암피실린/설바탐

항생제 - 강화 아미노페니실린

**암피실린/설바탐(Ampicillin/sulbactam)**은 주사용 강화 아미노페니실린입니다. 암피실린의 광범위 살균 활성과 베타락타마제 억제제인 설바탐이 결합되어 있습니다. * **항균 스펙트럼**: 베타락타마제를 생성하는 대장균, 파스퇴렐라, 포도상구균, 클레브시엘라, 프로테우스의 여러 균주에 효과적입니다. 클로스트리디움 및 박테로이데스와 같은 혐기성 세균에도 효과가 있습니다. * **임상적 유용성**: 주로 개와 고양이에서 경구용 아목시실린/클라불란산 투여가 불가능하거나(예: 금식, 중증 환자, 구토), 패혈증, 폐렴, 심각한 교상 등 중증 감염으로 인해 고농도의 주사 투여가 필요할 때 사용됩니다. * **한계**: 녹농균 및 특정 제1형 베타락타마제 생성균(엔테로박터, 세라티아 등)에는 효과가 없습니다. > **임상 요점**: 동일 용량 기준으로 클라불란산이 설바탐보다 더 강력한 베타락타마제 억제제이지만, 설바탐은 염색체성 베타락타마제 유발 가능성이 적고 조직 침투력과 안정성이 더 뛰어나다는 장점이 있습니다.

작용 기전: * **Ampicillin** binds to **penicillin-binding proteins (PBPs)** located inside the bacterial cell wall → inhibits the third and final stage of bacterial cell wall synthesis → cell lysis and death. * **Sulbactam** irreversibly binds to and inactivates **beta-lactamases** (Richmond-Sykes types II-VI) → protects the **beta-lactam ring** of ampicillin from enzymatic hydrolysis. * *Note*: Sulbactam has weak intrinsic antibacterial activity against certain organisms (*Neisseria*, *Moraxella*, *Bacteroides*) by binding to specific PBPs, providing a synergistic effect when combined with ampicillin.

동물 종별 용량

Cats

For respiratory infections using ampicillin/sulbactam (Unasyn®) · 50 mg/kg (combined) IV q8h · IV · q8h
As adjunctive treatment of serious bite wounds · 30-50 mg/kg q8h IV · IV · q8h
For intra-abdominal infections · 20 mg/kg IV or IM q6-8h · IV/IM · q6-8h · Extrapolation of human dose with limited studies in dogs and cats

Dogs

For respiratory infections · 50 mg/kg (combined) IV q8h · IV · q8h
For respiratory infections · 20 mg/kg IV or IM q6-8h · IV/IM · q6-8h
As adjunctive treatment of serious bite wounds · 30-50 mg/kg q8h IV · IV · q8h
For intra-abdominal infections · 20 mg/kg IV or IM q6-8h · IV/IM · q6-8h · Extrapolation of human dose with limited studies in dogs and cats

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

IVIM

금기

Patients with a history of severe hypersensitivity (e.g., anaphylaxis) to penicillins

이상반응

Pain at intramuscular injection sites
Thrombophlebitis (with intravenous injection)
Hypersensitivity reactions (including severe anaphylaxis, particularly after IV administration)
Neurotoxicity (e.g., ataxia in dogs) at high doses or prolonged use
Elevated liver enzymes
Tachypnea, dyspnea, edema, and tachycardia (reported in dogs)

약물 상호작용

Aminoglycosides (amikacin, gentamicin, tobramycin) · In vitro inactivation if mixed together; synergistic in vivo, but penicillins can inactivate aminoglycosides in patients with renal failure or when used in massive dosages. Amikacin is the most resistant to this inactivation.
Bacteriostatic antimicrobials (chloramphenicol, macrolides, tetracyclines, sulfonamides) · Potential in vitro antagonism between beta-lactam antibiotics and bacteriostatic antibiotics; clinical importance is unclear.
Probenecid · Reduces the renal tubular secretion of both ampicillin and sulbactam, maintaining higher systemic levels for a longer period.

모니터링

Clinical efficacy (resolution of infection signs)
Adverse effects (signs of hypersensitivity, neurological symptoms at high doses)

과용량

Neurological effects (e.g., ataxia) have rarely been reported in dogs receiving very high dosages of penicillins. In humans, very high dosages of parenteral penicillins, especially in those with renal disease, have induced CNS effects. If neurological signs develop, weigh the risks of continued use versus dosage reduction or switching to a different antibiotic class.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.