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sulbactam Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
beta-lactamase inhibitors	2492	68373-14-8

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: sulbactam penicillanic acid dioxide sulbactam sodium	A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone. Molecular weight: 233.24 Formula: C8H11NO5S CLOGP: 0.31 LIPINSKI: 0 HAC: 6 HDO: 1 TPSA: 91.75 ALOGS: -0.68 ROTB: 1 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Molecule

Description

Molfile Inchi Smiles

Synonyms:

sulbactam
penicillanic acid dioxide
sulbactam sodium

A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone.

Molecular weight: 233.24
Formula: C8H11NO5S
CLOGP: 0.31
LIPINSKI: 0
HAC: 6
HDO: 1
TPSA: 91.75
ALOGS: -0.68
ROTB: 1

Status: OFP

Legend:
OFP - off patent
OFM - off market
ONP - on patent

Drug dosage:

Dose	Unit	Route
1	g	P

ADMET properties:

Property	Value	Reference
MRTD (Maximum Recommended Therapeutic Daily Dose)	285.97 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
Vd (Volume of distribution)	0.32 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	5.10 mL/min/kg	Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma)	0.62 %	Lombardo F, Berellini G, Obach RS
t_half (Half-life)	1.10 hours	Lombardo F, Berellini G, Obach RS

Approvals:

Date	Agency	Company	Orphan
Dec. 31, 1986	FDA	PFIZER

FDA Adverse Event Reporting System (Female)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Enterocolitis haemorrhagic	88.78	20.18	23	5436	1517	46679086
Pyrexia	71.88	20.18	138	5321	348664	46331939
Hepatic function abnormal	63.02	20.18	43	5416	34378	46646225
Drug eruption	62.70	20.18	36	5423	21293	46659310
Klebsiella infection	59.10	20.18	24	5435	6638	46673965
Enterococcal infection	44.81	20.18	20	5439	6967	46673636
Renal impairment	44.56	20.18	49	5410	74323	46606280
Lemierre syndrome	42.59	20.18	8	5451	115	46680488
Disseminated intravascular coagulation	37.78	20.18	25	5434	18980	46661623
Infective aneurysm	37.58	20.18	9	5450	429	46680174
Linear IgA disease	35.76	20.18	11	5448	1350	46679253
Pneumonia aspiration	34.50	20.18	29	5430	31576	46649027
Toxic epidermal necrolysis	34.19	20.18	25	5434	22253	46658350
Fatigue	30.10	20.18	17	5442	608680	46071923
Culture stool positive	29.75	20.18	7	5452	309	46680294
Interstitial lung disease	29.65	20.18	34	5425	53915	46626688
Eosinophilic pneumonia acute	28.75	20.18	7	5452	358	46680245
Pathogen resistance	28.49	20.18	14	5445	6046	46674557
Crystal nephropathy	27.45	20.18	8	5451	817	46679786
Multiple organ dysfunction syndrome	27.43	20.18	32	5427	51678	46628925
Red blood cells urine positive	25.22	20.18	10	5449	2597	46678006
Arthralgia	24.99	20.18	6	5453	364597	46316006
Sepsis	24.45	20.18	51	5408	135963	46544640
Pseudomembranous colitis	23.25	20.18	10	5449	3185	46677418
Acute generalised exanthematous pustulosis	22.73	20.18	14	5445	9391	46671212
Proteus infection	22.57	20.18	7	5452	883	46679720
Pneumonia	22.36	20.18	95	5364	376225	46304378
Klebsiella test positive	21.79	20.18	7	5452	990	46679613
Acute disseminated encephalomyelitis	21.61	20.18	5	5454	205	46680398
Implant site hypersensitivity	21.46	20.18	4	5455	55	46680548
Systemic candida	21.39	20.18	9	5450	2718	46677885
Neuromuscular block prolonged	21.33	20.18	6	5453	540	46680063
Shock haemorrhagic	21.26	20.18	13	5446	8611	46671992
Drug resistance	21.17	20.18	17	5442	17351	46663252
Lymphocyte count decreased	21.01	20.18	20	5439	25569	46655034
Platelet count decreased	20.96	20.18	40	5419	99984	46580619
Anaphylactic shock	20.88	20.18	18	5441	20256	46660347
Rash morbilliform	20.54	20.18	9	5450	3000	46677603

FDA Adverse Event Reporting System (Male)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Hepatic function abnormal	114.88	17.69	88	6956	41857	29903577
Enterocolitis haemorrhagic	74.08	17.69	21	7023	956	29944478
Pneumonia	62.66	17.69	196	6848	334110	29611324
Cardiac septal defect	54.74	17.69	12	7032	185	29945249
Interstitial lung disease	54.66	17.69	69	6975	60128	29885306
Pneumonia aspiration	54.30	17.69	55	6989	37725	29907709
Pathogen resistance	50.90	17.69	29	7015	8381	29937053
Hangover	50.59	17.69	16	7028	1062	29944372
Kidney duplex	47.68	17.69	12	7032	344	29945090
Pyrexia	43.83	17.69	160	6884	294329	29651105
Rash	39.96	17.69	117	6927	191772	29753662
Incision site pain	37.39	17.69	15	7029	1989	29943445
Drug eruption	35.72	17.69	31	7013	17495	29927939
C-reactive protein increased	35.02	17.69	47	6997	43426	29902008
Clostridium test positive	33.62	17.69	14	7030	2042	29943392
Wound dehiscence	33.02	17.69	16	7028	3325	29942109
Multiple-drug resistance	31.86	17.69	15	7029	2926	29942508
Pseudomembranous colitis	29.15	17.69	14	7030	2854	29942580
Lymphocyte count decreased	27.83	17.69	28	7016	19027	29926407
Klebsiella infection	26.99	17.69	18	7026	6869	29938565
Liver disorder	26.83	17.69	34	7010	29688	29915746
Rebound effect	26.78	17.69	11	7033	1550	29943884
Death	26.60	17.69	27	7017	357256	29588178
Acute generalised exanthematous pustulosis	26.49	17.69	17	7027	6081	29939353
Pneumonia bacterial	26.28	17.69	20	7024	9383	29936051
Megacolon	26.14	17.69	11	7033	1646	29943788
Enterococcus test positive	25.45	17.69	9	7035	843	29944591
Stenotrophomonas test positive	24.72	17.69	7	7037	317	29945117
Respiratory failure	24.46	17.69	65	6979	100577	29844857
Toxic epidermal necrolysis	23.73	17.69	25	7019	17915	29927519
Alanine aminotransferase increased	23.38	17.69	53	6991	74223	29871211
Red blood cells urine positive	23.08	17.69	10	7034	1607	29943827
Pulmonary alveolar haemorrhage	22.94	17.69	16	7028	6565	29938869
Coagulopathy	21.38	17.69	24	7020	18463	29926971
Platelet count decreased	21.33	17.69	64	6980	106065	29839369
Paradoxical drug reaction	21.16	17.69	11	7033	2651	29942783
Renal impairment	21.08	17.69	55	6989	84129	29861305
Aspartate aminotransferase increased	20.79	17.69	46	6998	63376	29882058
White blood cell count increased	20.65	17.69	35	7009	39638	29905796
Drug-induced liver injury	20.25	17.69	25	7019	21249	29924185
Conjunctivitis	20.15	17.69	16	7028	7984	29937450
Protein urine present	19.97	17.69	13	7031	4762	29940672
Fall	19.83	17.69	9	7035	181863	29763571
Septic shock	19.59	17.69	45	6999	63562	29881872
Disseminated intravascular coagulation	19.43	17.69	25	7019	22146	29923288
Toxicity to various agents	18.95	17.69	9	7035	177174	29768260
Nutritional condition abnormal	18.21	17.69	6	7038	454	29944980
Blood creatine phosphokinase increased	18.13	17.69	35	7009	43813	29901621
Blood urea increased	18.10	17.69	29	7015	31352	29914082

Pharmacologic Action:

Source	Code	Description
ATC	J01CG01	ANTIINFECTIVES FOR SYSTEMIC USE ANTIBACTERIALS FOR SYSTEMIC USE BETA-LACTAM ANTIBACTERIALS, PENICILLINS Beta-lactamase inhibitors
FDA MoA	N0000000202	beta Lactamase Inhibitors
MeSH PA	D000900	Anti-Bacterial Agents
MeSH PA	D000890	Anti-Infective Agents
MeSH PA	D065093	beta-Lactamase Inhibitors
MeSH PA	D004791	Enzyme Inhibitors
FDA EPC	N0000175930	beta Lactamase Inhibitor

Drug Use (View source of the data)

Disease	Relation	SNOMED_ID	DOID
Infection of skin AND/OR subcutaneous tissue	indication	19824006
Infection due to Escherichia coli	indication	71057007
Rhinoscleroma	indication	72409005	DOID:11336
Cholangitis	indication	82403002	DOID:9446
Female genital tract infection	indication	125585007
Infectious disease of abdomen	indication	128070006
Infection due to Enterobacteriaceae	indication	128945009
Bacterial peritonitis	indication	197171003
Infection due to Staphylococcus aureus	indication	406602003
E. Coli Gynecological Infections	indication
Klebsiella Pneumoniae Peritonitis	indication
E. Coli Peritonitis	indication
Skin and Skin Structure Bacteroides Fragilis Infection	indication
Bacteroides Gynecological Infections	indication
Inflammatory Disease of Female Pelvic Organs	indication
Skin and Skin Structure Acinetobacter Infection	indication
Bacteroides Peritonitis	indication
Skin and Skin Structure Proteus Infection	indication
Intra-Abdominal E. Coli Abscess	indication
Streptococcal meningitis	off-label use	4510004	DOID:11574
Pyrexia of unknown origin	off-label use	7520000
Bacterial pneumonia	off-label use	53084003	DOID:874
Infection of bone	off-label use	111253001
Meningococcal meningitis	off-label use	192644005
Sepsis of the newborn	off-label use	206376005
Human bite - wound	off-label use	262555007
Diverticulitis of gastrointestinal tract	off-label use	271366000
Neonatal meningitis	off-label use	276674008
Dog bite - wound	off-label use	283734005
Cat bite - wound	off-label use	283782004
Infective otitis media	off-label use	312218008
Diabetic Foot Infection	off-label use
Kidney disease	contraindication	90708001	DOID:557
Infectious mononucleosis	contraindication	271558008	DOID:8568
Pseudomembranous enterocolitis	contraindication	397683000

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	3.1	acidic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

Target	Class	Pharos	UniProt	Action	Type	Activity value (-log[M])	Bioact source	MoA source
Serine beta-lactamase-like protein LACTB, mitochondrial	Enzyme	P83111	LACTB_HUMAN		IC50	5.01	WOMBAT-PK
Beta-lactamase TEM	Enzyme		BLAT_ECOLX	INHIBITOR	Ki	6.10	CHEMBL	CHEMBL
Beta-lactamase	Enzyme		Q7X575_ECOLX		IC50	5.62	CHEMBL
Beta-lactamase	Enzyme		AMPC_ENTCL		IC50	6	CHEMBL
Beta-lactamase	Enzyme		BLAC_STAAU		IC50	5.19	CHEMBL
Beta-lactamase	Enzyme		Q0VTR6_ACIPI		IC50	5.95	CHEMBL
Beta-lactamase	Enzyme		Q0VTR8_ACIPI		IC50	5.11	CHEMBL
Carbapenem-hydrolizing beta-lactamase SFC-1	Enzyme		Q6JP75_SERFO		IC50	4.64	CHEMBL
ADC-18 protein	Unclassified		Q0VTS0_ACIPI		IC50	4.93	CHEMBL
Beta-lactamase	Enzyme		AMPC_ECOLI		IC50	4.18	CHEMBL
Beta-lactamase	Enzyme		AMPC_PSEAE		IC50	4.57	CHEMBL
Beta-lactamase 1	Unclassified		BLAC_BACCE		IC50	4.60	CHEMBL
Beta-lactamase	Enzyme		D5HSX5_9GAMM		IC50	5.40	CHEMBL
Beta-lactamase	Enzyme		A8RR46_BACCS		IC50	7.12	CHEMBL
Beta-lactamase	Enzyme		A1E3K9_ECOLX		IC50	5.21	CHEMBL
Beta-lactamase OXA-1	Enzyme		BLO1_ECOLX		IC50	4.66	CHEMBL
Class D beta-lactamase	Unclassified		Q50H31_BRAPL		IC50	4.92	CHEMBL
Beta-lactamase TEM	Enzyme		BLAT_SALTI		Ki	6.10	WOMBAT-PK
Beta-lactamase GES-13	Enzyme		D1MIX9_PSEAI		IC50	6.43	CHEMBL

External reference:

ID	Source
4019937	VUID
N0000148022	NUI
D02223	KEGG_DRUG
69388-84-7	SECONDARY_CAS_RN
4019381	VANDF
4019937	VANDF
C0038665	UMLSCUI
CHEBI:9321	CHEBI
0RN	PDB_CHEM_ID
CHEMBL403	ChEMBL_ID
CHEMBL1200944	ChEMBL_ID
D013407	MESH_DESCRIPTOR_UI
4845	INN_ID
DB09324	DRUGBANK_ID
S4TF6I2330	UNII
130313	PUBCHEM_CID
10769	IUPHAR_LIGAND_ID
10167	RXNORM
5520	MMSL
d04403	MMSL
002811	NDDF
002812	NDDF
398916003	SNOMEDCT_US
412516007	SNOMEDCT_US
96008003	SNOMEDCT_US

Pharmaceutical products:

Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
UNULLSYN	HUMAN PRESCRIPTION DRUG LABEL	2	0049-0013	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAMUSCULAR	NDA	26 sections
UNULLSYN	HUMAN PRESCRIPTION DRUG LABEL	2	0049-0014	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAMUSCULAR	NDA	26 sections
UNULLSYN	HUMAN PRESCRIPTION DRUG LABEL	2	0049-0024	INJECTION, POWDER, FOR SOLUTION	50 mg	INTRAMUSCULAR	NDA	25 sections
UNULLSYN	HUMAN PRESCRIPTION DRUG LABEL	2	0049-0031	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAMUSCULAR	ANDA	26 sections
UNULLSYN	HUMAN PRESCRIPTION DRUG LABEL	2	0049-0032	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAMUSCULAR	ANDA	26 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0409-2689	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	25 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0409-2987	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	25 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6116	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	24 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6117	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	24 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6118	INJECTION, POWDER, FOR SOLUTION	50 mg	INTRAVENOUS	ANDA	24 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6119	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	25 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6120	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	25 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6121	INJECTION, POWDER, FOR SOLUTION	50 mg	INTRAVENOUS	ANDA	24 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6122	INJECTION, POWDER, FOR SOLUTION	125 mg	INTRAVENOUS	ANDA	25 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	0641-6123	INJECTION, POWDER, FOR SOLUTION	125 mg	INTRAVENOUS	ANDA	25 sections
ampicillin and sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	25021-142	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	25 sections
ampicillin and sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	25021-143	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	25 sections
ampicillin and sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	25021-144	INJECTION, POWDER, FOR SOLUTION	50 mg	INTRAVENOUS	ANDA	25 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	36000-094	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	26 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	36000-095	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	26 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	44567-210	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	23 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	44567-211	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	23 sections
Ampicillin and Sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	44567-212	INJECTION, POWDER, FOR SOLUTION	5 g	INTRAVENOUS	ANDA	21 sections
Ampicillin and Sulbactam	Human Prescription Drug Label	2	55150-116	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAMUSCULAR	ANDA	23 sections
Ampicillin and Sulbactam	Human Prescription Drug Label	2	55150-117	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAMUSCULAR	ANDA	23 sections
Ampicillin and Sulbactam	Human Prescription Drug Label	2	55150-118	INJECTION, POWDER, FOR SOLUTION	50 mg	INTRAVENOUS	ANDA	23 sections
Ampicillin and Sulbactam	Human Prescription Drug Label	2	55150-178	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	22 sections
Ampicillin and Sulbactam	Human Prescription Drug Label	2	55150-179	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	22 sections
ampicillin and sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	66794-206	INJECTION, POWDER, FOR SOLUTION	0.50 g	INTRAVENOUS	ANDA	13 sections
ampicillin and sulbactam	HUMAN PRESCRIPTION DRUG LABEL	2	66794-207	INJECTION, POWDER, FOR SOLUTION	1 g	INTRAVENOUS	ANDA	13 sections