Peer-reviewed veterinary case report
Ampicillin-sulbactam drug levels in dogs with and without kidney
By Wang, Zhe et al.·Published in Journal of veterinary pharmacology and therapeutics·2025·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Pharmacokinetics of Ampicillin-Sulbactam in Azotemic and Non-Azotemic Dogs.
- Species:
- dog
Plain-English summary
A group of 29 dogs, including 19 with kidney problems (azotemic) and 10 healthy dogs, were treated with ampicillin-sulbactam, an antibiotic, to see how well their bodies processed the drug. The azotemic dogs had higher levels of the medication in their blood and it stayed in their system longer compared to the healthy dogs. This means that for azotemic dogs, giving the antibiotic every 12 hours was effective in maintaining adequate drug levels to fight infections. The study suggests that this dosing schedule is appropriate for treating infections in dogs with kidney issues.
People also search for: dog kidney problems treatment · ampicillin for dogs · azotemia in dogs symptoms
Abstract
Previous research has shown that azotemic dogs have a lower clearance and higher drug plasma concentrations of ampicillin compared to healthy dogs. The objective of this study was to determine the pharmacokinetics of ampicillin-sulbactam after multiple intravenous doses in hospitalized azotemic and non-azotemic dogs. This prospective study included 29 client-owned dogs; 19 azotemic and 10 non-azotemic. Ampicillin-sulbactam was administered at a combined dose of 22 mg/kg intravenously every 8 h for up to 5 days. Blood samples were obtained at baseline (prior to administration of the first dose of ampicillin-sulbactam), and 1-, 4-, and 8-h post-ampicillin-sulbactam administration each day. Plasma ampicillin was measured using LC-MS and non-compartmental pharmacokinetic modeling and dose interval modeling were performed. Plasma ampicillin exposure (azotemic mean 214.5 ug/mL × h ± 110.8, non-azotemic mean 60.3 ± 35.7; p < 0.0009) and half-life (azotemic mean 3.9 h ± 2.4, non-azotemic mean 1.5 h ± 0.3; p < 0.00001) were statistically greater in azotemic dogs compared to non-azotemic dogs. Single dose interval modeling predicted that 100% of azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 2) with q12 h dosing and 79% of azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 8) with q12 h dosing. Comparatively, 20% of non-azotemic dogs were predicted to have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 2) with q12 h dosing and 0 non-azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 8) with q12 h dosing. This study demonstrated that q12-h dosing of ampicillin-sulbactam in azotemic dogs over multiple days of administration is sufficient to reach the PK-PD target (> 50% of dosing interval > MIC) against susceptible bacteria.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/40072220/