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Information


Amoxicillin is a widely-used antibiotic drug. It belongs to the penicillin group of drugs and is prescribed to treat certain infections that are caused by bacteria. It can also be used alongside other medications to treat stomach ulcers caused by H. pylori infection.

In the United States (U.S.), its brand names include Larotid, Amoxil, DisperMox, Moxilin, and Trimox.

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Indications for use


Infectious and inflammatory diseases caused by susceptible microorganisms, including bronchitis, pneumonia, angina, acute otitis media, pharyngitis, sinusitis, urethritis, cystitis, pyelonephritis, endometritis, uncomplicated gonorrhea, infections of the skin and soft tissues, gastrointestinal tract (peritonitis, enteritis, cholecystitis, cholangitis), leptospirosis, listeriosis, borreliosis, meningitis, prevention of bacteremia, bacterial endocarditis associated with surgical manipulations (in particular dental ones), in patients at risk of developing bacteria oval endocarditis; combination therapy of gastric ulcer and duodenal ulcer associated with Helicobacter pylori (in combination with metronidazole or clarithromycin and antisecretory drugs), sepsis (together with aminoglycosides); treatment and prevention of anthrax.

Contraindications


Hypersensitivity (including to other drugs from the penicillin group, cephalosporins, carbapenems), allergic diathesis, bronchial asthma, hay fever, infectious mononucleosis, lymphocytic leukemia, history associated with the use of antibiotics. You should not prescribe the drug to patients with infectious mononucleosis, lymphocytic leukemia, since they often appear erythematous rash in patients receiving amoxicillin. When a skin rash appears, amoxicillin should be canceled.

Dosage and administration


Amoxicillin is taken orally. Adults and children over 10 years old (weighing more than 40 kg) should be prescribed 0.5 g (2 capsules) 3 times a day; in case of severe infection, the dose is increased to 1.0 g (4 capsules) 3 times a day. The maximum daily dose is 6 g (24 capsules). For the treatment of acute otitis media, appoint 0.5 g (2 capsules) 3 times a day. Children aged 5 to 10 years (with a body weight of 20 to 40) are prescribed 0.25 g (1 capsule) 3 times a day. The course of treatment is 5-12 days (for streptococcal infections - at least 10 days). Patients with creatinine clearance below 10 ml per minute reduce the dose of the drug by 15-50%, with anuria, the dose should not exceed 2 g per day. For the treatment of uncomplicated gonorrhea, 3.0 g is administered once (preferably in combination with 1.0 g of probenecid). For the prevention of endocarditis, 3.0 g is administered once a day for 1 hour before surgery and 1.5 g after 6-8 hours. For the treatment and prevention of anthrax in adults and children weighing more than 20 kg, 0.5 g (2 capsules) is prescribed every 8 hours for 2 months.

Side effects


Allergic reactions: possible urticaria, skin flushing, erythematous rash, angioedema, rhinitis, conjunctivitis; rarely - fever, arthralgia, eosinophilia, exfoliative dermatitis, exudative erythema multiforme (including Stevens-Johnson syndrome); reactions similar to serum sickness; in rare cases - anaphylactic shock.

On the part of the digestive system: change in taste, nausea, vomiting, stomatitis, glossitis, dysbacteriosis, diarrhea, pain in the anus, rarely - pseudomembranous enterocolitis.

On the part of the liver and biliary tract: a moderate increase in the activity of "liver" transaminases, rarely - hepatitis and cholestatic jaundice.

On the part of the nervous system (with long-term use in high doses): agitation, anxiety, insomnia, ataxia, confusion, behavior change, depression, peripheral neuropathy, headache, dizziness, convulsions.

Laboratory changes: leukopenia, neutropenia, thrombocytopenic purpura, transient anemia.

Other effects: shortness of breath, tachycardia, interstitial nephritis, pain in the joints, candida disease of the oral cavity and vagina, superinfection (especially in patients with chronic diseases or low body resistance).

Interaction with other drugs


Reduces the effectiveness of estrogen-containing oral contraceptive drugs, drugs, in the process of metabolism of which para-aminobenzoic acid is formed, ethinyl estradiol - the risk of developing "breakthrough" bleeding. Decreases clearance and increases the toxicity of methotrexate. Strengthens digoxin absorption. Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index). Monitoring of prothrombin time should be carried out with simultaneous appointment with anticoagulants.

Antacids, glucosamine, laxatives slow down and reduce, and ascorbic acid increases absorption. Excretion is slowed by probenecid, allopurinol, sulfinpyrazone, acetylsalicylic acid, indomethacin, oxyphenbutazone, phenylbutazone and other drugs that suppress tubular secretion.

Antibacterial activity decreases with simultaneous use with bacteriostatic chemotherapeutic agents, increases - when combined with aminoglycosides and metronidazole. There is complete cross-resistance of ampicillin and amoxicillin.




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