ampicillin/sulbactam / Generic mfg. - LARVOL DELTA

Evaluation and Management of Patient Referred for "Normal Saline Allergy" (ACAAI 2025) - "With recent NS infusion, he developed urticaria, abdominal pain and hypoxia to SpO2 70%, only resolving after epinephrine administration. He also endorses prior anaphylaxis to azithromycin, ceftriaxone, piperacillin/tazobactam, clindamycin, levofloxacin, and ampicillin/sulbactam...The reproducibility of symptoms with NS and tolerance of other fluids prompted evaluation. Testing identified chlorhexidine as the likely culprit, which poses a logistical challenge as chlorhexidine is a standard component of peripheral intravenous line placement kits."

Clinical • Allergy • Anemia • Cardiovascular • Dermatology • Genetic Disorders • Hematological Disorders • Immunology • Sickle Cell Disease • Urticaria • Vascular Neurology

Suspected Tazobactam Allergy in A Case of Anaphylaxis in Multiple Drug Allergy (ACAAI 2025) - "The patient's listed allergies included: penicillin, piperacillin-tazobactam, and multiple cephalosporin. Penicillin resulted in anaphylaxis 9 years prior, as well as anaphylaxis to ceftriaxone and cefepime. Penicillin skin testing was negative and he passed 2-step amoxicillin challenge. He subsequently tolerated Ampicillin-sulbactam. Based off susceptibilities, the primary team requested to change therapy to ceftolozane-tazobactam...He was treated for anaphylaxis with intramuscular epinephrine. Tryptase during event was 13.4μg/L. Discussion This case highlights the importance of history in drug allergy evaluation, as well as consideration of tazobactam as a separate allergenic agent."

Clinical • Allergy • Asthma • Immunology • Inflammation • Pruritus • Respiratory Diseases

Clinical characteristics and influencing factors of severe influenza A virus pneumonia in children coinfected with gram-negative bacteria: A retrospective analysis. (PubMed, J Int Med Res) - "In the observation group, all H. influenzae isolates were sensitive to ceftriaxone, cefotaxime and meropenem, while resistance rates to ampicillin, trimethoprim-sulfamethoxazole, cefuroxime and ampicillin/sulbactam were 60.4%, 75%, 27.8% and 6.2%, respectively. All M. catarrhalis isolates were sensitive to ampicillin/sulbactam, amoxicillin/sulbactam and ciprofloxacin, whereas resistance rates to ampicillin and trimethoprim-sulfamethoxazole were 67.9% and 10.7%, respectively.ConclusionSevere influenza A virus pneumonia complicated by gram-negative bacterial infection is more common in children aged <5 years. Younger age and the presence of underlying diseases increase the likelihood of gram-negative bacterial coinfection. Persistent fever, wheezing and significant elevations in C-reactive protein level, procalcitonin level, platelet count and monocyte count are important early warning signs for the clinical identification of gram-negative bacterial infection."

Journal • Retrospective data • Critical care • Infectious Disease • Influenza • Pediatrics • Pneumonia • Respiratory Diseases • CRP

Mathematical modelling of synergistic triple-antibiotic therapy against carbapenem-resistant Acinetobacter baumannii at clinically achievable concentrations. (PubMed, J Med Microbiol) - "To evaluate the efficacy of colistin-meropenem-ampicillin/sulbactam combinations at standard dosages and develop a predictive mathematical model for synergistic interactions against CRAB.Methodology. The triple combination achieves universal synergy at standard dosages, potentially reducing toxicity risks. Our mathematical model enables rapid prediction of effective combinations from routine susceptibility tests, offering a transformative approach to optimizing therapy against multidrug-resistant pathogens."

Journal

Myocarditis in a Dog Positive for Brucella canis. (PubMed, J Am Anim Hosp Assoc) - "The dog was hospitalized for 6 days on IV fluid therapy and treated with ampicillin/sulbactam and enrofloxacin. She was discharged on amoxicillin-clavulanic acid and maropitant citrate...It was revealed that two of her littermates had tested positive for Brucella canis, so antimicrobial therapy was switched to enrofloxacin and doxycycline...However, myocarditis is a rare clinical manifestation of brucellosis in humans. Depending on patient history, clinical signs, and diagnostic findings, brucellosis is a zoonotic disease that may be a differential diagnosis in dogs with suspected myocarditis."

Journal • Cardiovascular • Infectious Disease • Inflammation • TNNI3

Revisiting acute chest syndrome (ACS) associated with sickle cell disease (SCD) vaso-occlusive pain episodes (VOE): Insight from a prospective, multicenter Phase-3 randomized controlled trial (ASH 2025) - P3 | "ACSseverity was defined a priori as mild (no oxygen (O2) use or RBC transfusion), moderate (O2 use ortransfusion), or severe (bilevel positive airway pressure (BiPAP) use, intubation, or pediatric intensive careunit (PICU) transfer). 271 patients enrolled (median age 15[11,18] years, 51% male; 74% HbSS/Sb°; 76% onHydroxyurea (HU)...Across all sites, 96% of patients receivedantibiotics (50% ceftriaxone, 28% ampicillin-sulbactam, 7% vancomycin, 11% other) and 82% receivedazithromycin. Site-level use ranged from 0-100% for ceftriaxone and 50-100% for azithromycin... ACS remains common in patients with SCD-VOE (20%), with 14% of ACS diagnosed duringtheir hospital stay. Two-thirds of subjects who developed ACS had a CXR done in the ED that wasnegative. ACS may have been missed in patients who did not get a CXR, and radiographic changes oftenlag behind symptoms."

Clinical • P3 data • Addiction (Opioid and Alcohol) • Cardiovascular • Genetic Disorders • Hematological Disorders • Pain • Pediatrics • Respiratory Diseases • Sickle Cell Disease

Gonococcal Endocarditis of the Native Aortic Valve: A Rare but Aggressive Cause of Valvular Destruction (AHA 2025) - "The patient was started on broad-spectrum antibiotics, including vancomycin and ampicillin-sulbactam.Intraoperatively, vegetations were observed on the left and right coronary leaflets, with a small perivalvular abscess at the left-right coronary commissure. Given the potentially devastating consequences of delayed recognition, this case emphasizes the importance of considering gonococcal etiology in endocarditis, particularly in young, sexually active individuals without classic symptoms. Reporting such cases helps towards forming evidence-based treatment guidelines and strengthening awareness of this rare presentation."

Cardiovascular • Infectious Disease • Inflammation • Musculoskeletal Pain

A Rare Complication of Hepatic Cysts in Advanced Autosomal Dominant Polycystic Kidney and Liver Disease (ACG 2025) - "Patient was empirically started on intravenous meropenem and later de-escalated to ampicillin-sulbactam...The patient improved clinically and was discharged on oral amoxicillin-clavulanate, with plans for outpatient dialysis, and outpatient kidney and liver transplant evaluation. This case highlights a rare, but serious complication of ADPKD/PLD: hepatic cyst infection leading to sepsis and AKI on CKD...Figure: Figure 1: Non-contrast CT Imaging of the Abdomen Showing Extensive Polycystic Changes in Both Kidneys and Liver, Consistent with Advanced Autosomal Dominant Polycystic Kidney and Liver Disease. Liver cyst with measurement (13.8 cm x 11 cm) indicates the hepatic cyst that was drained percutaneously, with 1000 mL serous drainage output."

Metastases • Autosomal Dominant Polycystic Kidney Disease • Chronic Kidney Disease • Genetic Disorders • Hepatology • Infectious Disease • Nephrology • Polycystic Kidney Disease • Renal Disease • Septic Shock

Liver Abscess and ARDS in a Healthy Young Male Following Routine Dental Cleaning: An Uncommon Sequelae of Group G Streptococcal bacteremia (ACG 2025) - "He was started on IV piperacillin-tazobactam and underwent IR-guided abscess drainage...Post-extubation, antibiotics were narrowed to ampicillin-sulbactam...He improved with ertapenem and was discharged with outpatient follow-up. PLA in healthy individuals is rare...Early recognition and multidisciplinary care are critical to favorable outcomes as complications of PLA, such as ARDS, can occur due to systemic inflammatory response. This case adds to the limited literature on GGS-induced liver abscess in healthy individuals, highlighting the systemic implications of what may appear to be a routine outpatient procedure.Figure: CT abdomen with contrast shows a 6.1 cm * 6.2 cm * 6.4 cm right hepatic lobe fluid collection"

Clinical • Acute Respiratory Distress Syndrome • Hepatology • Immunology • Infectious Disease • Inflammation • Mood Disorders • Respiratory Diseases • Systemic Inflammatory Response Syndrome

A Rare Case of Septic Shock Secondary to Bacteroides fragilis Empyema in the Setting of Ruptured Liver Abscess (ACG 2025) - "Initially, the patient received broad-spectrum IV antibiotics, including piperacillin-tazobactam, which was later narrowed to ampicillin-sulbactam based on culture sensitivities. underscores the critical nature of this infection. Timely diagnosis through imaging and microbiological analysis, coupled with antibiotics and surgical drainage, is crucial for successful management"

Clinical • Addiction (Opioid and Alcohol) • Cardiovascular • Diabetes • Hepatology • Hypertension • Infectious Disease • Metabolic Disorders • Respiratory Diseases • Septic Shock • Type 2 Diabetes Mellitus

A Rare Long Term Complication (ACG 2025) - "The patient was started on intravenous ampicillin-sulbactam 3 grams every 6 hours...A high index of suspicion and early treatment improve outcomes. Management should be individualized based on timing, location, and cause, with supportive measures (e.g., wound care, adequate feeding) as important as surgical repair.Figure: Figure 1Figure: Figure 2"

Cough • Gastrointestinal Disorder • Otorhinolaryngology • Respiratory Diseases

A Case Report of Clostridium perfringens Bacteremia Following Colorectal Cancer Resection (ACG 2025) - "Infectious Disease was consulted and recommended treatment with ampicillin-sulbactam with the transition to oral amoxicillin-clavulanate upon discharge. CT abdomen and pelvis showing colitis in the sigmoid colon (red arrows).Figure: Figure 2. CT abdomen and pelvis showing colitis in the descending colon (red arrows) and colonic hyperemia (blue arrow)."

Case report • Clinical • Biliary Cancer • Colon Cancer • Colorectal Cancer • Gastric Cancer • Gastroenterology • Gastrointestinal Cancer • Gastrointestinal Disorder • Genito-urinary Cancer • Immunology • Infectious Disease • Nephrology • Neutropenia • Oncology • Prostate Cancer • Renal Disease • Solid Tumor

A Rare Case of Pylephlebitis Arising From Sigmoid Diverticulitis (ACG 2025) - "Patient was treated with ampicillin-sulbactam and discharged on amoxicillin-clavulanate. Thrombophlebitis was thought to be provoked, heparin drip was initiated, and transitioned to Eliquis with plans for 3 months of therapy...It was seen that these individuals did not have an underlying hypercoagulable state or mesenteric vein involvement. Overall, the decision to use anticoagulation should be individualized to patient risk factors and comorbidities."

Clinical • Cardiovascular • Fibrosis • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Hypertension • Immunology • Infectious Disease • Pancreatitis • Portal Hypertension • Thrombosis

A case of empyema caused by Streptococcus pyogenes in an immunocompetent adult: a rare pulmonary manifestation. (PubMed, Future Microbiol) - "Initial empirical treatment with piperacillin-tazobactam was escalated to meropenem and vancomycin due to increased inflammatory markers and positive blood cultures...Susceptibility testing confirmed sensitivity to penicillin-class antibiotics, leading to targeted therapy with ceftriaxone, ampicillin-sulbactam, and later, oral amoxicillin-clavulanate...The patient was ultimately discharged in good condition. In conclusion, although S. pyogenes is an uncommon cause of community-acquired pneumonia, it should be considered in cases with rapid progression and empyema complications."

Journal • Cough • Dermatology • Infectious Disease • Pain • Pneumonia • Respiratory Diseases

MAN'S BEST FRIEND, MEDICINE'S WORST NIGHTMARE: A SEVERE CASE OF CAPNOCYTOPHAGA CANIMORSUS BACTEREMIA (CHEST 2025) - "He was treated empirically with meropenem, doxycycline, and daptomycin...Inotropic support with dobutamine was initiated for superimposed cardiogenic shock...Blood cultures resulted positive for C. canimorsus and antibiotics were de-escalated to ampicillin-sulbactam, with clinical improvement... This case highlights the rapid progression of septic shock with associated multiorgan failure following a dog bite. High clinical suspicion, broad spectrum antibiotics, and aggressive supportive care are vital for decreasing mortality associated with C. canimorsus. Regardless of immune status, patients admitted with an animal bite should have broad antibiotic coverage, until culture data can direct antibiotic therapy."

Clinical • Acute Kidney Injury • Acute Respiratory Distress Syndrome • Anemia • Cardiovascular • Hematological Disorders • Infectious Disease • Metabolic Disorders • Renal Disease • Respiratory Diseases • Septic Shock

Characterization of Carbapenem-Resistant Gram-Negative Bacilli Isolates in Multispecialty Private Hospitals in Lagos, Nigeria. (PubMed, Infect Dis Rep) - "Emerging CR-GNB, specifically CP-GNB, in Nigeria emphasize the need for specific therapeutic management of infected patients. Antimicrobial stewardship and long-term surveillance efforts must be implemented in healthcare settings, as well as improved, accelerated microorganism identification techniques."

Journal • Critical care • Infectious Disease • Oncology • Pneumonia

Evaluation of a Novel Rapid Phenotypic Antimicrobial Susceptibility Testing System. (PubMed, Antibiotics (Basel)) - "The Selux DX system provides rapid and reliable phenotypic AST results, supporting earlier clinical decision-making and antimicrobial stewardship. However, discrepancies with certain antimicrobial agents, particularly among highly resistant reference isolates, highlight the need for further validation in larger, multicenter studies."

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INTRALOBAR PULMONARY SEQUESTRATION PRESENTED AS LUNG ABSCESSES: A CASE REPORT (CHEST 2025) - "Empirical IV ampicillin/sulbactam was initiated while awaiting microbiological results... This case highlights the diagnostic and management complexities of intralobar sequestration complicated by lung abscesses. Early imaging, multidisciplinary collaboration, and timely surgical referral are crucial for optimal patient outcomes. Pulmonary sequestration should be included in the differential diagnosis of recurrent lung infections, particularly when cavitary lesions and anomalous vascular supply are present."

Case report • Clinical • Anorexia • Chronic Cough • Cough • Infectious Disease • Musculoskeletal Pain • Pneumonia • Respiratory Diseases • Tuberculosis

ACUTE HEMORRHAGIC SEPTICEMIA: A CASE OF NEARLY FATAL INVASIVE PASTURELLA MULTOCIDA INFECTION (CHEST 2025) - "The patient received standard care of septic shock with IV fluids, vasopressors, and broad-spectrum antibiotics (piperacillin-tazobactam and vancomycin)...Simple infections are treated with β-lactams, doxycycline, or fluroquinolones, but cephalexin, dicloxacillin and erythromycin are ineffective. Invasive infections warrant aggressive interventions to maintain hemodynamics with parenteral use of ampicillin-sulbactam, piperacillin-tazobactam or carbapenems...The role of FFP was unsuccessful in our case as the driving factor behind the hemorrhagic septicemia was Pasteurella infection rather than simple warfarin reversal or DIC... Zoonotic infections, especially from domestic pets, remain important to recognize early for proper management. Social history is often overseen but can be key in unlocking the mystery behind an unusual serious presentations. Future studies in regards of rising Pasteurella species infection, treatment, and vaccination would be needed."

Clinical • Acute Kidney Injury • Cardiovascular • Chronic Obstructive Pulmonary Disease • Diabetes • Diabetic Nephropathy • Fatigue • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Metabolic Disorders • Nephrology • Renal Disease • Respiratory Diseases • Septic Shock

SELENIUM SULFIDE STRICTURES: TOXIC INGESTION OF DANDRUFF SHAMPOO (CHEST 2025) - "Empiric antibiotics – ampicillin sulbactam were started to cover for aspiration pneumonia...Antibiotic regimen was broadened to piperacillin tazobatem... There have been no documented case of substantial amounts of toxic SSe ingestion in humans. Our case illustrates acute bronchial mucosal injury secondary to caustic ingestion of anti-dandruff shampoo with regurgitant aspiration."

CNS Disorders • Fibrosis • Immunology • Infectious Disease • Liver Cancer • Pneumonia • Respiratory Diseases • Seborrheic Dermatitis • Septic Shock • Solid Tumor • Vascular Neurology

AMYL NITRITE-INDUCED METHEMOGLOBINEMIA FOLLOWING THE INGESTION OF VCR CLEANER (CHEST 2025) - "A urine drug screen was positive for alcohol, amphetamine, and THC; however, the patient has prescriptions for methylphenidate and THC...He was treated with methylene blue (MB), ascorbic acid, intravenous fluid, sodium bicarbonate drip, thiamine, and ampicillin/sulbactam... This case highlights the serious complications of MetHb following the ingestion of amyl nitrite-containing VCR cleaner. MetHb can present with a wide range of symptoms, depending on the levels of methemoglobin. Our patient presented to the hospital with altered mental status, nausea, and dizziness and was found to have a MetHb level of 57.1%."

Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Metabolic Disorders • Pulmonary Disease

VAPING-INDUCED FUSOBACTERIUM NECROPHORUM EMPYEMA IN A HEALTHY YOUNG MALE (CHEST 2025) - "He was started on broad coverage with vancomycin, doxycycline, and piperacillin- tazobactam...Later his antibiotics were narrowed down to ampicillin-Sulbactam... This case underscores the need for vaping cessation, patient education, being aware of the risk of atypical infections, and appropriate escalation of care, including surgical intervention, to improve outcomes."

Clinical • Cough • Human Immunodeficiency Virus • Infectious Disease • Influenza • Novel Coronavirus Disease • Otorhinolaryngology • Pneumonia • Respiratory Diseases

COMMUNITY-ACQUIRED VRE EMPYEMA IN A HEALTHY YOUNG ADULT (CHEST 2025) - "The patient's presenting vitals in the emergency department were stable, and initial labs showed leukocytosis of 19.9 K/mm3, lactate dehydrogenase of 368 U/L, total protein of 7.7 g/dL and lactic acid of 1.8 mmol/ L. CT Chest confirmed complex left-sided loculated pleural effusion (see Figure 1.) The patient was started on Vancomycin and Ceftriaxone...Antibiotics were switched to Penicillin G initially and escalated to Linezolid and Ampicillin / Sulbactam due to recurrent fevers. The patient showed improvement in respiratory status and fevers and was discharged on a two-week course of oral Linezolid and Amoxicillin / Clavulanic Acid... In young, healthy patients, VRE is rarely considered as a possibility for community-acquired pneumonia or empyema. It is important to recognize the possibility of VRE-associated infections in immunocompetent patients without prior intra-abdominal infections."

Clinical • Cardiovascular • Cough • Fatigue • Infectious Disease • Nephrology • Obstructive Sleep Apnea • Pneumonia • Respiratory Diseases • Sleep Apnea • Sleep Disorder

A VASCULAR CONUNDRUM: LEMIERRE'S SYNDROME WITH SUPERIOR VENA CAVA OBSTRUCTION: A MULTIDISCIPLINARY TRIUMPH (CHEST 2025) - "He also reported severe dental and jaw pain after a dental abscess treated unsuccessfully with amoxicillin and had lost 9 lbs unintentionally...Although approximately 50% residual stenosis persisted, venous flow improved markedly, and the patient was transitioned from IV heparin to oral eliquis. Intravenous ampicillin-sulbactam was continued for three weeks, followed by oral augmentin, leading to significant symptomatic relief. This case highlights the evolving challenge of managing Lemierre's syndrome, particularly when complicated by SVC thrombosis. Early recognition, prompt imaging, and a coordinated multidisciplinary approach—including advanced interventional procedures—are critical to reducing thrombus burden, preventing long-term complications, and improving patient outcomes in this rare but life-threatening condition."

Anorexia • Cardiovascular • Cough • Dental Disorders • Fatigue • Fibrosis • Hematological Disorders • Immunology • Infectious Disease • Otorhinolaryngology • Pulmonary Disease • Respiratory Diseases • Thrombosis

HIDING IN THE PERICARDIUM: A CASE OF E. FAECALIS PERICARDITIS (CHEST 2025) - "The patient was empirically treated with vancomycin, cefepime and metronidazole...Based on the antibiogram, antibiotics were narrowed to ampicillin-sulbactam... Enterococcal microorganisms are a rare cause of pleural empyema and pericarditis but can occur in patients with predisposing comorbidities. It is important to identify enterococcus early and consider longer duration and appropriate selection of antibiotic course to prevent complications such as bacterial pericarditis."

Clinical • Back Pain • Cardiovascular • Congestive Heart Failure • Glomerulonephritis • Heart Failure • Hypertension • Infectious Disease • Lupus Nephritis • Musculoskeletal Pain • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases • Tuberculosis