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http://www.drugs.com/sfx/ampicillin-side-effects.html

Ampicillin/Sulbactam

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Ampicillin/Sulbactam:

Diarrhea; pain, swelling, or redness at injection site.

Seek medical attention right away if any of these SEVERE side effects occur when using Ampicillin/Sulbactam:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or severe diarrhea; chest pain; chills; fever; severe nausea or vomiting; stomach pain or cramps; unusual bruising or bleeding; vaginal irritation or discharge; vein inflammation or tenderness; white patches in mouth.

Ampicillin Solution

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Ampicillin Solution:

Black, "hairy" tongue; diarrhea (mild); inflammation and redness of the tongue; nausea; second infection; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Ampicillin Solution:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; chills; fever; itching; muscle pain; pain, redness, or swelling at the injection site; severe diarrhea; stomach pain/cramps; vaginal irritation or discharge.

For the professional

Ampicillin

As with other penicillins, it may be expected that untoward reactions will be essentially limited to sensitivity phenomena. They are more likely to occur in individuals who have previously demonstrated hypersensitivity to penicillins and in those with a history of allergy, asthma, hay fever, or urticaria.

The following adverse reactions have been reported as associated with the use of Ampicillin:

Gastrointestinal

Glossitis, stomatitis, black "hairy" tongue, nausea, vomiting, enterocolitis, pseudomembranous colitis, and diarrhea. (These reactions are usually associated with oral dosage forms.)

Hypersensitivity Reactions

Skin rashes and urticaria have been reported frequently. A few cases of exfoliative dermatitis and erythema multiforme have been reported. Anaphylaxis is the most serious reaction experienced and has usually been associated with the parenteral dosage form.

Note: Urticaria, other skin rashes, and serum sickness-like reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids. Whenever such reactions occur, Ampicillin should be discontinued, unless, in the opinion of the physician, the condition being treated is life-threatening and amenable only to Ampicillin therapy. Serious anaphylactic reactions require the immediate use of epinephrine, oxygen, and intravenous steroids.

Liver– A moderate rise in serum glutamic oxaloacetic transaminase (SGOT) has been noted, particularly in infants, but the significance of this finding is unknown. Mild transitory SGOT elevations have been observed in individuals receiving larger (two to four times) than usual and oft-repeated intramuscular injections. Evidence indicates that glutamic oxaloacetic transaminase (GOT) is released at the site of intramuscular injection of Ampicillin sodium and that the presence of increased amounts of this enzyme in the blood does not necessarily indicate liver involvement.

Hemic and Lymphatic Systems– Anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported during therapy with the penicillins. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena.

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Ampicillin

Alternative Medicine
The following information is specific for alternative and complementary medicine. For additional evidence-based information on diseases, conditions, symptoms, diagnosis, treatment and wellness issues, continue searching the Healthwise Knowledgebase.

Also indexed as:

Amficot, Omnipen, Principen, Totacillin

Ampicillin is used to treat diseases caused by bacterial infections; it is a type of antibiotic called an aminopenicillin.
Herbs

Summary of Interactions for Ampicillin
Depletion or interference
   Vitamin C*
   Vitamin K*

Adverse interaction--None known

Side effect reduction/prevention
Bifidobacterium longum*
Lactobacillus acidophilus*
Lactobacillus casei*
Probiotics*
Saccharomyces boulardii*
Saccharomyces cerevisiae*
Vitamin K*

Supportive interaction
Saccharomyces boulardii*

Reduced drug absorption/bioavailability
Khat

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements

Vitamin C

Test tube studies show that ampicillin significantly reduces the amount of vitamin C in the blood.1 Controlled research is needed to determine whether individuals might benefit from supplementing vitamin C while taking ampicillin.

Probiotics

A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms-such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii-helps prevent antibiotic-induced diarrhea.2

The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast-such as Saccharomyces boulardii3 or Saccharomyces cerevisiae (baker's or brewer's yeast)4-helps prevent recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection.5 Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.

Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as "dysbiosis"). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.6

Vitamin K

Several cases of excessive bleeding have been reported in people who take antibiotics.7, 8, 9, 10 This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal.11 Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.
Interactions with Herbs

Khat (Catha edulis)

Khat is an herb found in East Africa and Yemen that has recently been imported into the United States. Studies have shown that chewing khat significantly reduces the absorption of ampicillin,12 which might reduce the effectiveness of the antibiotic. Therefore, people taking ampicillin should avoid herbal products that contain khat.
Other Interactions

Food

Taking ampicillin with food reduces the amount of drug that is absorbed regardless of the type of meal eaten.13 Therefore, ampicillin should be taken an hour before or two hours after a meal.

Carbohydrates

Normally, bacteria in the intestines help break down indigestible carbohydrates into useable forms. Ampicillin blocks this process, which may result in increased undigested carbohydrates in the intestine, increased water in the stool, and diarrhea.14 Consequently, people taking ampicillin might experience fewer episodes of diarrhea if they eat a diet low in indigestible carbohydrate during the treatment period. Consult a health practitioner to learn about sources of indigestible carbohydrate.

Dietary Fiber

Controlled studies with amoxicillin, an antibiotic similar to ampicillin, have shown that a diet low in fiber (7 g/day) increases the absorption of the drug when compared to a high-fiber diet (36 g/day).15 However, further research is needed to determine whether different amounts of dietary fiber exert the same effect on ampicillin. Until more information is available, people taking ampicillin might benefit more from eating a low-fiber diet during the treatment period.

Alcohol

Normally, the body converts alcohol to acetaldehyde, which test tube studies show blocks the action of ampicillin.16 Whether drinking alcoholic beverages affects the activity of ampicillin in the body is unknown; therefore, until more information is available, people taking ampicillin should avoid alcohol.

References

1. Alabi ZO, Thomas KD, Ogunbona O, Elegbe IA. The effect of antibacterial agents on plasma vitamin C levels. Afr J Med Med 1994;23:143-6.
2. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].
3. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].
4. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.
5. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.
6. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].
7. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4.
8. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7.
9. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2.
10. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5.
11. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531-9.
12. Attel OA, Ali AA, Ali HM. Effect of khat chewing on the bioavailability of ampicillin and amoxicillin. J Antimicrob Chemother 1997;39:523-5.
13. Hamid S, Beg AE. Influence of ethnic diets on ampicillin bioavailability and pharmacokinetics in healthy Pakistani subjects. Pol J Pharmacol Pharm 1987;39:337-42.
14. Rao SS, Edwards CA, Austen CJ, et al. Impaired colonic fermentation of carbohydrate after ampicillin. Gastroenterology 1988;94:928-32.
15. Lutz M, Espinoza J, Arancibia A. Effect of structured dietary fiber on bioavailability of amoxicillin. Clin Pharmacol Ther 1987;42:220-4.
16. Nunez-Vergara LJ, Yudelevich J, Squella JA, Speisky H. Drug-acetaldehyde interactions during ethanol metabolism in vitro. Alcohol Alcohol 1991;26:139-46