ampicillin/sulbactam / Generic mfg. - LARVOL DELTA

Rhabdomyosarcoma in adults with severe thrombocytopenia: Challenges in clinical management and therapeutic complications. (PubMed, Respir Med Case Rep) - "Initial treatment included ampicillin/sulbactam, trimethoprim/sulfamethoxazole, and dexamethasone. Chemotherapy with doxorubicin and ifosfamide was delayed due to thrombocytopenia, elevated D-dimer and fibrinogen levels, and an echocardiographic finding that required differentiation between thrombus and metastatic lesion. Anticoagulation with fondaparinux and transfusions were initiated, and the patient received 10 sessions of radiotherapy...Despite these interventions, the patient progressed to refractory shock, severe hypoxemia, and died from cardiac arrest. This case highlights the challenges in managing ARMS in adults with severe thrombocytopenia."

Journal • Cardiovascular • Hematological Disorders • Infectious Disease • Oncology • Pain • Respiratory Diseases • Rhabdomyosarcoma • Sarcoma • Septic Shock • Solid Tumor • Thrombocytopenia • Thrombosis

There is no significant difference in the treatment of aspiration pneumonia in dogs with ampicillin-sulbactam versus ampicillin-sulbactam and enrofloxacin. (PubMed, J Am Vet Med Assoc) - "Empirical treatment with MT is likely appropriate for dogs with AP lacking signs of critical illness. In dogs for which eDT was deemed clinically necessary, outcomes are not worse."

Journal • Immunology • Infectious Disease • Inflammation • Pneumonia • Respiratory Diseases • Systemic Inflammatory Response Syndrome

PERIPROCEDURAL ANTIBIOTICS FOR PERORAL ENDOSCOPIC MYOTOMY (POEM): A PROPENSITY SCORES MATCHED COHORT STUDY (DDW 2025) - "Periprocedural antibiotics were defined as 1 st /2 nd generation cephalosporins, fluoroquinolones, or ampicillin-sulbactam administered on the day of the procedure. Primary outcomes were: 1) incidence of fever (measured on postprocedural days 0-1) and 2) postprocedural infectious complications between postprocedural days 3-7, defined by diagnoses such as sepsis, mediastinitis, or bacteremia, or initiation of some antibiotics that are typically not used for prophylaxis (e.g., piperacillin/tazobactam, carbapenems, vancomycin)...Our analysis did not reveal any statistically significant correlation between the use of periprocedural antibiotics and the incidence of postprocedural infections or other adverse outcomes. These findings imply that the administration of periprocedural antibiotics may not be essential for the prevention of infectious complications following POEM."

Infectious Disease • Septic Shock

Diabetic Ketoacidosis and Necrotizing Soft Tissue Infection. (PubMed, J Educ Teach Emerg Med) - "Suspected NSTI are typically polymicrobial and myonecrosis and should be treated with: 1) vancomycin (or linezolid), 2) either piperacillin/tazobactam, ampicillin/sulbactam, or a carbapenem, 3) clindamycin to decrease toxin production.2,4Initial treatment of DKA is isotonic fluids, and insulin therapy should be withheld until serum potassium levels are obtained since prolonged serum acidosis can drive potassium intracellularly...However, some studies have shown no benefit to insulin bolus in adults.5-6. Diabetes, diabetic ketoacidosis, necrotizing soft tissue infection, gas gangrene, myonecrosis."

Journal • Anesthesia • Cardiovascular • Dermatology • Diabetes • Infectious Disease • Metabolic Disorders • Myocardial Infarction • Pain • Pancreatitis

A Case Report: Acute Suppurative Thyroiditis Presenting with Thyroid Abscess (ESPE-ESE 2025) - "The patient was started on antibiotherapy (ampicillin sulbactam and metronidazole) with drainage...Recurrence of the abscess, worsening of symptoms, widespread necrosis may require lobectomy. As a result, although rare, AST and thyroid abscess are possible even in immunocompetent patients without congenital anomaly and thyroid disorder"

Case report • Clinical • Endocrine Cancer • Endocrine Disorders • Hepatology • Infectious Disease • Musculoskeletal Pain • Oncology • Otorhinolaryngology • Pain • Thyroid Gland Carcinoma

Pulmonary Brucellosis as a Rare Etiology for Ground Glass Opacities in the Lung (ATS 2025) - "She was initially started on vancomycin and ampicillin-sulbactam, which was later switched to rifampin and doxycycline to cover brucellosis. In this case, the patient responded well to doxycycline and rifampin. Given its rarity and varied presentation, pulmonary brucellosis should be considered in the differential diagnosis for patients with pneumonia, especially in endemic areas or those with relevant exposure or with positive serological tests."

Cough • Diabetes • Immunology • Infectious Disease • Inflammatory Arthritis • Metabolic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pneumonia • Respiratory Diseases • Rheumatology • Seronegative Spondyloarthropathies

Atypical Presentation of Lemierre's Syndrome Due to Pseudomonal Parotitis (ATS 2025) - "Despite initiation of Ampicillin and Sulbactam, continued decline ensued...Treatment course included IV Linezolid and Piperacillin/Tazobactam...Physicians and advanced practitioners should consider Lemierre's Syndrome as a differential in severe clinical contexts. Our patient had a successful clinical outcome, underscoring the high survival rate with prompt recognition and treatment."

Cardiovascular • Mumps • Musculoskeletal Diseases • Novel Coronavirus Disease • Orthopedics • Otorhinolaryngology • Pain • Pneumonia • Pulmonary Embolism • Respiratory Diseases • Xerostomia

Severe Acute Respiratory Distress Syndrome (ARDS) in an Infant With Disseminated Herpes Simplex Virus Pneumonitis (ATS 2025) - "The infant was started on ampicillin-sulbactam and gentamycin for suspected neonatal sepsis...Studies however suggest that only 84% of infants receive acyclovir when neonatal sepsis is suspected, despite untreated neonatal HSV having an 80% mortality rate (2)(3). This case highlights the need for heightened awareness and consideration of HSV in neonatal care to improve outcomes. Further research is needed for evaluation of maternal suppressive therapy and association with neonatal HSV."

Acute Respiratory Distress Syndrome • Herpes Simplex • Inflammation • Pediatrics • Pneumonia • Respiratory Diseases • Septic Shock • CRP

A Case of Tension Hydropneumothorax Secondary to Gastric Contents Following Hiatal Hernia Repair (ATS 2025) - "Her postoperative course was complicated by mediastinitis and empyema, managed with ampicillin/sulbactam, fluconazole, and intrapleural alteplase with dornase. Discussion Hydropneumothorax may arise after Type IV hiatal hernia repair due to anatomical and physiological disruptions from herniation, such as incarceration, ischemia-induced perforation, or subsequent interventions. This unique case, with a series of complications including recurrent repairs, gastric perforation, empyema, and partial gastrectomy with RYGB, underscores the need for provider vigilance and a high index of suspicion for postoperative complications."

Clinical • Anesthesia • Cardiovascular • CNS Disorders • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Psychiatry • Respiratory Diseases

Leptospirosis in the Concrete Jungle: A Case Report in an Urban Setting Presenting With Septic Shock and Encephalitis (ATS 2025) - "He was treated with vancomycin, ceftriaxone and azithromycin to cover for community acquired pneumonia and acyclovir with ampicillin-sulbactam to cover for meningitis/encephalitis. As climate change and urbanization brings greater areas of warm and humid environments and exposure to this organism, leptospirosis is estimated to increase in global burden. A heightened awareness of the disease through careful consideration of patient demographics, epidemiological factors and clinical features should allow for early detection of disease."

Case report • Clinical • Acute Kidney Injury • Addiction (Opioid and Alcohol) • Anesthesia • CNS Disorders • Hepatology • Human Immunodeficiency Virus • Inflammation • Musculoskeletal Pain • Pain • Pneumonia • Renal Disease • Respiratory Diseases • Septic Shock

A Case of Leptospirosis Induced Acute Respiratory Distress Syndrome (ATS 2025) - "Antibiotics were changed to ceftriaxone and azithromycin due to concern for leptospirosis, with a positive IgM confirming the high clinical suspicion of our infectious disease team. Of note, this patient was originally on ampicillin-sulbactam and changed to ceftriaxone once there was suspicion for leptospirosis. Placing leptospirosis on the differential as well as taking a detailed social history in similar cases may allow for earlier diagnosis and more targeted antibiotic therapy."

Clinical • Acute Kidney Injury • Acute Respiratory Distress Syndrome • Cardiovascular • Dyslipidemia • Fatigue • Heart Failure • Hematological Disorders • Hematological Malignancies • Hepatology • Immunology • Infectious Disease • Multiple Myeloma • Nephrology • Oncology • Renal Disease • Respiratory Diseases • Septic Shock • Thrombocytopenia

An Unexpected Myriad of Pulmonary Complications Following Vaping and Anabolic Steroid Use (ATS 2025) - "He was treated with oseltamivir and ceftriaxone...He was treated with ampicillin-sulbactam, required chest tube placement and pressors in the setting of obstructive shock...Early transfer to ECMO-capable centers should be prioritized to enhance patient outcomes in severe cases. Monitoring patients with a history of vaping or steroid use for complications is essential, as their clinical presentations may differ from conventional cases."

Acute Respiratory Distress Syndrome • Cardiovascular • Cough • Hematological Disorders • Infectious Disease • Influenza • Pneumococcal Infections • Pneumonia • Respiratory Diseases

A Case of Legionella Pneumonia Causing Late Diffuse Alveolar Hemorrhage and Atypical Hemolytic Uremic Syndrome (ATS 2025) - "He was found to have multifocal pneumonia on imaging and was started on Vancomycin, Ampicillin/Sulbactam, and Azithromycin. On day 2, his urinary legionella antigen returned positive, and he was transitioned to Piperacillin/Tazobactam and Levofloxacin...This is a growing area of research which may lead to earlier diagnosis of aHUS. Eculizumab, a complement inhibitor used to treat aHUS, was not given prophylactically due to infection risk, and by the time aHUS was confirmed on skin biopsy, the patient was recovering and was thus deferred."

Clinical • Atypical Hemolytic Uremic Syndrome • Complement-mediated Rare Disorders • Cough • Gastrointestinal Disorder • Hematological Disorders • Infectious Disease • Inflammation • Nephrology • Pneumonia • Respiratory Diseases • HP

Clearing the Air: Use of Intrapleural Fibrinolytics in a Case of Streptococcus Intermedius Empyema (ATS 2025) - "The patient received broad spectrum antibiotics with vancomycin, doxycycline and ampicillin-sulbactam. Combining accurate pathogen identification with effective treatments like alteplase can optimize management strategies and improve patient care in empyema cases. Despite the promising insights regarding the potential benefits of targeted treatments, more research is required to fully understand its clinical implications and optimize management strategies."

Clinical • Cardiovascular • Cough • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Infectious Disease • Respiratory Diseases

A Unique Case of Ureaplasma Parvum Causing Disseminated Infection and Hyperammonemia in an Immunocompetent Patient (ATS 2025) - "A 48-year-old female with borderline personality disorder, multiple sclerosis, methamphetamine use, and type two diabetes presented with osteomyelitis of the left temporomandibular joint. She was started on ampicillin-sulbactam and subsequently developed septic arthritis of the right elbow, cellulitis of the left forearm, and a loculated left pleural effusion...Her antibiotics were switched to doxycycline and her fever and white blood cell count improved...While she had multiple sclerosis, she had not received ocrelizumab in over 6 months prior to onset of her symptoms. This case emphasizes the limitations of our standard cultures and the importance of listening to the history."

Clinical • Borderline Personality Disorder • CNS Disorders • Dermatology • Diabetes • Epilepsy • Immunology • Infectious Disease • Inflammation • Metabolic Disorders • Multiple Sclerosis • Personality Disorder • Respiratory Diseases • Rheumatology

A Rare Case of Allan Herndon Dudley Syndrome Associated With Severe Tracheobronchomalacia and Endobronchial Polyposis (ATS 2025) - "Subsequently, the patient was started on Ampicillin/Sulbactam for aspiration pneumonia...Our patient was found to have severe tracheomalacia and endobronchial polyps requiring custom-made tracheostomy. Hence, bronchoscopic evaluation may be necessary for AHDS patients who have hypoxia despite medical management to evaluate for tracheobronchomalacia and endobronchial polyps as it can reduce the length of hospital stay with appropriate management."

Clinical • Ataxia • Cardiovascular • CNS Disorders • Constipation • Cough • Developmental Disorders • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Infectious Disease • Mental Retardation • Movement Disorders • Pneumonia • Psychiatry • Pulmonary Disease • Respiratory Diseases

Clinical Differences Between Survivors and Non-survivors of Ventilator-Associated Pneumonia in a Tertiary Hospital in Japan (ATS 2025) - "Survivors were significantly younger (69.1 vs 71.7 years, p<0.01) and received sulbactam (SBT)/ampicillin (ABPC) as the initial antibiotics significantly more (45.5% vs 10%, p=0.006) than non-survivors... These data suggest that VAP patients who survived were younger and received treatment with narrow-spectrum antibiotics, such as SBT/ABPC. Isolation of MRSA might be critical, and MRSA infection should be prevented to improve survival of VAP patients."

Clinical • Infectious Disease • Pneumonia • Respiratory Diseases

A Case of Purulent Pericarditis Due to Actinomyces From an Odontogenic Focus (ATS 2025) - "Two weeks prior, he was diagnosed with a dental infection and completed a course of amoxicillin-clavulanate...The patient's purulent pericarditis was treated with ampicillin-sulbactam 3g and he was transitioned to ertapenem 1g daily on discharge...This case highlights the potential for actinomyces odontogenic infections to cross fascial planes and result in unexpected purulent infections in the thoracic region. It also underscores the importance of promptly treating oral infections and emphasizes the need to expand antibiotic coverage to include anaerobic organisms."

Clinical • Cardiovascular • Immunology • Infectious Disease • Inflammation • Mood Disorders • Pain • Pulmonary Disease

A Complicated Case of Acinetobacter Empyema in a Patient With Metastatic Lung Adenocarcinoma (ATS 2025) - "Preliminary cultures showed gram negative coccobacilli, and she was empirically started on ceftriaxone and azithromycin...Final cultures came back with Acinetobacter calcoaceticus-baumanni, and antibiotics were change to ampicillin-sulbactam alone. Her dyspnea improved with lytic therapy, and the patient was discharged on a four-week course of sulfamethoxazole-trimethoprim...Cases of empyema are uncommon, as A. baumannii typically affects the respiratory and urinary tracts (4, 1). However, when empyema does occur, it often requires aggressive management, and prompt identification of the pathogen is crucial for guiding targeted therapy"

Clinical • Metastases • Infectious Disease • Lung Adenocarcinoma • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Solid Tumor

An Unexpected Presentation of MRSA Pneumonia (ATS 2025) - "Empiric treatment with piperacillin-tazobactam was initiated...Pleural fluid cultures grew Streptococcus anginosus and antibiotic coverage was narrowed to ampicillin-sulbactam...Antibiotics were broadened to cefepime, vancomycin, and metronidazole...Patient was continued on all three antibiotics and therapeutic IV heparin was initiated. Once the patient showed clinical improvement on day 9, antibiotic coverage was narrowed to IV linezolid and later to oral doxycycline to complete a total antibiotic course of 36 days...However, despite a high negative predictive value (96.1%-99.8%), nasal MRSA screens may fail to detect pulmonary MRSA infections, so it remains a possibility that MRSA was a contributing pathogen on admission. Thus, providers should maintain a high degree of suspicion when there is evidence of clinical deterioration."

Acute Respiratory Distress Syndrome • Cardiovascular • Cerebral Palsy • CNS Disorders • Epilepsy • Infectious Disease • Pediatrics • Pneumonia • Pulmonary Embolism

Rare Kluyvera Ascorbata Infection in a Post-hemicolectomy Patient: Severe Sepsis With Peritoneal Hematoma (ATS 2025) - "A Gram stain showed gram-negative rods, and cultures eventually grew Kluyvera ascorbata, which was resistant to ampicillin and ciprofloxacin, but sensitive to ampicillin-sulbactam for which he was treated with a two-week course. Kluyvera ascorbata is emerging as a clinically significant pathogen, especially in immunocompromised patients, where it can cause life-threatening infections despite its previous classification as a benign saprophyte. Given the rising incidence of infections caused by Kluyvera species, this case underscores the need for further investigation into optimal treatment protocols, particularly in critically ill patients."

Clinical • Cardiovascular • Diabetes • Dyslipidemia • Hypertension • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Oncology • Osteoarthritis • Pain • Rheumatology • Septic Shock • Type 2 Diabetes Mellitus

Streptococcal Cellulitis: A Potentially Life-Threatening Infection Beyond Skin Involvement (ATS 2025) - "A CT scan showed generalized soft tissue swelling consistent with cellulitis.She was treated with ampicillin-sulbactam and underwent urgent surgical debridement...She received intravenous fluids and escalating doses of norepinephrine, vasopressin, stress-dose steroids, and methylene blue to maintain adequate BP, and antibiotics were escalated to vancomycin and piperacillin-tazobactam...Clindamycin or linezolid inhibit toxin production, and in refractory cases, intravenous immunoglobulin may be used. Given the high mortality rate, clinicians must maintain a high index of suspicion for STSS in patients with GAS infections and shock.NB: AI was used to refine the language, not to create content."

Cardiovascular • Dermatology • Diabetes • Hypotension • Infectious Disease • Inflammation • Metabolic Disorders • Nephrology • Pain • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Septic Shock

The Forbidden Kiss: Pasteurella Multocida Bacteremia Without an Apparent Source (ATS 2025) - "She responded well to antibiotics and was eventually discharged to complete a two week course of ampicillin-sulbactam...The patient had not realized the potential infectious risk from point of care glucose testing, and she was counseled on proper technique to prevent future recurrence. This case reminds us of the importance of a thorough history to help identify additional sources of infection and avoid unnecessary testing to reduce healthcare costs."

Acute Kidney Injury • Cardiovascular • Diabetes • Endocrine Disorders • Hematological Disorders • Hypertension • Infectious Disease • Metabolic Disorders • Nephrology • Renal Disease • Thrombocytopenia • Type 2 Diabetes Mellitus

Evaluation of MicroScan and VITEK 2 systems for susceptibility testing of Enterobacterales with updated breakpoints. (PubMed, J Clin Microbiol) - "The CA was ≥90% for most agents tested on both systems (exceptions were ampicillin-sulbactam, cefoxitin, minocycline, and nitrofurantoin). The median instrument TTR was less for VITEK (11.7 vs 18 hours, P < 0.001), yielding an overall faster turnaround time.IMPORTANCEThere are limited data directly comparing the performance of commercial antimicrobial susceptibility testing systems for contemporary bacterial strains using the Clinical and Laboratory Standards Institute broth microdilution method as the reference standard and applying updated breakpoints. These data will hopefully encourage labs to perform the necessary verification or validation studies needed to implement current breakpoints and ensure antimicrobial resistance is detected."

Journal • Infectious Disease • Pneumonia

A Laboratory Protocol for Routine Therapeutic Drug Monitoring of Beta-Lactams Antimicrobials in Horses and Dogs. (PubMed, Antibiotics (Basel)) - "Ampicillin and sulbactam were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the plasma or serum of animals treated with ampicillin alone or combined with sulbactam. The method was successfully applied to samples collected from animals hospitalized in our veterinary hospital and proved helpful in understanding the pharmacokinetics of this antibiotic in critically ill patients. Combined with minimum inhibitory concentration (MIC) data, this approach enables PK/PD evaluations to support the development of personalized therapeutic strategies and optimized dosing regimens for animals."

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