Sultamicillin

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Sultamicillin
Sultamicillin.svg
Systematic (IUPAC) name
[(2R)-3,3-dimethyl-4,4,7-trioxo-4λ6-thia-1-azabicyclo
[3.2.0]heptane-2-carbonyl]oxymethyl(2R)-6-{[(2S)-
2-amino-2-phenyl-acetyl]amino}-3,3-dimethyl-7-oxo-
4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate
Clinical data
AHFS/Drugs.com International Drug Names
Legal status ?
Routes Oral
Identifiers
CAS number 76497-13-7 N
ATC code J01CR04
PubChem CID 444022
ChemSpider 392048 YesY
UNII 65DT0ML581 YesY
KEGG D05972 YesY
ChEBI CHEBI:51770 YesY
ChEMBL CHEMBL506110 YesY
Chemical data
Formula C25H30N4O9S2 
Mol. mass 594.659 g/mol
 N (what is this?)  (verify)

Sultamicillin is an oral form of the antibiotic combination (codrug or mutual prodrug) ampicillin/sulbactam. It contains esterified ampicillin and sulbactam and is marketed under a number of trade names, including Saltum from Morepen Lab and Unasyn from Pfizer.

Sultamicillin with improved pharmacokinetic changes which has led to various changes of ampicillin & sulbactam properties.

Sultamicillin increased the absorption and decreased the chances of diarrhoea and dysentery. Sultamicillin also offered - the oral sulbactam advantage, there by, extending the spectrum of action to resistant strains (betalactamase producing strains). Oral sulbactam with parenteral form provides a regimen of continuous sulbactam therapy throughout the treatment resulting in better clinical results.

Sultamicillin - chemical evaluation[edit]

Sultamicillin is a mutual prodrug of ampicillin and sulbactam. Ampicillin - a semi-synthetic orally active broad spectrum penicillin is linked via a methylene group with a betalactamase inhibitor. Sultamicillin is chemically oxymethyl penicillinate sulphone ester of Ampicillin.

Sultamicillin - mechanism of action[edit]

Sultamicillin after absorption releases ampicillin and sulbactam into the system, so all the antibacterial efficacy of sultamicillin is due to ampicillin and sulbactam. Ampicillin exerts antibacterial activity against sensitive organisms by inhibiting biosynthesis of cell wall mucopeptide where as sulbactam irreversibly inhibits most important betalactamases that occur in resistant strains.

Indication[edit]

Skin and Soft Tissue Infections - Furuncles, carbuncles, cellulitis, paronychia, impetigo contagiosa, diabetic foot ulcers and abscesses caused by Staphylococcus aureus and Streptococcus pyogenes.

Upper Respiratory Tract Infections - Pharyngitis and tonsillitis caused by S. pyogenes and S. aureus. Acute and chronic sinusitis caused by S. aureus, S. pneumoniae, H. influenzae and S. pyogenes. Otitis media particularly suppurative otitis media with or without mastoiditis antrum.

Lower Respiratory Tract Infections - Bacterial pneumonias, bronchitis, bronchiectasis caused by S. pneumoniae, H. influenzae, Staphylococcus aureus and S. pyogenes. Acute exacerbations of COPD.

Urinary Tract Infections - Pyelonephritis, cystitis caused by E.coli, P. mirabilis, Klebsiella, Enterobacter and Staphylococcus aureus.

Surgical Infections - Prophylaxis and treatment of surgical site infections, peri-operative prophylaxis in orthopaedic and cardiovascular surgery.

Gynaecological Infections - Caused by betalactamase producing strains of Escherichia coli and Bacteroids sp. (including B. Fragilis).

Infections of Gastrointestinal tract - Bacterial esophagitis, treatment of H. pylori infections as a part of MDT in ulcer management.

Dosage and administration[edit]

Adults (including elderly patients): 375 mg - 750 mg (1-2 tablets) twice daily.

Children weighing less than 30 kg: Sultamicillin 25 - 50 mg / kg body wt. / day in two divided doses.

Sultamicillin has increased bioavailability as compared to Ampicillin.


after or before meal?

References[edit]

  • Singh GS. Beta-lactams in the new millennium. Part-II: cephems, oxacephems, penams and sulbactam.

Mini Rev Med Chem. 2004 Jan;4(1):93-109. Review. doi:10.2174/1389557043487547 PMID 14754446