Ampicillin/sulbactam:

Intravenous penicillin

ECMO Dose Adjustment:

YES—dose at the higher end of the normal dosing range due to potential for sequestration

Renal Impairment Dose Adjustment*:

YES—a decreased dose may be warranted in some patients

CRRT Dose Adjustment:

YES—the dose may need to be increased relative to the renal impairment dose

Hepatic Impairment Dose Adjustment:

NONE

Adult Dose:

3 g IV every 6 hours

Pediatric Dose¹:

100–200 mg ampicillin/kg/day IV divided every 6 hours; maximum 3 g/dose (2 g ampicillin/1 g sulbactam), 12 g/day (8 g ampicillin/4 g sulbactam)

Neonatal Dose²:

Gestational Age ≤ 34 weeks:

Gestational Age > 34 weeks:

*Dose adjustment will be dependent on acuity and severity of impairment

¹Meningitis: 200–400 mg ampicillin/kg/day IV divided every 6 hours, maximum 12 g/day of ampicillin

²Meningitis: Postnatal Age ≤ 7 days: 100 mg ampicillin/kg/dose IV every 8 hours; Postnatal Age > 7 days: 75 mg ampicillin/kg/dose IV every 6 hours