Ampicillin + cloxacillin

Oral
Susceptible infections
Adult: Per capsule contains ampicillin 250 mg and cloxacillin 250 mg: 1 capsule 4 times daily. In severe infections, the dose can be increased up to 12 capsules daily.
Child: Per dose contains ampicillin 125 mg and cloxacillin 125 mg: 1 dose 4 times daily.

Intramuscular
Moderate to severe infections
Adult: 500 mg (ampicillin 250 mg and cloxacillin 250 mg) or 1 g (ampicillin 500 mg and cloxacillin 500 mg) every 6 hr. Doses higher than 500 mg should be given in two different sites of not more than 500 mg in 3ml.

Intramuscular
Severe infections
Adult: 500 mg (ampicillin 250 mg and cloxacillin 250 mg) or 1 g (ampicillin 500 mg and cloxacillin 500 mg) every 6 hr. Doses higher than 500 mg should be given in two different sites of not more than 500 mg in 3ml.

Intravenous
Severe infections
Adult: 500 mg (ampicillin 250 mg and cloxacillin 250 mg) in 10 ml or 1 g (ampicillin 500 mg and cloxacillin 500 mg) in 20 ml of water for inj. Given slowly over 3-4 minutes, repeated every 6 hr.
Child: 2-10 yr: Half the adult dose. < 2 yr: Quarter of adult dose.

Penicillin allergy.

Allergy to cephalosporins, infectious mononucleosis, neonates with jaundice, history of convulsions, lactation.

G.I.disturbances, pruritus, urticaria, erythema, exfoliative dermatitis, rashes, fever, joint pain, eosinophilia, bronchial asthma, angioneuratic oedema, hemolytic anaemia, serum sickness, CNS effects like hyperactivity, agitation, insomnia, anxiety, behavioural changes, confusion, dizziness and convulsions.
Potentially Fatal: Anaphylactic reaction.

Failure of oral contraceptives, increased rash with allopurinol, reduced bactericidal activity with chloramphenicol, erythromycin and tetracyclines.
Potentially Fatal: NA.

Reduced absorption for ampicillin & delayed obsorption for cloxacillin.

Ampicillin interferes with serum albumin, urinary aminoacid electrophoresis and urine sugar estimations. Cloxacillan interfers with Bradshows's test for Bence-Jones protein in urine and measurement of urinary 17-oxosteroids or 17-oxogenic steroids.

Ampicillin exerts bactericidal action on both gm+ve and gm-ve organisms. Its spectrum includes gm+ve organisms eg, S pneumoniae and other Streptococci, L monocytogenes and gm-ve bacteria eg, M catarrhalis, N gonorrhoea, N meningitidis, E coli, P mirabilis, Salmonella, Shigella, and H influenzae. Ampicillin exerts its action by inhibiting the synthesis of bacterial cell wall. Cloxacillin is a penicillinase-resistant penicillin. It is active against gm+ve organisms including penicillinase-producing strains of Staphylococci. Cloxacillin is highly active against Staph aureus, Strep pyogenes, Strep viridans and Strep pneumoniae. It is also active against penicillinase-producing gonococci and against N meningitidis and H influenzae. Other gm-ve organisms are resistant to cloxacillin as are also methicillin-resistant strains of Staphylococci.

Penicillins

J01CF02 - cloxacillin ; Belongs to the class of beta-lactamase resistant penicillins. Used in the systemic treatment of infections.
J01CA01 - ampicillin ; Belongs to the class of penicillins with extended spectrum. Used in the systemic treatment of infections.
S01AA19 - ampicillin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.