Sulbactam
/api/v1/drug/sulbactamMechanism of action
Sourced from openFDAMechanism-of-action class: beta Lactamase Inhibitors.
Indications
Sourced from openFDA- Ampicillin and sulbactam for injection is indicated for the treatment of infections due to susceptible strains of the designated microorganisms in the conditions listed below. Skin and Skin Structure Infections caused by beta-lactamase producing strains of Staphylococcus aureus , Escherichia coli ,* Klebsiella spp.* (including K.
Contraindications
Sourced from openFDA- The use of ampicillin and sulbactam for injection is contraindicated in individuals with a history of serious hypersensitivity reactions (e.g., anaphylaxis or Stevens-Johnson syndrome) to ampicillin, sulbactam or to other beta-lactam antibacterial drugs (e.g., penicillins and cephalosporins). Ampicillin and sulbactam for injection is contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with ampicillin and sulbactam for injection.contraindicated
Dosage & administration
Sourced from openFDAAmpicillin and sulbactam for injection may be administered by either the IV or the IM routes. For IV administration, the dose can be given by slow intravenous injection over at least 10-15 minutes or can also be delivered in greater dilutions with 50-100 mL of a compatible diluent as an intravenous infusion over 15-30 minutes. Ampicillin and sulbactam for injection may be administered by deep intramuscular injection (see DIRECTIONS FOR USE-Preparation for Intramuscular Injection section). The recommended adult dosage of ampicillin and sulbactam for injection is 1.5 g (1 g ampicillin as the sodium salt plus 0.5 g sulbactam as the sodium salt) to 3 g (2 g ampicillin as the sodium salt plus 1 g sulbactam as the sodium salt) every six hours. This 1.5 to 3 g range represents the total of ampicillin content plus the sulbactam content of ampicillin and sulbactam for injection, and corresponds to a range of 1 g ampicillin/0.5 g sulbactam to 2 g ampicillin/1 g sulbactam. The total dose of sulbactam should not exceed 4 grams per day. Pediatric Patients 1 Year of Age or Older The recommended daily dose of ampicillin and sulbactam for injection in pediatric patients is 300 mg per kg of body weight administered via intravenous infusion in equally divided doses every 6 hours. This 300 mg/kg/day dosage represents the total ampicillin content plus the sulbactam content of ampicillin and sulbactam for injection, and corresponds to 200 mg ampicillin/100 mg sulbactam per kg per day.
Warnings & precautions
Sourced from openFDAHypersensitivity Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients on penicillin therapy. These reactions are more apt to occur in individuals with a history of penicillin hypersensitivity and/or hypersensitivity reactions to multiple allergens. There have been reports of individuals with a history of penicillin hypersensitivity who have experienced severe reactions when treated with cephalosporins. Before therapy with a penicillin, careful inquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens. If an allergic reaction occurs, ampicillin and sulbactam for injection should be discontinued and the appropriate therapy instituted. Hepatotoxicity Hepatic dysfunction, including hepatitis and cholestatic jaundice has been associated with the use of ampicillin and sulbactam for injection. Hepatic toxicity is usually reversible; however, deaths have been reported. Hepatic function should be monitored at regular intervals in patients with hepatic impairment. Severe Cutaneous Adverse Reactions Ampicillin and sulbactam for injection may cause severe skin reactions, such as toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), dermatitis exfoliative, erythema multiforme, and Acute generalized exanthematous pustulosis (AGEP). If patients develop a skin rash they should be monitored closely and ampicillin and sulbactam for injection discontinued if lesions progress (see CONTRAINDICATIONS and ADVERSE REACTIONS sections).
Adverse reactions
Sourced from openFDAAdult Patients Ampicillin and sulbactam for injection is generally well tolerated. The following adverse reactions have been reported in clinical trials. Local Adverse Reactions Pain at IM injection site – 16% Pain at IV injection site – 3% Thrombophlebitis – 3% Phlebitis – 1.2% Systemic Adverse Reactions The most frequently reported adverse reactions were diarrhea in 3% of the patients and rash in less than 2% of the patients. Additional systemic reactions reported in less than 1% of the patients were: itching, nausea, vomiting, candidiasis, fatigue, malaise, headache, chest pain, flatulence, abdominal distension, glossitis, urine retention, dysuria, edema, facial swelling, erythema, chills, tightness in throat, substernal pain, epistaxis and mucosal bleeding. Pediatric Patients Available safety data for pediatric patients treated with ampicillin and sulbactam for injection demonstrate a similar adverse events profile to those observed in adult patients. Additionally, atypical lymphocytosis has been observed in one pediatric patient receiving ampicillin and sulbactam for injection. Adverse Laboratory Changes Adverse laboratory changes without regard to drug relationship that were reported during clinical trials were: Hepatic : Increased AST (SGOT), ALT (SGPT), alkaline phosphatase, and LDH. Hematologic : Decreased hemoglobin, hematocrit, RBC, WBC, neutrophils, lymphocytes, platelets and increased lymphocytes, monocytes, basophils, eosinophils, and platelets. Blood Chemistry : Decreased serum albumin and total proteins. Renal : Increased BUN and creatinine.
Use in specific populations
Sourced from openFDAPregnancy Reproduction studies have been performed in mice, rats, and rabbits at doses up to ten (10) times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to ampicillin and sulbactam for injection. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed (see PRECAUTIONS Drug/Laboratory Test Interactions section).
Overdosage
Sourced from openFDANeurological adverse reactions, including convulsions, may occur with the attainment of high CSF levels of beta-lactams. Ampicillin may be removed from circulation by hemodialysis. The molecular weight, degree of protein binding and pharmacokinetics profile of sulbactam suggest that this compound may also be removed by hemodialysis.
Approval history
Sourced from openFDA- Dec 31, 1986NDANDA050608Pfizer
- Nov 25, 2005ANDAANDA065188Hq Speclt Pharma
- Nov 29, 2005ANDAANDA065222Istituto Bio Ita Spa
- Nov 30, 2005ANDAANDA065176Hq Speclt Pharma
- Jul 25, 2006ANDAANDA065310Sandoz
- Nov 27, 2006ANDAANDA065314Istituto Bio Ita Spa
- Dec 22, 2009ANDAANDA065406Acs Dobfar
- May 23, 2023NDANDA216974Entasis Therap
FAERS reports
- 1Pyrexia2017.9%
- 2Pneumonia1917.5%
- 3Drug Ineffective1445.6%
- 4Dyspnoea1174.6%
- 5Diarrhoea1094.3%
- 6Rash1034.0%
- 7Sepsis933.6%
- 8Pain833.2%
- 9Nausea813.2%
- 10Off Label Use793.1%
- 11Vomiting793.1%
- 12Anaemia742.9%
- 13Hypotension732.9%
- 14Condition Aggravated682.7%
- 15Respiratory Failure682.7%
Literature
Recent PubMed references pinned to Sulbactam as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Transcriptome-constrained genome-scale metabolic modeling reveals central carbon and amino acid metabolic reprogramming underlying colistin-sulbactam synergy in Acinetobacter baumannii.Antimicrobial agents and chemotherapy · 2026 · Bian X, Zhu Y, Liu X, et al.PMID 42084367DOI 10.1128/aac.01848-25
- Sulbactam-Durlobactam for Carbapenem-Resistant Acinetobacter baumannii-calcoaceticus Complex.Pathogens (Basel, Switzerland) · 2026 · Nappi FPMID 42075775DOI 10.3390/pathogens15040449
- Glutamine Potentiates Cefoperazone-Sulbactam against Klebsiella pneumoniae by Enhancing Cellular Uptake and ROS Production.ACS infectious diseases · 2026 · Li SH, Chen YY, Fu HZ, et al.PMID 42053167DOI 10.1021/acsinfecdis.6c00129
- Comparative activity of sulbactam and sulbactam/durlobactam against carbapenem-resistant A. baumannii isolates producing OXA-23 or OXA-23 plus PER-1 enzymes.The Journal of antibiotics · 2026 · Mirza HC, Üsküdar Güçlü A, Ünlü S, et al.PMID 41963516DOI 10.1038/s41429-026-00919-x
- Sulbactam-durlobactam plus ceftriaxone dosing and novel treatment regimens for Mycobacterium abscessus lung disease.Antimicrobial agents and chemotherapy · 2026 · Singh S, Shrivastava A, Boorgula GD, et al.PMID 41954387DOI 10.1128/aac.01437-25
- Effects of Sulbactam on behavioral and neuronal deficits in an MPTP-induced Parkinson's disease rat model.Brain research bulletin · 2026 · Yang SC, Tsou SH, Liao WC, et al.PMID 41856255DOI 10.1016/j.brainresbull.2026.111831
- Cerebrospinal Pharmacokinetic and Pharmacodynamic Evaluation of Sulbactam: Dosing Considerations for Acinetobacter baumannii Meningitis in Pediatric Patients.Journal of the Pediatric Infectious Diseases Society · 2026 · Onita T, Ikawa KPMID 41810872DOI 10.1093/jpids/piag017
- bla TEM-1 and blaTEM-176 overexpression underlies atypical ampicillin/sulbactam resistance in non-ESBL Salmonella from raw chicken.Journal of applied microbiology · 2026 · Zwe YH, Yuk HGPMID 41604208DOI 10.1093/jambio/lxag031
Clinical trials
The 10 most recently updated of 69 ClinicalTrials.gov registrations naming Sulbactam as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Sulbactam-Durlobactam in CRAB Infection: A Real-World Cohort StudyRecruiting · Observational · 200 enrolled · Sichuan Provincial People's HospitalNCT07601711updated 2026-05-22
- A Study to Assess the Safety and Risk of Hypersensitivity Reactions of Sulbactam-durlobactam in Adults With Acinetobacter Baumannii-calcoaceticus (ABC) Complex InfectionRecruiting · Observational · 100 enrolled · Innoviva Specialty TherapeuticsNCT06746883updated 2026-05-22
- One Versus Five Days of Antibiotics After AppendectomyNot yet recruiting · Interventional · 200 enrolled · Ministry of Health and Population, EgyptNCT07563933updated 2026-05-04
- Efficacy and Safety of BV100 Plus Low Dose Polymyxin B Versus Colistin Plus High-dose Ampicillin/Sulbactam in Patients With Hospital-acquired or Ventilator-associated Bacterial Pneumonia Due to Carbapenem-resistant Acinetobacter Baumannii-calcoaceticus ComplexRecruiting · Phase 3 · Interventional · 248 enrolled · BioVersys SASNCT07326540updated 2026-05-04
- Testing a Novel Combination Treatment (Arm D) Versus Standard of Care for Intensive Phase Treatment for Mycobacterium Abscessus Pulmonary Disease in People With or Without Cystic Fibrosis in the Finding the Optimal Regimen for Mycobacterium Abscessus Treatment (FORMaT) Adaptive Platform TrialNot yet recruiting · Phase 2 · Interventional · 300 enrolled · The University of QueenslandNCT07485010updated 2026-03-20
- A Study to Assess Sulbactam-durlobactam in Pediatric Patients With Acinetobacter Baumannii-calcoaceticus Complex InfectionRecruiting · Phase 1 · Interventional · 48 enrolled · Innoviva Specialty TherapeuticsNCT06801223updated 2026-03-03
- Short Versus Standard of Care Antibiotic Duration for Children Hospitalized for CAPRecruiting · Phase 4 · Interventional · 236 enrolled · Medical College of WisconsinNCT06494072updated 2026-03-02
- Assessing Role of Probiotics in Children Aged 6-36 Months Treated for PneumoniaNot yet recruiting · Interventional · 330 enrolled · Anabio R&DNCT07399717updated 2026-02-10
- Antibacterial Tactics Based on Presepsin Level in Thoracic Aorta Surgery PatientsRecruiting · Interventional · 50 enrolled · Petrovsky National Research Centre of SurgeryNCT06336213updated 2026-01-29
- Therapeutic Options for CRABRecruiting · Phase 4 · Interventional · 108 enrolled · Clinical Hospital Centre ZagrebNCT06440304updated 2026-01-21
Frequently asked questions
- How does Sulbactam work?
- Mechanism-of-action class: beta Lactamase Inhibitors.
- What is Sulbactam used for?
- According to FDA labeling, Sulbactam carries indications including: Ampicillin and sulbactam for injection is indicated for the treatment of infections due to susceptible strains of the designated microorganisms in the conditions listed below. Skin and Skin Structure Infections caused by beta-lactamase producing strains of Staphylococcus aureus , Escherichia coli ,* Klebsiella spp.* (including K.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Sulbactam?
- Sulbactam is classified as Beta-lactamase inhibitors, beta Lactamase Inhibitor, beta Lactamase Inhibitors.
- What are the brand names for Sulbactam?
- Sulbactam is marketed under brand names including Unasyn, Xacduro.
- What are the contraindications for Sulbactam?
- Sulbactam labeling lists contraindications including: The use of ampicillin and sulbactam for injection is contraindicated in individuals with a history of serious hypersensitivity reactions (e.g., anaphylaxis or Stevens-Johnson syndrome) to ampicillin, sulbactam or to other beta-lactam antibacterial drugs (e.g., penicillins and cephalosporins). Ampicillin and sulbactam for injection is contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with ampicillin and sulbactam for injection.. Always consult the full prescribing information and a clinician.
sulbactam is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.