Ultracillin (Ampicillin / Sulbactam)

Disclaimer: This information is for educational purposes and is not a substitute for professional medical advice. Ultracillin is a prescription-only antibiotic that must be administered by a healthcare professional. Do not use if you have a history of allergy to penicillin.

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Ultracillin (Ampicillin/Sulbactam): A Guide to the Enhanced Penicillin Antibiotic

Manufacturer: SEDICO (South Egypt Drug Industries Company), Egypt

Category: Penicillin Antibiotic with a Beta-Lactamase Inhibitor

Active Ingredients:

• Ultracillin 375 mg Vial: 250 mg Ampicillin + 125 mg Sulbactam
• Ultracillin 750 mg Vial: 500 mg Ampicillin + 250 mg Sulbactam
• Ultracillin 1500 mg Vial: 1000 mg (1 g) Ampicillin + 500 mg Sulbactam

Summary

Ultracillin is a powerful combination antibiotic, administered by injection, that contains Ampicillin and Sulbactam. This combination is designed to overcome a common form of bacterial resistance. While Ampicillin is the component that kills bacteria, Sulbactam acts as a protective shield, allowing Ampicillin to work effectively against a wider range of bacteria than it could on its own. It is used to treat a variety of moderate to severe infections throughout the body.

Mechanism of Action: The "Protector and Killer" Synergy

The effectiveness of Ultracillin comes from its two active ingredients working together in a highly synergistic way:

1. Ampicillin (The "Killer"): This is a broad-spectrum penicillin antibiotic that kills bacteria by inhibiting the synthesis of their cell walls, causing them to break down and die.
2. Sulbactam (The "Protector"): Many bacteria defend themselves by producing enzymes called beta-lactamases, which destroy antibiotics like Ampicillin before they can work. Sulbactam is a beta-lactamase inhibitor. It irreversibly binds to and neutralizes these enzymes, effectively protecting the Ampicillin from being destroyed.

This combination restores Ampicillin's activity against many resistant strains of bacteria, significantly broadening its spectrum of use.

Therapeutic Indications: When is Ultracillin Used?

Ultracillin is indicated for infections caused by susceptible, beta-lactamase-producing organisms, including:

• Upper & Lower Respiratory Tract Infections: Sinusitis, otitis media, tonsillitis, bacterial pneumonia, and bronchitis.
• Urinary Tract Infections and Pyelonephritis (kidney infection).
• Skin and Soft Tissue Infections: Often caused by *Staphylococcus*.
• Intra-abdominal Infections: Including peritonitis and cholecystitis.
• Gynecological Infections: Such as endometritis and pelvic cellulitis.
• Bacterial Septicemia (bloodstream infections).
• Gonococcal Infections.
• Surgical Prophylaxis: To reduce the incidence of post-operative wound infections.

Dosage and Administration

Important: Ultracillin is administered by intramuscular (IM) or intravenous (IV) injection by a healthcare professional.

• Adults: The usual dosage is 1.5 g to 3 g of Ultracillin per day, given in divided doses every 6-8 hours. The total daily dose of Sulbactam should not exceed 4 g.
• Children, Infants, and Neonates: The usual dosage is 150 mg/kg/day, given in divided doses every 6 or 8 hours. (In the first week of life, dosing is typically every 12 hours).
• Renal Impairment: The dosing frequency must be reduced in patients with impaired kidney function.

The vial must be reconstituted with a sterile diluent (like sterile water for injection or lidocaine for IM use) before administration.

Key Contraindications, Warnings, and Interactions

• Contraindications: Strictly contraindicated in individuals with a history of a serious allergic reaction (e.g., anaphylaxis) to any penicillin antibiotic.
• Hypersensitivity: Serious and occasionally fatal hypersensitivity reactions can occur. A hypersensitivity test may be performed before the first dose.
• Drug Interactions:
  • Allopurinol: Concomitant use with Ampicillin substantially increases the incidence of skin rash.
  • Probenecid: Blocks the renal excretion of both Ampicillin and Sulbactam, leading to higher and more prolonged blood levels.
• Pregnancy and Lactation: While animal studies have not shown harm, safety in human pregnancy has not been fully established. Low concentrations are excreted in breast milk, so caution should be exercised.

Frequently Asked Questions (FAQ)

Why is Ultracillin a combination? Why not just use Ampicillin?

Many bacteria have learned to produce enzymes (beta-lactamases) that destroy Ampicillin. Ultracillin adds Sulbactam, which blocks these enzymes, making the Ampicillin effective again against these resistant bacteria. It's an "enhanced" version of Ampicillin.

Is the injection painful?

Pain at the injection site is a common side effect, especially with the intramuscular (IM) route. To minimize this, the injection is given deep into a large muscle, and sometimes the drug is reconstituted with a local anesthetic like lidocaine.

What is a "superinfection"?

This is an infection that occurs on top of an earlier one, especially following treatment with broad-spectrum antibiotics. The antibiotic can kill off beneficial bacteria, allowing non-susceptible organisms (like fungi) to grow unchecked. If this happens, Ultracillin should be discontinued and the new infection treated appropriately.

Sources

1. Ampicillin and Sulbactam Professional Information - Drugs.com
2. Ampicillin/Sulbactam - StatPearls, NCBI
3. Official Product Leaflet for Ultracillin.