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Ampicillin is considered a third generation or aminopenicillin and is used widely to treat mild-to-severe infections due to susceptible organisms. Ampicillin has been linked with idiosyncratic liver injury, but very rarely and in isolated case reports.


Liver safety of Ampicillin

Mechanism of action of Ampicillin

Ampicillin (am" pi sil' in) is an oral, third generation penicillin that is one of the most commonly used antibiotics worldwide. Ampicillin has been available in the United States since the mid-1960s and continues to be widely used for bacterial infections in both children and adults. Ampicillin is indicated for mild-to-severe upper respiratory tract infections caused by susceptible agents, such as (but not limited to) Escherichia coli, Hemophilis influenzae, Listeria monocytogenesis, Neisseria gonorrhoeae, Proteus mirabilis, Salmonella, Shigella, Staphylococcus aureus (non-penicillinase producing), Staphylococcus aureus, and Streptococcus pneumoniae. Ampicillin is also used for pneumonia, meningitis, endocarditis and uncomplicated gonorrhea. Ampicillin is available orally in multiple generic formulations as capsules of 250 and 500 mg and is usually given in doses of 250 to 500 mg every 6 to 8 hours for 7 to 14 days. Ampicillin is also available in parenteral form (intramuscular and intravenous) and recommended doses are 2 to 4 grams daily in divided doses given every 4 to 6 hours.

The combination of ampicillin and sulbactam sodium combines a third generation aminopenicillin and a beta-lactamase inhibitor and is used to treat serious bacterial infections due to susceptible organisms. Given parenterally, ampicillin and sulbactam can cause mild transient aminotransferase elevations and has been linked to very rare instances of acute liver injury.


Liver safety of Ampicillin

Mechanism of action of Ampicillin

The combination of ampicillin (am" pi sil' in) with sulbactam (sul bak' tam) is a broad spectrum, potent antibiotic which combines a third generation, aminopencillin with a beta lactamase inhibitor. This combination was approved for use in the United States in 1986. Current indications are for moderate-to-severe skin and skin structure, intra-abdominal and gynecological infections due to susceptible gram-positive and gram-negative bacteria, including beta-lactamase-producing strains of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Bacteroides species, Enterobacter species, Neisseria meningitidis and gonorrhoeae, Moraxella catarrhalis and Acinetobacter calcoaceticus. The combination of ampicillin and sulbactam is available in a parenteral form generically and under the name Unasyn. The typical dose is 1.5 to 3 grams intramuscularly or intravenously every 6 hours for 7 to 14 days.

The natural or "first generation" penicillins are bactericidal antibiotics naturally derived from the mold, Penicillium chrysogenum. Their basic structure includes a thiazolidine ring connected to a beta-lactam ring with a variable side chain. Penicillins bind to bacterial proteins and inhibit synthesis of the bacterial cell wall, causing cell lysis particularly in rapidly growing organisms. Bacterial resistance to penicillin is usually mediated by beta-lactamase, an enzyme which destroys the beta-lactam ring of penicillin, rendering it inactive. Penicillin was introduced into medicine in the 1940’s and ushered in the modern era of antibiotic therapy, ending the dominance of many diseases that had been major causes of morbidity and mortality. At present, several first generation penicillins are available in the United States: the benzathine, potassium, procaine and sodium salts of penicillin G and the orally available penicillin V potassium. These agents are discussed together as they are rare causes of hepatotoxicity and can be considered similar enough to be grouped together.

Other drugs within this class:

Drug Name



Synonyms of Ampicillin [USAN:USP:INN:BAN:JAN]

  • AB-PC
  • AB-PC Sol
  • Acillin
  • Adobacillin
  • Alpen
  • Amblosin
  • Amcill
  • Amfipen
  • Amfipen V
  • Aminobenzylpenicillin
  • Amipenix S
  • Ampi-bol
  • Ampi-Co
  • Ampi-Tab
  • Ampichel
  • Ampicil
  • Ampicilina
  • Ampicilina [INN-Spanish]
  • Ampicillin
  • Ampicillin A
  • Ampicillin acid
  • Ampicillin anhydrate
  • Ampicillina
  • Ampicillina [DCIT]
  • Ampicilline
  • Ampicilline [INN-French]
  • Ampicillinum
  • Ampicillinum [INN-Latin]
  • Ampicin
  • Ampifarm
  • Ampikel
  • Ampimed
  • Ampipenin
  • Ampiscel
  • Ampisyn
  • Ampivax
  • Ampivet
  • Amplacilina
  • Amplin
  • Amplipenyl
  • Amplisom
  • Amplital
  • Ampy-Penyl
  • Austrapen
  • AY 6108
  • AY-6108
  • BA 7305
  • Bayer 5427
  • Binotal
  • Bonapicillin
  • Britacil
  • BRL 1341
  • BRL-1341
  • Campicillin
  • Cimex
  • Copharcilin
  • D-(-)-alpha-Aminobenzylpenicillin
  • D-(-)-alpha-Aminopenicillin
  • D-(-)-Ampicillin
  • D-Ampicillin
  • D-Cillin
  • Delcillin
  • Deripen
  • Divercillin
  • Doktacillin
  • Duphacillin
  • EC 200-709-7
  • EINECS 200-709-7
  • Grampenil
  • Guicitrina
  • HI 63
  • HSDB 3009
  • Lifeampil
  • Morepen
  • Norobrittin
  • Novo-ampicillin
  • NSC 528986
  • NSC-528986
  • Nuvapen
  • Olin Kid
  • Omnipen
  • Orbicilina
  • P 50
  • P-50
  • Pen A
  • Pen Ampil
  • Penbristol
  • Penbritin
  • Penbritin paediatric
  • Penbritin syrup
  • Penbrock
  • Penicillin, (aminophenylmethyl)-
  • Penicline
  • Penimic
  • Pensyn
  • Pentrex
  • Pentrexl
  • Pentrexyl
  • Pfizerpen A
  • Polycillin
  • Ponecil
  • Princillin
  • Principen
  • Qidamp


Semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic.


  • Anti-Bacterial Agents
  • Anti-Infective Agents

Penicillin antibiotics

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