Pivsulbactam

(BAN)
Synonyms: CP-47904; Sulbactam Pivoxil (USAN). Pivaloyloxymethyl penicillanate 1,1-dioxide.
Cyrillic synonym: Пивсульбактам.

💊 Chemical information

Chemical formula: C14H21NO7S = 347.4.
CAS — 69388-79-0.

💊 Profile

Sulbactam is a penicillanic acid sulfone with beta-lactamase inhibitory properties. It is active against Neisseriaceae and Acinetobacter baumanii, but generally has only weak antibacterial activity against other organisms. It is an irreversible inhibitor of many plasmid-mediated and some chromosomal beta-lactamases and has a similar spectrum of beta-lactamase inhibition to clavulanic acid, although it is regarded as less potent. Sulbactam can therefore enhance the activity of penicillins and cephalosporins against many resistant strains of bacteria. It is given with ampicillin in the treatment of infections where beta-lactamase production is suspected. Sulbactam is poorly absorbed from the gastrointestinal tract and is given by injection as the sodium salt. The pharmacokinetics of parenteral sulbactam and ampicillin are similar. For oral use the mutual prodrug sultamicillin is available in some countries. Sulbactam is also given orally as the pivoxil derivative, pivsulbactam, with amoxicillin. Sulbactam has also been given with cefoperazone.
1. Campoli-Richards DM, Brogden RN. Sulbactam/ampicillin: a review of its antibacterial activity, pharmacokinetic properties, and therapeutic use. Drugs 1987; 33: 577–609
2. Payne DJ, et al. Comparative activities of clavulanic acid, sulbactam, and tazobactam against clinically important β-lactamases. Antimicrob Agents Chemother 1994; 38: 767–72
3. Nicolas-Chanoine MH. Inhibitor-resistant β-lactamases. J Antimicrob Chemother 1997; 40: 1–3
4. Lee NLS, et al. β-Lactam antibiotic and β-lactamase inhibitor combinations. JAMA 2001; 285: 386–8
5. Lode H. Role of sultamicillin and ampicillin/sulbactam in the treatment of upper and lower bacterial respiratory tract infections. Int J Antimicrob Agents 2001; 18: 199–209
6. Kanra G. Experience with ampicillin/sulbactam in severe infections. J Int Med Res 2002; 30 (suppl 1): 20A–30A
7. Rafailidis PI, et al. Ampicillin/sulbactam: current status in severe bacterial infections. Drugs 2007; 67: 1829–49
8. Akova M. Sulbactam-containing beta-lactamase inhibitor combinations. Clin Microbiol Infect 2008; 14 (suppl 1): 185–8.

Breast feeding.

Although sulbactam is distributed into breast milk in small amounts,1 no adverse effects have been seen in breast-fed infants and the American Academy of Pediatrics considers that it is usually compatible with breast feeding.2
1. Foulds G, et al. Sulbactam kinetics and excretion into breast milk in postpartum women. Clin Pharmacol Ther 1985; 38: 692–6
2. American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001; 108: 776–89. Correction. ibid.; 1029. Also available at: http://aappolicy.aappublications.org/cgi/content/full/ pediatrics%3b108/3/776 (accessed 28/05/04)

💊 Preparations

USP 31: Ampicillin and Sulbactam for Injection.

Proprietary Preparations

Austria: Combactam; Ger.: Combactam; Turk.: Ampisid. Multi-ingredient: Arg.: Aminoxidin Sulbactam; Ampi-Bis Plus; Ampigen SB; Darzitil SB; Prixin; Sulperazon†; Trifamox IBL; Unasyna; Unsayna†; Austria: Unasyn; Braz.: Combactan; Sulbacter†; Sulbamox; Trifamox; Unasyn; Chile: Sulbamox; Sulperazon; Unasyn; Cz.: Sulperazon; Unasyn; Fr.: Unacim; Ger.: Unacid; Gr.: Begalin-P; Hong Kong: Sulperazon; Unasyn; Hung.: Unasyn; India: Keftragard; Lactagard; Sulbacef; Sulbacin; Sultax; Zosul; Indon.: Fosular; Stabactam; Sulperazon; Israel: Unasyn; Ital.: Bethacil; Loricin; Unasyn; Jpn: Sulperazon†; Unasyn-S†; Malaysia: Sulbacin; Sulperazon; Unasyn; Mex.: Megamox; Trifamox IBL; Unasyna; Philipp.: Sulperazone; Unasyn; Pol.: Sulperazon; Unasyn; Rus.: Sulcef (Сульцеф); Sulperason (Сульперазон); Sultasin (Сультасин); Trifamox IBL (Трифамокс ИБЛ); Unasyn (Уназин); Singapore: Unasyn; Spain: Unasyn; Thai.: Cebactam; Cefper; Sulam; Sulcef; Sulperazon; Unasyn; Turk.: Combicid; Duobak; Duobaktam; Duocid; Nobecid; Primasef; Sulbaksit; Sulcid; Sulperazon; Sultasid; USA: Unasyn; Venez.: Ampibactan; Ampitren†; Fipexiam; Sinif; Sulperazon; Unasyn.
Published May 08, 2019.