氨苄西林與舒巴坦 (Ampicillin/Sulbactam)
Ampicillin and Sulbactam
Ampicillin sodium and sulbactam sodium
別名: Ampibactan · Bacimex · Begalin-P · Bethacil · Comabactan · Galotam · Loricin · Sulam · Sulperazon · Synergistin · Unacid · Unacim · Unasyna
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For respiratory infections | 50 mg/kg (combined) IV q8h | IV | q8h | — | 🌎 NA |
| For respiratory infections | 20 mg/kg IV or IM q6-8h | IV/IM | q6-8h | — | 🌎 NA |
| As adjunctive treatment of serious bite wounds | 30-50 mg/kg q8h IV | IV | q8h | — | 🌎 NA |
| For intra-abdominal infections | 20 mg/kg IV or IM q6-8h | IV/IM | q6-8h | — | 🌎 NA |
- For intra-abdominal infections: Extrapolation of human dose with limited studies in dogs and cats
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For respiratory infections using ampicillin/sulbactam (Unasyn®) | 50 mg/kg (combined) IV q8h | IV | q8h | — | 🌎 NA |
| As adjunctive treatment of serious bite wounds | 30-50 mg/kg q8h IV | IV | q8h | — | 🌎 NA |
| For intra-abdominal infections | 20 mg/kg IV or IM q6-8h | IV/IM | q6-8h | — | 🌎 NA |
- For intra-abdominal infections: Extrapolation of human dose with limited studies in dogs and cats
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
氨苄西林/舒巴坦 (Ampicillin/sulbactam) 是一種注射用增效氨基青黴素。它結合了氨苄西林的廣效殺菌活性與舒巴坦（一種β-內醯胺酶抑制劑）。
- 抗菌譜：對許多產生β-內醯胺酶的細菌有效，如大腸桿菌、巴斯德桿菌、葡萄球菌、克雷伯氏菌和變形桿菌。也涵蓋梭狀芽孢桿菌和擬桿菌等厭氧菌。
- 臨床應用：主要用於犬貓無法口服阿莫西林/克拉維酸（例如禁食、重症或嘔吐）時，或嚴重感染（如敗血症、肺炎、嚴重咬傷）需要高濃度注射給藥時。
- 限制：對綠膿桿菌及某些第一型β-內醯胺酶產生菌（如腸桿菌、沙雷氏菌）無效。
臨床要點：以同等劑量比較，克拉維酸是比舒巴坦更強的β-內醯胺酶抑制劑，但舒巴坦具有較不易誘發染色體β-內醯胺酶、組織穿透力佳及穩定性較高等優點。
作用機轉
- 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.
安全性與警告
禁忌症
- Patients with a history of severe hypersensitivity (e.g., anaphylaxis) to penicillins
不良反應
- 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)
注意事項
Use cautiously in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., cephalosporins, cefamycins, carbapenems) due to potential cross-reactivity. Patients with severe renal dysfunction may require increased intervals between doses. Safe use during pregnancy has not been firmly established (FDA Category B; Papich Class A), use only when potential benefits outweigh risks.
藥物交互作用
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.
Potential in vitro antagonism between beta-lactam antibiotics and bacteriostatic antibiotics; clinical importance is unclear.
Reduces the renal tubular secretion of both ampicillin and sulbactam, maintaining higher systemic levels for a longer period.
監測
- Clinical efficacy (resolution of infection signs)
- Adverse effects (signs of hypersensitivity, neurological symptoms at high doses)
藥物動力學
吸收
Sulbactam sodium is not appreciably absorbed from the GI tract; must be given parenterally. When administered IV/IM, sulbactam's pharmacokinetic profile closely mirrors that of ampicillin in most species.
分佈
Penicillins cross the placenta. Both ampicillin and sulbactam are distributed into breast milk in low concentrations.
代謝
Ampicillin undergoes minimal hepatic metabolism.
排除
Primarily excreted unchanged in the urine via glomerular filtration and active tubular secretion. In calves, plasma concentrations of sulbactam were consistently higher than ampicillin during the elimination phase.
過量
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.
可用產品
劑型
- Powder for injection (reconstitution required)
人用標示
- Ampicillin Sodium/Sulbactam Sodium Powder (injection): 1.5 g (1 g ampicillin/0.5 g sulbactam)
- Ampicillin Sodium/Sulbactam Sodium Powder (injection): 3 g (2 g ampicillin/1 g sulbactam)
- Ampicillin Sodium/Sulbactam Sodium Powder (injection): 15 g bulk (10 g ampicillin/5 g sulbactam)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Unreconstituted powder should be stored at or below 30°C. Reconstituted to 45 mg/mL: stable for 8 hours at room temperature and 48 hours at 4°C. Reconstituted to 30 mg/mL: stable for 72 hours at 4°C. Diluted solutions in 0.9% NaCl for IV administration are stable at room temperature for 8 hours. IM reconstituted solutions should be administered within 1 hour.
飼主須知
- 僅供住院使用：由於此藥物必須透過注射（靜脈或肌肉）給藥，且需要頻繁投藥（每6至8小時一次），因此最適合在寵物住院期間由醫療人員施打。
- 用途：這是一種強效的抗生素組合，用於治療嚴重或具抗藥性的細菌感染，通常在寵物無法耐受口服藥物時使用。
- 安全性：通常非常安全，但如果您的寵物曾對青黴素類藥物有過敏反應，請務必告知獸醫團隊。
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