Anaerobes: Clostridium species, Peptococcus species, Peptostreptococcus species, Bacteroides species including B. fragilis.Gynecological Infections
Ampicillin/sulbactam can be used to treat gynecological infections caused by beta-lactamase producing strains of Escherichia coli, and Bacteroides (including B. fragilis).Bone and joint infections
Ampicillin/sulbactam can be used in the treatment of bone and joint infections caused by susceptible beta-lactamase producing bacteria.Intra-abdominal infections
Ampicillin/sulbactam can be used to treat intra-abdominal infections caused by beta-lactamase producing strains of Escherichia coli, Klebsiella (including K. pneumonia), Bacteroides fragilis, and Enterobacter.Skin and skin structure Infections
This medication can be used to treat skin and skin structure infections caused from beta-lactamase-producing strains of Staphylococcus aureus, Enterobacter, Escherichia coli, Klebsiella (including K. pneumoniae), Proteus mirabilis, Bacteroides fragilis, and Acinetobacter calcoaceticus. Examples of skin conditions treated with ampicillin-sulbactam are moderate to severe diabetic foot infections and type 1 Necrotizing fasciitis, commonly referred to as "flesh-eating bacteria". Contraindications
Ampicillin/sulbactam is contraindicated in individuals who have a history of a penicillin allergy. Symptoms of allergic reactions may range from rash to potentially life-threatening conditions, such as anaphylaxis. Patients who have asthma, eczema, hives, or hay fever are more likely to develop undesirable reactions to any of the penicillins. Adverse effects
Reported adverse events include both local and systemic reactions. Local adverse reactions are characterized by redness, tenderness, and soreness of the skin at the injection site. The most common local reaction is injection site pain. It has been reported to occur in 16% of patients receiving intramuscular injections, and 3% of patients receiving intravenous injections.
Research suggests failure rates are higher when urethroplasty corrects a born condition rather than disease or injury so patients and families considering surgery for hypospadias should have realistic expectations about the risks and benefits. Age at surgery
The results of surgery are probably not influenced by the age at which repair is done. Teens and adults typically spend one night in the hospital after surgery. Preoperative hormones
Hormones potentially increase the size of the penis, and have been used in children with proximal hypospadias who have a smaller penis. Numerous articles report testosterone injections or topical creams increase the length and circumference of the penis. However, few studies discuss the impact of this treatment on the success of corrective surgery, with conflicting results. Surgery
Hypospadias repair is done under general anesthesia, most often supplemented by a nerve block to the penis or a caudal block to reduce the general anesthesia needed, and to minimize discomfort after surgery.Many techniques have been used during the past 100 years to extend the urinary channel to the desired location. Today, the most common operation, known as the tubularized incised plate or "TIP" repair, rolls the urethral plate from the low meatus to the end of the glans. TIP repair, also called the Snodgrass Repair (after the creator of the method, Dr. Warren Snodgrass), is the most widely used procedure and surgical method for hypospadias repair worldwide. This procedure can be used for all distal hypospadias repairs, with complications afterwards expected in less than 10% of cases.Less consensus exists regarding proximal hypospadias repair.