Sultamicillin tosilate CAS 83105-70-8 SULTAMICILLIN TOSILATE

For anti-infective drug, it is used for acute suppuration of chronic bronchitis and other pulmonary diseases, flu bacillus infection of children and acute tonsillitis

Sultamicillin is indicated for infections caused by susceptible micro-organisms. Typical indications are upper respiratory tract infections including sinusitis, otitis media and tonsillitis; lower respiratory tract infections including bacterial pneumonias and bronchitis; urinary tract infections and pyelonephritis; skin and soft tissue infections; intra-abdominal infections and gonococcal infections.

Sultamicillin may also be indicated in patients requiring sulbactam/ampicillin therapy following initial treatment with sulbactam/ampicillin IM/IV.

The recommended dose of sultamicillin in adults (including elderly patients) is 375-750 mg orally twice daily. In both adults and children treatment is usually continued until 48 hours after pyrexia and other abnormal signs have resolved. Treatment is normally given for 5-14 days but the treatment period may be extended if necessary. In the treatment of uncomplicated gonorrhoea, sultamicillin can be given as a single oral dose of 2.25 grams (six 375 mg tablets). Concomitant probenecid 1.0 gram should be administered in order to prolong plasma concentrations of sulbactam and ampicillin. Cases of gonorrhoea with a suspected lesion of syphilis should have dark field examinations before receiving sultamicillin and monthly serological tests for a minimum of four months. It is recommended that there be at least 10 days treatment for any infection caused by hemolytic streptococci to prevent the occurrence of acute rheumatic fever or glomerulonephritis. Use in Children and Infants The dosage for most infections in children weighing less than 30 kg is sultamicillin 25-50 mg/kg/day orally in 2 divided doses depending on the severity of the infection and the physician’s judgment. For children weighing 30 kg or more the usual adult dose should be given. Use in Patients with Renal Impairment In patients with severe impairment of renal function (creatinine clearance 30 ml/min), the elimination kinetics of sulbactam and ampicillin are similarly affected and hence the plasma ratio of one to the other will remain constant. The dose of sultamicillin in such patients should be administered less frequently in accordance with usual practice for ampicillin.

The use of this product is contraindicated in individuals with a history of an allergic reaction to any of the penicillins.

Limited information is available on the acute toxicity of ampicillin sodium and sulbactam sodium in humans. Overdosage of the drug would be expected to produce manifestations that are principally extensions of the adverse reactions reported with the drug. The fact that high CSF concentrations of -lactam antibiotics may cause neurologic effects, including seizures, should be considered. Because ampicillin and sulbactam are both removed from the circulation by hemodialysis, these procedures may enhance elimination of the drug from the body if overdosage occurs in patients with impaired renal function.