Role of sultamicillin and ampicillin/sulbactam in the treatment of upper and lower bacterial respiratory tract infections.

The emergence of beta-lactamase-mediated resistance to beta-lactam antibiotics among key respiratory tract pathogens has threatened the usefulness of the beta-lactam agents familiar to physicians as being clinically effective and well tolerated. This article reassesses the clinical usefulness of ampicillin when administered in combination with the beta-lactamase inhibitor sulbactam, either intravenously or orally (as the mutual prodrug sultamicillin), in the treatment of upper and lower respiratory tract infections. Numerous clinical studies and several meta-analyses indicate that ampicillin/sulbactam and sultamicillin are clinically effective and well tolerated in both adults and children, in agreement with published North American and European guidelines.