Sulbactam

Identification

Summary

Sulbactam is an beta-lactamase inhibitor antibiotic combined with other antibiotics to treat a variety of susceptible bacterial infections.

Brand Names
Unasyn
Generic Name
Sulbactam
DrugBank Accession Number
DB09324
Background

Sulbactam is a β-lactamase inhibitor given in combination with β-lactam antibiotics to inhibit β-lactamase, an enzyme produced by bacteria that destroys antibiotic activity.

Type
Small Molecule
Groups
Approved
Structure
Thumb
Weight
Average: 233.242
Monoisotopic: 233.035793157
Chemical Formula
C8H11NO5S
Synonyms
  • (2S,5R)-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo(3.2.0)heptane-2-carboxylic acid 4,4-dioxide
  • (2S,5R)-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid 4,4-dioxide
  • Penicillanic acid 1,1-dioxide
  • Penicillanic acid sulfone
  • Sulbactam
  • Sulbactamum
External IDs
  • CP 45899
  • CP-45899
  • CP45899

Pharmacology

Indication

Sulbactam is currently available in combination products with ampicillin. Within this formulation it is indicated for the treatment of infections due to susceptible strains of the designated microorganisms in the conditions listed below. Skin and Skin Structure Infections caused by beta-lactamase producing strains of Staphylococcus aureus, Escherichia coli, Klebsiella spp. (including K. pneumoniae), Proteus mirabilis, Bacteroides fragilis, Enterobacter spp., and Acinetobacter calcoaceticus. Intra-Abdominal Infections caused by beta-lactamase producing strains of Escherichia coli, Klebsiella spp. (including K. pneumoniae), Bacteroides spp. (including B. fragilis), and Enterobacter spp. Gynecological Infections caused by beta-lactamase producing strains of Escherichia coli, and Bacteroides spp. (including B. fragilis).

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Not Available

Mechanism of action

Sulbactam is an irreversible inhibitor of β-lactamase; by binding and inhibiting β-lactamase produced by bacterial cells, sulbactam is thereby able to prevent it from reducing antibiotic activity. Although sulbactam alone possesses little useful antibacterial activity, except against the Neisseriaceae, whole organism studies have shown that sulbactam restores ampicillin activity against beta-lactamase producing strains. In particular, sulbactam has good inhibitory activity against the clinically important plasmid mediated beta-lactamases most frequently responsible for transferred drug resistance. The presence of sulbactam in formulations with ampicillin effectively extends the antibacterial spectrum of ampicillin to include many bacteria normally resistant to it and to other beta-lactam antibacterials. Thus, products with ampicillin + sulbactam possess the properties of a broad-spectrum antibacterial and a beta-lactamase inhibitor.

TargetActionsOrganism
ABeta-lactamase
inhibitor
Staphylococcus aureus
Absorption

Peak serum concentrations are reached almost immediately following a 15-minute intravenous infusion of sulbactam + ampicillin. Mean peak serum levels for sulbactam range from 48 to 88 mcg/mL following intravenous administration of 2000 mg of ampicillin plus 1000 mg sulbactam. After an intramuscular injection of 1000 mg ampicillin plus 500 mg sulbactam, peak sulbactam serum levels ranging from 6 to 24 mcg/mL are attained.

Volume of distribution

Penetration of both ampicillin and sulbactam into cerebrospinal fluid in the presence of inflamed meninges has been demonstrated after IV administration.

Protein binding

Approximately 38% reversibly bound to human serum protein.

Metabolism
Not Available
Route of elimination

Approximately 75 to 85% of both ampicillin and sulbactam are excreted unchanged in the urine during the first 8 hours after administration.

Half-life

~1 hr

Clearance

Not Available

Adverse Effects
Adverseeffects
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Toxicity

Not Available

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Sulbactam which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Sulbactam which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Sulbactam which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Sulbactam which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Sulbactam which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Sulbactam which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Sulbactam which could result in a higher serum level.
AcrivastineSulbactam may decrease the excretion rate of Acrivastine which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Sulbactam which could result in a higher serum level.
Adefovir dipivoxilAdefovir dipivoxil may decrease the excretion rate of Sulbactam which could result in a higher serum level.
Interactions
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Food Interactions
No interactions found.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Sulbactam benzathine49MU89FVBV83031-43-0YSEPFTSCLHUBNH-HFKSPEPWSA-N
Sulbactam sodiumDKQ4T82YE669388-84-7NKZMPZCWBSWAOX-IBTYICNHSA-M
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
ALFASID 1 G IM/IV ENJEKSIYON ICIN TOZ ICEREN FLAKON, 1 ADETSulbactam (500 mg) + Ampicillin (1000 mg)Injection, powder, for solutionIntramuscular; IntravenousYAVUZ İLAÇ ECZA DEPOSU MEDİKAL ÜRÜNLER SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
ALFASID 1 GR IM ENJ. ICIN TOZ ICEREN FLAKON, 1 ADETSulbactam (500 mg) + Ampicillin (1000 mg)Injection, powder, for solutionIntramuscular; IntravenousYAVUZ İLAÇ ECZA DEPOSU MEDİKAL ÜRÜNLER SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
ALFASID 250 MG IM ENJ.ICIN TOZ ICEREN FLAKON, 1 ADETSulbactam (125 mg) + Ampicillin sodium (250 mg)Injection, powder, for solutionIntramuscular; IntravenousYAVUZ İLAÇ ECZA DEPOSU MEDİKAL ÜRÜNLER SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
ALFASID 250 MG IM/IV ENJ.ICIN TOZ ICEREN FLAKON, 1 ADETSulbactam (125 mg) + Ampicillin sodium (250 mg)Injection, powder, for solutionIntramuscular; IntravenousYAVUZ İLAÇ ECZA DEPOSU MEDİKAL ÜRÜNLER SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
ALFASID 500 MG IM ENJ.ICIN TOZ ICEREN FLAKONSulbactam (500 mg) + Ampicillin (1000 mg)Injection, powder, for solutionIntramuscularYAVUZ İLAÇ ECZA DEPOSU MEDİKAL ÜRÜNLER SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
ALFASID 500 MG IM/IV ENJ.ICIN TOZ ICEREN FLAKONSulbactam (500 mg) + Ampicillin (1000 mg)Injection, powder, for solutionIntramuscular; IntravenousYAVUZ İLAÇ ECZA DEPOSU MEDİKAL ÜRÜNLER SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
AMPICILINA + SULBACTAM 1.5 G POLVO ESTÉRIL PARA INYECCIÓNSulbactam sodium (0.5 g) + Ampicillin sodium (1 g)Injection, powder, for solutionIntravenousNORTH CHINA PHARMACEUTICAL CO LTD2015-04-162021-10-01Colombia flag
AMPICILINA + SULBACTAM 1.5 G POLVO PARASOLUCIÓN INYECTABLESulbactam sodium (0.5 g) + Ampicillin sodium (1 g)Injection, powder, for solutionIntramuscular; IntravenousPHARMAYECT S.A.2008-06-25Not applicableColombia flag
AMPICILINA Y SULBACTAM 1.5 G.Sulbactam (0.5 g) + Ampicillin sodium (1 g)Injection, powder, for solutionIntramuscular; IntravenousFARMALOGICA S.A.2006-11-102020-04-07Colombia flag
Ampicillin and SulbactamSulbactam sodium (1 g/20mL) + Ampicillin sodium (2 g/20mL)Injection, powder, for solutionIntramuscular; IntravenousWG Critical Care, LLC2005-11-30Not applicableUS flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Ampicillin and SulbactamSulbactam sodium (1 g/1) + Ampicillin sodium (2 g/1)Injection, powder, for suspensionIntramuscular; IntravenousCardinal Health2011-05-202014-02-28US flag

Categories

ATC Codes
J01CG01 — Sulbactam
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as alpha amino acids and derivatives. These are amino acids in which the amino group is attached to the carbon atom immediately adjacent to the carboxylate group (alpha carbon), or a derivative thereof.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Amino acids, peptides, and analogues
Direct Parent
Alpha amino acids and derivatives
Alternative Parents
Penams / Thiazolidines / Tertiary carboxylic acid amides / Sulfones / Azetidines / Monocarboxylic acids and derivatives / Carboxylic acids / Azacyclic compounds / Organopnictogen compounds / Organonitrogen compounds
show 3 more
Substituents
Aliphatic heteropolycyclic compound / Alpha-amino acid or derivatives / Azacycle / Azetidine / Beta-lactam / Carbonyl group / Carboxamide group / Carboxylic acid / Hydrocarbon derivative / Lactam
show 12 more
Molecular Framework
Aliphatic heteropolycyclic compounds
External Descriptors
penicillanic acids (CHEBI:9321)
Affected organisms
  • Streptococcus pyogenes
  • Streptococcus pneumoniae
  • Staphylococcus saprophyticus
  • Haemophilus influenzae
  • Neisseria gonorrhoeae
  • Escherichia coli
  • Staphylococcus aureus
  • Enterococcus faecalis
  • Moraxella catarrhalis
  • Staphylococcus epidermidis
  • Proteus vulgaris
  • Klebsiella
  • Proteus mirabilis
  • Providencia stuartii
  • Streptococcus viridans
  • Providencia rettgeri
  • Morganella morganii
  • Bacteroides
  • Bacteroides fragilis
  • Peptococcus
  • Peptostreptococcus
  • Clostridium

Chemical Identifiers

UNII
S4TF6I2330
CAS number
68373-14-8
InChI Key
FKENQMMABCRJMK-RITPCOANSA-N
InChI
InChI=1S/C8H11NO5S/c1-8(2)6(7(11)12)9-4(10)3-5(9)15(8,13)14/h5-6H,3H2,1-2H3,(H,11,12)/t5-,6+/m1/s1
IUPAC Name
(2S,5R)-3,3-dimethyl-4,4,7-trioxo-4λ⁶-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid
SMILES
[H][C@@]12CC(=O)N1[C@@]([H])(C(O)=O)C(C)(C)S2(=O)=O

References

General References
  1. Totir MA, Helfand MS, Carey MP, Sheri A, Buynak JD, Bonomo RA, Carey PR: Sulbactam forms only minimal amounts of irreversible acrylate-enzyme with SHV-1 beta-lactamase. Biochemistry. 2007 Aug 7;46(31):8980-7. Epub 2007 Jul 13. [Article]
  2. Helfand MS, Totir MA, Carey MP, Hujer AM, Bonomo RA, Carey PR: Following the reactions of mechanism-based inhibitors with beta-lactamase by Raman crystallography. Biochemistry. 2003 Nov 25;42(46):13386-92. [Article]
  3. INVIMA Product Authorization: Sulamp Duo (amoxicillin/sulbactam) coated tablets for oral use [Link]
  4. MiVademecum Colombia: Minovelt (ceftriaxone/sulbactam) product information [Link]
KEGG Drug
D02223
KEGG Compound
C07770
PubChem Compound
130313
PubChem Substance
310265206
ChemSpider
115306
BindingDB
50021954
RxNav
10167
ChEBI
9321
ChEMBL
CHEMBL403
ZINC
ZINC000000897244
PDBe Ligand
0RN
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Sulbactam
PDB Entries
4fh2
FDA label
Download (8.76 MB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedOtherAcinetobacter Infections1
4CompletedPreventionBreast Cancer1
4CompletedPreventionSurgical Site Infections1
4CompletedTreatmentGonorrhea1
4CompletedTreatmentInfection1
4CompletedTreatmentIntraabdominal Infections2
4CompletedTreatmentPneumonia1
4CompletedTreatmentRecurrent Upper and Lower Respiratory Tract Infections (RTIs) / Urinary Tract Infection1
4CompletedTreatmentRecurrent Upper and Lower Respiratory Tract Infections (RTIs) / Urinary Tract Infections in Children1
4CompletedTreatmentSkin Diseases, Bacterial1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Injection, powder, for solutionIntramuscular
Injection, powder, for solutionIntramuscular; Intravenous
Injection, powder, for solutionIntravenous
Injection, powder, for suspensionIntramuscular; Intravenous
Injection, powder, for solutionParenteral
Injection, solutionIntramuscular; Intravenous
InjectionIntramuscular; Intravenous
InjectionIntramuscular; Intravenous
InjectionIntramuscular
Injection, powder, for solution
SuspensionConjunctival; Ophthalmic
Injection, powder, for solutionParenteral
SolutionConjunctival; Ophthalmic150 mg
Injection, solutionIntramuscular
Injection, powder, for solutionParenteral547.12 MG/1062.91MG
Powder500 mg/1vial
Tablet, coatedOral
SolutionConjunctival; Ophthalmic; Topical300 mg
SolutionConjunctival; Ophthalmic300 mg
SolutionConjunctival; Ophthalmic100 mg
Powder
Injection, powder, lyophilized, for solutionIntramuscular; Intravenous
Powder, for suspensionOral
Tablet, film coated
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility48.5 mg/mLALOGPS
logP-0.92ALOGPS
logP-0.89ChemAxon
logS-0.68ALOGPS
pKa (Strongest Acidic)3.09ChemAxon
pKa (Strongest Basic)-3.8ChemAxon
Physiological Charge-1ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area91.75 Å2ChemAxon
Rotatable Bond Count1ChemAxon
Refractivity48.21 m3·mol-1ChemAxon
Polarizability20.63 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Targets

Drugtargets2
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Kind
Protein
Organism
Staphylococcus aureus
Pharmacological action
Yes
Actions
Inhibitor
General Function
Beta-lactamase activity
Specific Function
Not Available
Gene Name
blaZ
Uniprot ID
P00807
Uniprot Name
Beta-lactamase
Molecular Weight
31348.98 Da
References
  1. Totir MA, Helfand MS, Carey MP, Sheri A, Buynak JD, Bonomo RA, Carey PR: Sulbactam forms only minimal amounts of irreversible acrylate-enzyme with SHV-1 beta-lactamase. Biochemistry. 2007 Aug 7;46(31):8980-7. Epub 2007 Jul 13. [Article]
  2. Helfand MS, Totir MA, Carey MP, Hujer AM, Bonomo RA, Carey PR: Following the reactions of mechanism-based inhibitors with beta-lactamase by Raman crystallography. Biochemistry. 2003 Nov 25;42(46):13386-92. [Article]

Drug created on November 17, 2015 17:59 / Updated on May 07, 2021 21:41