Ampicillin-sulbactam (Unasyn) is currently in short supply.

The Antimicrobial Stewardship Program recommends restricting IV ampicillin-sulbactam supply to patients with Acinetobacter infections AND no other beta-lactam options based on susceptibility testing. Alternatives to ampicillin-sulbactam should be employed in ALL other cases.

Recommendations for alternatives:

• Non-Acinetobacter infections in patients with a functioning gastrointestinal tract
  • Oral amoxicillin/clavulanate
• Community-acquired pneumonia requiring IV therapy
  • Ceftriaxone plus doxycycline OR azithromycin
• Pneumonia with oral anaerobes requiring IV therapy (e.g. pneumonia after witnessed aspiration or in the setting of poor dentition)
  • Ceftriaxone plus or minus clindamycin OR metronidazole
• Mild skin-soft tissue infections requiring IV therapy
  •  Cefazolin
• Bites due to cats, dogs, or humans requiring IV therapy
  • Doxycycline or moxifloxacin
• Surgical prophylaxis prior to certain clean-contaminated head & neck procedures
  • Cefazolin and metronidazole
• Intra-abdominal infection
  • Ceftriaxone and metronidazole
  • Oral amoxicillin/clavulanate

• Micromedex
• Clinical Pharmacology
• FDA DailyMed