The International Study of Unruptured Intracranial Aneurysms (ISUIA) provided prognostic data both in people having previously had a subarachnoid hemorrhage and people who had aneurysms detected by other means. Those having previously had a SAH were more likely to bleed from other aneurysms. In contrast, those having never bled and had small aneurysms (smaller than 10 mm) were very unlikely to have a SAH and were likely to sustain harm from attempts to repair these aneurysms. On the basis of the ISUIA and other studies, it is now recommended that people are considered for preventive treatment only if they have a reasonable life expectancy and have aneurysms that are highly likely to rupture. Moreover, there is only limited evidence that endovascular treatment of unruptured aneurysms is actually beneficial. Treatment
Management involves general measures to stabilize the person while also using specific investigations and treatments. These include the prevention of rebleeding by obliterating the bleeding source, prevention of a phenomenon known as vasospasm, and prevention and treatment of complications.Stabilizing the person is the first priority. Those with a depressed level of consciousness may need to be intubated and mechanically ventilated. Blood pressure, pulse, respiratory rate, and Glasgow Coma Scale are monitored frequently. Once the diagnosis is confirmed, admission to an intensive care unit may be preferable, especially since 15 percent may have further bleeding soon after admission. Nutrition is an early priority, mouth or nasogastric tube feeding being preferable over parenteral routes.
History
The introduction and use of ampicillin alone started in 1961. The development and introduction of this drug allowed the use of targeted therapies against gram-negative bacteria. With the rise of beta-lactamase producing bacteria, ampicillin and the other penicillin-derivatives became ineffective to these resistant organisms. With the introduction of beta-lactamase inhibitors such as sulbactam, combined with ampicillin made beta-lactamase producing bacteria susceptible. Formulation
Ampicillin-sulbactam only comes in a parenteral formulation to be either used as intravenous or intramuscular injections, and can be formulated for intravenous infusion. It is formulated in a 2:1 ratio of ampicillin:sulbactam. The commercial preparations available include:
1.5 grams (1 gram ampicillin and 0.5 gram sulbactam)→Brand names: Unasyn, Unasyn ADD-Vantage, Unasyn Piggyback

3 grams (2 grams ampicillin and 1 gram sulbactam)→Brand names: Unasyn, Unasyn ADD-Vantage, Unasyn Piggyback

15 grams (10 grams ampicillin and 5 grams sulbactam)→Brand name: Unasyn

Society and culture
Names
Unasyn (US)
Subacillin (Taiwan)
Unictam (Egypt)
Ultracillin (Egypt)
Fortibiotic
Sulbin (Egypt)
Novactam (Egypt)
Sulbacin (Kenya)

References
External links
"Ampicillin mixture with Sulbactam". Drug Information Portal. U.S. National Library of Medicine.