Ampicillin

Section 1.1

Midwives may independently prescribe, order and administer this drug.

A broad spectrum anti-microbial synthetic Penicillin inhibiting bacterial cell wall synthesis. It is an antibacterial agent with a broad spectrum of bactericidal activity against Penicillin-susceptible Gram-positive organisms and other common Gram-negative pathogens.

Indications and Clinical Use:

Intravenous Ampicillin for intrapartum chemophophylaxis against GBS infection.

Contraindications:

Hypersensitivity to Ampicillin or any other component of the formulation or to other penicillins.

Warnings and Precautions:

*Clostridium difficile associated diarrhea (CDAD) has been reported and can occur over two months after the use of many antibacterial agents, including Ampicillin. CDAD ranges in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon which in turn leads to the overgrowth of C. difficile.

Use with caution in asthmatic and renal impaired patients.

Breastfed infants may develop slightly looser stools than normal.

Pregnancy Category:

Human Data Suggests Risk in the 1st Trimester

Lactation Category:

Category L1 – Compatible

Adverse Reactions:

Fever, rash, nausea and vomiting, penicillin encephalopathy and seizure.

Dosage and Administration:

IV: 2 g initial dose followed by 1 g every 4 hours until delivery.
Administer over 10-15 minutes (1-2 g).

Onset of Action:

Peak serum concentrations occur immediately once administration is complete.

Half-life:

0.7-1.5 hours in adults. Serum concentrations may still be detectable within 6 hours of administration.