therapy. In such cases, discontinue the drug and substitute appropriate treatment.

A high percentage (43 to 100 percent) of patients with infectious mononucleosis who receive Ampicillin develop a skin rash. Typically, the rash appears 7 to 10 days after the start of oral Ampicillin therapy and remains for a few days to a week after the drug is discontinued. In most cases, the rash is maculopapular, pruritic, and generalized. Therefore, the administration of Ampicillin is not recommended in patients with mononucleosis. It is not known whether these patients are truly allergic to Ampicillin.

Prescribing Ampicillin for injection in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Information for Patients

Patients should be counseled that antibacterial drugs including Ampicillin should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Ampicillin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may: (1) decrease the effectiveness of the immediate treatment, and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by Ampicillin or other antibacterial drugs in the future.

Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of the antibiotic. If this occurs, patients should contact their physician as soon as possible.

Laboratory Tests

As with any potent drug, periodic assessment of organ system function, including renal, hepatic, and hematopoietic, should be made during prolonged therapy.

Transient elevation of serum transaminase has been observed following administration of Ampicillin. The significance of this finding is not known.

Drug Interactions

The concurrent administration of allopurinol and Ampicillin increases substantially the incidence of skin rashes in patients receiving both drugs as compared to patients receiving Ampicillin alone. It is not known whether this potentiation of Ampicillin rashes is due to allopurinol or the hyperuricemia present in these patients.

Drug/Laboratory Test Interactions

With high urine concentrations of Ampicillin, false-positive glucose reactions may occur if Clinitest, Benedict’s Solution, or Fehling’s Solution are used. Therefore, it is recommended that glucose tests based on enzymatic glucose oxidase reactions (such as Clinistix or Tes-Tape) be used.

Carcinogenesis, Mutagenesis, and Impairment of Fertility

No long-term animal studies have been conducted with this drug.

Pregnancy Category B

Reproduction studies have been performed in laboratory animals at doses several times the human dose and have revealed no evidence of adverse effects due to Ampicillin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Labor and Delivery

Oral Ampicillin-class antibiotics are poorly absorbed during labor. Studies in guinea pig showed that intravenous administration of Ampicillin slightly decreased the uterine tone and frequency of contractions, but moderately increased the height and duration of contractions. However, it is not known whether use of these drugs in humans during labor or delivery has immediate or delayed adverse effects on the fetus, prolongs the duration of labor, or increases the likelihood that forceps delivery or other obstetrical intervention or resuscitation of the newborn will be necessary.

Nursing Mothers

Ampicillin is excreted in trace amounts in human milk. Therefore, caution should be exercised when Ampicillin-class antibiotics are administered to a nursing woman.

Pediatric Use

Guidelines for the administration of these drugs to children, including neonates are presented in DOSAGE AND ADMINISTRATION section.

Clinitest is a registered trademark of Miles, Inc.

Clinistix is a registered trademark of Bayer Corporation.

Tes-Tape is a registered trademark of Eli Lilly Company.

Manufactured in Austria by Sandoz GmbH

Rev. August 2017

Usual dosage range:

Oral: 250 to 500 mg every 6 hours

IM, IV: 1 to 2 g every 4 to 6 hours or 50 to 250 mg/kg/day in divided doses (maximum: 12 g/day)

Endocarditis, treatment (off-label dose; AHA [Baddour 2015]): IV:

Enterococcus, native or prosthetic valve (penicillin/gentamicin-susceptible strains): 2 g every 4 hours with concomitant ceftriaxone for 6 weeks or 2 g every 4 hours with concomitant gentamicin for 4 to 6 weeks (4 weeks for native valve and symptoms present <3 months; 6 weeks for native valve and symptoms present ≥3 months or for prosthetic valve)

Enterococcus, native or prosthetic valve (penicillin-susceptible/aminoglycoside-resistant strains): 2 g every 4 hours with concomitant ceftriaxone for 6 weeks

Enterococcus, native or prosthetic valve (penicillin-susceptible/gentamicin-resistant/streptomycin-susceptible strains): 2 g every 4 hours with concomitant streptomycin for 4 to 6 weeks (4 weeks for native valve and symptoms present <3 months; ≥6 weeks for native valve and symptoms present ≥3 months or prosthetic valve).

HACEK organisms, native or prosthetic valve (off-label use): 2 g every 4 hours for 4 weeks (native valve) or 6 weeks (prosthetic valve).

Viridans group streptococcus (VGS) and S. bovis:

Native valve: Highly penicillin-susceptible (MIC ≤0.12 mcg/mL): 2 g every 4 hours for 4 weeks (monotherapy) or for 2 weeks with concomitant gentamicin

Native valve: Relatively penicillin-resistant (MIC >0.12 to <0.5 mcg/mL): 2 g every 4 hours for 4 weeks with concomitant gentamicin for the first 2 weeks

Prosthetic valve: Highly penicillin-susceptible (MIC ≤0.12 mcg/mL): 2 g every 4 hours for 6 weeks (with or without concomitant gentamicin for the first 2 weeks)

Prosthetic valve: Relatively or fully penicillin-resistant (MIC >0.12 mcg/mL): 2 g every 4 hours with concomitant gentamicin for 6 weeks

Endocarditis, prophylaxis (off-label use):

Dental, oral, or respiratory tract procedures: IM, IV: 2 g within 30 to 60 minutes prior to procedure in patients not allergic to penicillin and unable to take oral amoxicillin. IM injections should be avoided in patients who are receiving anticoagulant therapy. In these circumstances, orally administered regimens should be given whenever possible. Intravenously administered antibiotics should be used for patients who are unable to tolerate or absorb oral medications. Note: American Heart Association (AHA) guidelines now recommend prophylaxis only in patients undergoing invasive procedures and in whom underlying cardiac conditions may predispose to a higher risk of adverse outcomes should infection occur (Wilson 2007).

Genitourinary and gastrointestinal tract procedures: IM, IV: Note: Routine prophylaxis for GI/GU procedures is no longer recommended by the AHA. Consider only in patients with the highest risk of adverse outcome from endocarditis (eg, prosthetic heart valve, previous endocarditis, some categories of congenital heart disease, cardiac valvulopathy in cardiac transplant patients) who have an established GI or GU enterococcal infection or for those already receiving antibiotic therapy to prevent a wound infection or sepsis associated with a GI or GU procedure in which enterococcal coverage is desired (Wilson 2007).

High-risk patients: 2 g within 30 minutes prior to procedure, followed by ampicillin 1 g (or amoxicillin 1 g orally) 6 hours later; must be used in combination with gentamicin (Dajani 1997).

Moderate-risk patients: 2 g within 30 minutes prior to procedure (Dajani 1997).

Genitourinary or gastrointestinal infections: Oral, IM, IV: 500 mg every 6 hours

Group B streptococcus (maternal dose for neonatal prophylaxis) (off-label use): IV: 2 g initial dose, then 1 g every 4 hours until delivery (CDC 2010)

Listeria infections (off-label dosing; Lorber, 1997): IV:

Bacteremia: 200 mg/kg/day divided every 6 hours for ≥2 weeks

Brain abscess or rhombencephalitis: 200 mg/kg/day divided every 4 hours with concomitant aminoglycoside for ≥6 weeks

Endocarditis: 200 mg/kg/day divided every 6 hours with concomitant aminoglycoside for ≥4 to 6 weeks

Meningitis: 200 mg/kg/day divided every 4 hours with concomitant aminoglycoside for ≥3 weeks

Mild to moderate infections: Oral: 250 to 500 mg every 6 hours

Osteomyelitis, native vertebral (off-label use): Enterococcus spp (penicillin-susceptible): IV: 12 g continuous infusion every 24 hours or 2 g every 4 hours for 6 weeks; the addition of an aminoglycoside for 4 to 6 weeks is recommended in patients with infective endocarditis (IDSA [Berbari 2015])

Prosthetic joint infection, Enterococcus spp (penicillin-susceptible) (off-label use): IV: 12 g continuous infusion every 24 hours or 2 g every 4 hours for 4 to 6 weeks; consider addition of aminoglycoside (Osmon, 2013).

Prophylaxis in total joint replacement patients undergoing dental procedures which produce bacteremia (off-label use): Note: In general, patients with prosthetic joint implants do not require prophylactic antibiotics prior to dental procedures. In planning an invasive oral procedure, dental consultation with the patient's orthopedic surgeon may be advised to review the risks of infection (Sollecito 2015).

IM, IV: 2 g 1 hour prior to procedure (ADA/AAOS 2003).

Respiratory tract infections:

Oral: 250 mg 4 times daily

IM, IV: 250 to 500 mg every 6 hours

Sepsis/meningitis: IM, IV: Note: administer doses IV initially; IM may be used later in therapy course: 150 to 200 mg/kg/day divided every 3 to 4 hours (range: 6 to 12 g/day)

Surgical (perioperative) prophylaxis in liver transplantation (off-label use): IV: 2 g within 60 minutes prior to surgery in combination with cefotaxime. Doses may be repeated in 2 hours if procedure is lengthy or if there is excessive blood loss (Bratzler, 2013).

Urinary tract infections (ampicillin-susceptible Enterococcus; off-label use): IV: 1 to 2 g every 4 to 6 hours with or without an aminoglycoside (Heintz 2010)

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience nausea, vomiting, or diarrhea. Have patient report immediately to prescriber severe loss of strength and energy; bruising; bleeding; chills; pharyngitis; black, hairy tongue; mouth irritation; mouth sores; or signs of Clostridium difficile (C. diff)-associated diarrhea (abdominal pain or cramps, severe diarrhea or watery stools, or bloody stools) (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

Commonly reported side effects of ampicillin include: eosinophilia and skin rash. See below for a comprehensive list of adverse effects.

The manufacturer recommends:
Parenteral: 250 to 500 mg IM or IV every 6 hours
Oral: 250 mg orally every 6 hours

Approved indications:
Parenteral: Respiratory tract infections due to S pneumoniae, S aureus, H influenzae, and Group A beta-hemolytic streptococci
Oral: Respiratory tract infections due to nonpenicillinase-producing H influenzae and staphylococci, and streptococci (including S pneumoniae)

Some experts recommend:
Bacterial exacerbations of chronic bronchitis: 250 to 500 mg orally every 6 hours for 5 to 10 days, depending on the nature and severity of the infection

(Not approved by FDA)

Liver transplant: Ampicillin 1 g IV plus cefotaxime 1 g IV at induction of anesthesia, then every 6 hours during procedure and for 48 hours after final surgical closure

(Not approved by FDA)

Some experts recommend:
Mild: 500 to 750 mg orally every 6 hours
Moderate to severe: 0.5 to 1 g IV every 6 hours

AAP Recommendations:
Neonates:
Group B streptococcal meningitis:
7 days or younger: 50 to 100 mg/kg IV every 8 hours; some experts recommend 75 mg/kg IV every 6 hours
Older than 7 days: 50 to 75 mg/kg IV every 6 hours

Duration of therapy: At least 14 days (if uncomplicated)

Infants, children, adolescents: 50 to 100 mg/kg IV every 6 hours
Maximum dose: 12 g/day

The Manufacturer Recommends:
Children: 150 to 200 mg/kg/day IV in equally divided doses every 3 to 4 hours

Comments:
-Therapy may be started with IV administration and continued with IM injections.

Approved indications:
-Parenteral: Bacterial meningitis due to E coli, group B streptococci, and other gram-negative bacteria (L monocytogenes, N meningitidis)
-Oral: Meningitis due to N meningitidis

AAP General Dosing Recommendations for Susceptible Infections:
Neonates:
7 days or less, 2000 g or less: 50 mg/kg IM or IV every 12 hours
7 days or less, greater than 2000 g: 50 mg/kg IM or IV every 8 hours
8 to 28 days, 2000 g or less: 50 mg/kg IM or IV every 8 hours
8 to 28 days, greater than 2000 g: 50 mg/kg IM or IV every 6 hours

1 month or older:
Mild to moderate infections:
Parenteral: 25 to 37.5 mg/kg IM or IV every 6 hours
Oral: 12.5 to 25 mg/kg orally every 6 hours
Maximum dose: 4 g/day

Severe infections: 50 to 100 mg/kg IM or IV every 6 hours
Maximum dose: 12 g/day

The Manufacturer Recommends:
Parenteral:
Less than 40 kg: 25 to 50 mg/kg/day IM or IV in equally divided doses every 6 to 8 hours
40 kg or more: 250 to 500 mg IM or IV every 6 hours

Comments:
-Pediatric doses should not exceed recommended adult doses.

Ampicillin is excreted into human milk in small amounts. Candidiasis and diarrhea in the nursing infant have been reported, although a causal relationship was not established. Sensitization of the infant may occur. The American Academy of Pediatrics considers some other penicillins (amoxicillin, ticarcillin) to be compatible with breast-feeding. The manufacturer recommends that caution be used when administering ampicillin to nursing women.