암피실린
Ampicillin
Ampicillin sodium, Ampicillin trihydrate
다른 이름: Polyflex · Principen · Amfipen · Ampicare · aminobenzylpenicillin · ampicillinum anhydricum · anhydrous ampicillin · AY-6108 · BRL-1341 · NSC-528986 · P-50 · Ampicillin sodium · Aminopenicillin
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Susceptible infections (extra-label)
인증된 수의사 확인 필요
- q12h
NA
반드시 함께 고려할 임상 맥락 (3)
- ■ Because penicillins usually have minimal toxicity associated with their use, monitoring for efficacy is usually all that is required unless toxic signs develop. Serum levels and therapeutic drug monitoring are not routinely done with these agents.
- Ampicillin trihydrate (Polyflex®) powder for injection should be stored at or below 25°C (77°F), with excursions permitted up to 30°C (86°F). After reconstitution, it is stable for 3 months when refrigerated.
- Ampicillin sodium powder for injection should be stored at room temperature (15°C-30°C [59°F-86°F]). The drug is relatively unstable after reconstitution and should be used within 1 hour of reconstitution. As the concentration of the drug in solution increases, the stability of the drug decreases. Dextrose may also speed the destruction of the drug by acting as a catalyst in the hydrolysis of ampicillin.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
암피실린(Ampicillin)은 광범위, 시간 의존성, 살균성 아미노페니실린계 항생제입니다.
주요 약리학적 특징:
- 항균 스펙트럼: 많은 그람 양성균(페니실린 감수성 장구균인 E. faecium 포함), 혐기성균(Clostridium spp. 등), 일부 그람 음성 호기성균(E. coli, Klebsiella, Haemophilus, Proteus mirabilis)에 효과적입니다.
- 내성: 천연 페니실린과 마찬가지로 베타락타마제 생성 세균(Staphylococcus aureus 등)에 의해 쉽게 불활성화됩니다. 녹농균, 세라티아, 엔테로박터 및 비정형 원인균(마이코플라스마, 리케차, 진균)에는 효과가 없습니다.
- 임상적 유용성: 소동물에서 경구용 암피실린은 생체이용률이 더 높은 아목시실린으로 대체되었으나, 주사용 암피실린은 여전히 중요한 치료제입니다.
- 염 형태:
- 암피실린 나트륨(Sodium): 수용성이 높아 정맥(IV) 투여에 적합하며, 빠르고 높은 최고 혈청 농도를 제공합니다.
- 암피실린 삼수화물(Trihydrate): 근육(IM) 또는 피하(SC) 투여용 저장성 제제로, 흡수가 느리고 최고 혈청 농도가 낮습니다(나트륨염의 약 절반). 전신 감염 치료를 위해 높은 최소억제농도(MIC)가 요구되는 경우에는 사용하지 않아야 합니다.
작용 기전
Ampicillin is a beta-lactam antibiotic that exerts its bactericidal effect by interfering with bacterial cell wall synthesis.
- Mechanism: Ampicillin covalently binds to specific Penicillin-Binding Proteins (PBPs) (primarily transpeptidases) located inside the bacterial cell wall.
- Pathway: Binding to PBPs → inhibition of the final transpeptidation step of peptidoglycan cross-linking → weakening of the cell wall structure → activation of endogenous autolytic enzymes (autolysins) → osmotic lysis and bacterial cell death.
- Pharmacodynamics: Efficacy is time-dependent, meaning the free drug concentration must remain above the Minimum Inhibitory Concentration (MIC) for a significant portion of the dosing interval (typically >40-50% of the interval).
안전성·주의사항
금기사항
- Patients with a known hypersensitivity to penicillins
- Oral administration in patients with septicemia, shock, or grave illness (due to delayed/diminished GI absorption)
- Oral or parenteral use in small hindgut fermenters (rabbits, guinea pigs, chinchillas, hamsters) due to risk of fatal clostridial enterotoxemia
부작용
- Gastrointestinal upset (anorexia, vomiting, diarrhea)
- Antibiotic-associated diarrhea and superinfections (alteration of gut flora)
- Hypersensitivity reactions (rashes, fever, eosinophilia, anaphylaxis)
- Neurotoxicity (ataxia, seizures) at very high doses or prolonged use
- Elevated liver enzymes (rare)
- Tachypnea, dyspnea, edema, and tachycardia (reported in dogs)
주의
Cross-Reactivity: Use cautiously in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., cephalosporins, carbapenems), as cross-reactivity can occur.
Species Warning: Severe, potentially fatal enteritis and clostridial enterotoxemia can occur if administered to rabbits, guinea pigs, chinchillas, or hamsters.
Laboratory Interference: May cause false-positive urine glucose determinations when using cupric sulfate solutions (e.g., Clinitest). Glucose oxidase tests are unaffected.
약물 상호작용
Potential in vitro antagonism; clinical significance is debated but concurrent use is traditionally discouraged.
Ampicillin may decrease the renal excretion of methotrexate, leading to increased levels and potential toxicity.
Competitively blocks the tubular secretion of penicillins, increasing serum levels and prolonging half-life.
In vitro inactivation of aminoglycosides if mixed in the same syringe or fluid bag. May also occur in vivo in patients with severe renal failure.
Antagonism of bactericidal effect due to bacteriostatic action
Antagonism of bactericidal effect due to bacteriostatic action
Antagonism of bactericidal effect due to bacteriostatic action
In vitro inactivation if mixed in the same syringe; however, exhibits synergistic antimicrobial effects when used concurrently in vivo
모니터링
- Clinical efficacy (resolution of infection signs)
- Adverse effects (GI signs, hypersensitivity reactions)
- Therapeutic drug monitoring is not routinely required due to the wide therapeutic index
약동학
반감기
흡수
Relatively stable in gastric acid. Oral absorption is 30-55% in monogastric animals on an empty stomach; food decreases the rate and extent of absorption. Parenteral trihydrate salt achieves serum levels approximately 1/2 those of a comparable dose of the sodium salt.
분포
Widely distributed to many tissues (liver, lungs, muscle, bile, ascitic/pleural/synovial fluids). Volume of distribution is ~0.3 L/kg in dogs, 0.167 L/kg in cats, and 0.16-0.5 L/kg in cattle. Crosses inflamed meninges (10-60% of serum levels). Low levels in aqueous humor, tears, sweat, saliva, and milk. Crosses the placenta. Approximately 20% bound to plasma proteins.
대사
Some of the drug is metabolized by hydrolysis to inactive penicilloic acids.
배설
Eliminated primarily through renal mechanisms, principally by tubular secretion. Excreted in the urine.
과다투여
Acute oral penicillin overdoses are unlikely to cause significant problems other than gastrointestinal distress (vomiting, diarrhea, anorexia).
In humans, very high dosages of parenteral penicillins, particularly in patients with underlying renal disease, have induced CNS effects (e.g., seizures, ataxia). Treatment is generally supportive and symptomatic.
제품
제형
- Powder for injection (Ampicillin sodium)
- Powder for injection suspension (Ampicillin trihydrate)
- Oral capsules
- Powder for oral suspension
동물용의약품
- Ampicillin Trihydrate Injection Powder for Suspension: 10 g and 25 g vials (Polyflex)
인용의약품
- Ampicillin Sodium Powder for Injection: 250 mg, 500 mg, 1 g, 2 g vials
- Ampicillin Oral Capsules (as trihydrate): 250 mg, 500 mg (Principen)
- Ampicillin Powder for Oral Suspension (as trihydrate): 125 mg/5 mL, 250 mg/5 mL (Principen)
규제 현황
POM-V classification
POM-V (Prescription Only Medicine - Veterinarian)
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Capsules and powder for oral suspension: Store at room temperature (15-30°C). Reconstituted oral suspension: Stable for 14 days refrigerated (2-8°C) or 7 days at room temperature. Ampicillin trihydrate for injection (Polyflex): Stable for 3 months refrigerated. Ampicillin sodium for injection: Relatively unstable after reconstitution; generally use within 1 hour. Stability decreases as concentration increases. Dextrose speeds destruction. At ≤30 mg/mL in sterile water or 0.9% NaCl, stable up to 48 hours at 4°C.
보호자 정보
- 투여 방법: 수의사의 다른 지시가 없는 한, 적절한 흡수를 위해 이 약은 공복(식사 최소 1시간 전 또는 2시간 후)에 경구 투여해야 합니다.
- 보관 방법: 경구용 현탁액은 냉장 보관하고, 14일이 지난 남은 약은 폐기하십시오. 실온에 보관한 경우 7일 후에 폐기하십시오.
- 부작용: 가벼운 위장 장애(구토, 설사 또는 식욕 감소)가 발생할 수 있습니다. 이러한 증상이 심하거나 지속되면 수의사에게 연락하십시오.
- 알레르기 반응: 얼굴 부종, 두드러기, 발진 또는 호흡 곤란과 같은 알레르기 반응의 징후가 있는지 관찰하십시오. 이러한 증상이 나타나면 즉시 수의사의 진료를 받으십시오.
- 치료 완료: 반려동물의 상태가 호전된 것처럼 보이더라도, 내성균의 발생을 방지하기 위해 반드시 지시된 대로 처방된 약을 끝까지 먹이십시오.
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