Comparative Pharmacology
Head-to-head clinical analysis: TOTACILLIN versus UNASYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: TOTACILLIN versus UNASYN.
TOTACILLIN vs UNASYN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Bactericidal: inhibits cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidation. Active against gram-positive bacteria and some gram-negative bacteria.
Ampicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs); sulbactam is a beta-lactamase inhibitor that prevents degradation of ampicillin by beta-lactamases.
250-500 mg orally every 6 hours or 1-2 g intravenously every 4-6 hours.
3 g (ampicillin 2 g + sulbactam 1 g) IV every 6 hours; total daily dose of sulbactam not to exceed 4 g.
None Documented
None Documented
Terminal elimination half-life: 1.0-1.5 hours in normal renal function. Extended to 2-6 hours in renal impairment; requires dose adjustment when CrCl <30 mL/min.
Ampicillin: ~1 hour (normal renal function); sulbactam: ~1-1.4 hours (normal renal function); prolonged in renal impairment (ampicillin up to 20 hours, sulbactam up to 10-15 hours in anuria).
Renal: 90-95% unchanged via glomerular filtration and tubular secretion. Biliary/fecal: <5% as unchanged drug and metabolites.
Renal: ampicillin (~75-90% unchanged) and sulbactam (~75-85% unchanged); biliary/fecal: minimal (<5% for each component).
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic