ampicillin-sulbactam + fluconazole + gentamicin

This is a combination regimen consisting of three distinct antimicrobial agents:

• Ampicillin-sulbactam is a combination of a penicillin-class beta-lactam antibiotic (ampicillin) and a beta-lactamase inhibitor (sulbactam). Ampicillin inhibits bacterial cell wall synthesis, while sulbactam extends its spectrum by inhibiting beta-lactamases produced by resistant bacteria.
• Fluconazole is an antifungal agent from the triazole class. It inhibits fungal cytochrome P450 enzyme 14α-demethylase, disrupting ergosterol synthesis and compromising fungal cell membrane integrity.
• Gentamicin is an aminoglycoside antibiotic that binds to the 30S ribosomal subunit in bacteria, causing misreading of mRNA and inhibiting protein synthesis. This combination may be used empirically or therapeutically for severe mixed infections where both bacterial (including resistant Gram-negative and Gram-positive organisms) and fungal pathogens are suspected or confirmed. Such regimens are sometimes seen in complex intra-abdominal infections, pelvic inflammatory disease with suspected polymicrobial etiology, or immunocompromised patients at risk for both bacterial and fungal sepsis.