How does an elliptical machine effect ampicillin?

I write these on the elliptical. That’s it. No jokes here. Only my tears as I feel left out of jokes made by the medical and ID twitter accounts I follow but don't understand yet. Aside from that soul crushing fact, these antibiotic blogs are not only interesting to me but keep me on the cardio equipment at 0400. 

So, ampicillin? Change the ox for the p, is it that different than amoxicillin? Kinda. It has a similar coverage but unlike amoxicillin it can be given IV and IM (amoxicillin can be given IV just not approved here in the U.S. of A). It is also a beta-lactam antibiotic, well distributed in body tissues, and widely used in pregnancy for infections such as group B strep. 

What I think of, as a nurse, is the short half-life up to 90 minutes and the need to dose every 4-6 hours depending on kidney function. Also, as an outpatient drug? If I didn't have 3 extended release prescriptions I could take in the AM I don't know how it would be to have to remember to take something every 4-6 hours. Granted, thats a minor problem, however adherence is an issue for patient outcomes and for AMR. The most simple regimen is best for compliance. Ideally qd or bid is preferred. 

Fun facts; patients with infectious mononucleosis on ampicillin tend to develop a rash 7-10 days after starting the dug. The rash is generally generalized (bingo) and itchy or pruritic for you fancy people. A study in JAMA Pediatrics found that when amoxicillin was started 24 hours or more before delivery there was an increased risk of the newborn contracting ampicillin resistant group B strep. Adding silver nanoparticles to ampicillin causes a synergistic effects and allows for treatment against MRSA. So I am hearing that we need to bling out our antibiotics? Doesn't seem cost effective and I don't like gaudy displays, but it could look nice. Oh wait, never mind, talking about effectiveness not aesthetics. 

Finally, it has good absorption in the GI tract, can concentrate in the liver and kidneys, move into CSF, and crosses the placenta. That's my story and I'm sticking to it. 

Kinda short one today and I type this at a hockey tournament. I wonder what gnarly stuff you could culture off the floors here? Scary thought. Check out my podcast on Spotify and iTunes and share this or that if you feel it isn't that mind numbingly stupid. Stay well y'all. 

References

Ampicillin from StatPearls at the NIH: National Library of Medicine by Peechakara et al. 2022.

Augmented antibacterial activity of ampicillin with silver nanoparticles against methicillin-resistant Staphylococcus aureus (MRSA) from The Journal of Antibiotics October 2018 by Surwade et al. 

Image of group B strep, S. agalactiae from the every powerful Wikipedias.

Risk Factors Associated With Ampicillin-Resistant Infection in Newborns in the Era of Group B Streptococcal Prophylaxis from JAMA Pediatrics by Rentz et al. June 2004.




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