Use of ampicillin/sulbactam and sultamicillin in pediatric infections: a re-evaluation

Ampicillin/sulbactam is an effective solution to the emergence of beta -lac tamase-mediated resistance among common pediatric pathogens, and is a widel y recognized treatment option for a variety of pediatric infections. Recent antimicrobial surveillance data confirm the continued susceptibility of ma ny Grampositive and Gram-negative aerobes and anaerobes to ampicillin/sulba ctam. Pharmacokinetic studies have demonstrated high drug concentrations at a variety of infection sites, including cerebrospinal fluid and bone. Furt hermore, clinical studies have shown that ampicillin/sulbactam, administere d intravenously, intramuscularly or orally (as the mutual prodrug sultamici llin), is clinically and bacteriologically effective against upper and lowe r respiratory tract infections, urinary tract infections, skin, bone and so ft-tissue infections, and meningitis, and provides effective surgical proph ylaxis. Sultamicillin has an excellent tolerability profile, which is assoc iated with a low rate of treatment discontinuation. Accordingly, ampicillin /sulbactam and sultamicillin should be considered first-choice options for the management of a variety of pediatric infections.