Amoxil

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Amoxil

Amoxil contains Amoxicillin. It is a semisynthetic antibiotic. It is prescribed for bacterial infections treatment caused by Streptococcus species, Streptococcus pneumoniae, Staphylococcus spp., or Haemophilus influenzae.

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Amoxil (amoxicillin) is a penicillin antibiotic. It is used to treat many different types of infection caused by bacteria

How does it work?

Amoxicillin (active ingredient) is semi-synthetic penicillin that has a bactericidal effect. It has a wide spectrum of action. It inhibits transpeptidase, disrupts peptidoglycan synthesis during division and growth, and causes bacterial lysis.

What bacteria kills Amoxil?

The susceptibility of microorganisms to amoxicillin:

Usually sensitive microorganisms:

  • Gram-positive aerobes: Enterococcus faecalis, β-hemolytic streptococci (A, B, C and G), Listeria monocytogenes.

Microorganisms that can acquire resistance:

  • Gram-negative aerobes: Escherichia coli, Haemophilus influenzae, Helicobacter pylori, Proteus mirabilis, Salmonella typhi, Salmonella paratyphi, Pasteurella multocida.
  • Gram-positive aerobes: coagulase-negative staphylococcus, Staphylococcus aureus, Streptococcus pneumonia, Streptococcus viridans.
  • Gram-positive anaerobes: Clostridium spp.
  • Gram-negative anaerobes: Fusobacterium spp.
  • Others: Borrelia burgdorferi.

Microorganisms with natural resistance:

  • Gram-positive aerobes: Enterococcus faecium.
  • Gram-negative aerobes: Acinetobacter spp, Enterobacter spp. Klebsiella spp, Pseudomonas spp.
  • Gram-negative anaerobes: Bacteroides spp. (many Bacteroides fragilis strains are resistant).
  • Others: Chlamydia spp, Mycoplasma spp, Legionella spp.

When is Amoxil used?

The antibiotic is used to treat the following infectious and inflammatory diseases in adults and children:

  • acute bacterial sinusitis;
  • acute otitis media;
  • acute streptococcal tonsillitis and pharyngitis;
  • exacerbation of chronic bronchitis;
  • community-acquired pneumonia;
  • acute cystitis;
  • asymptomatic bacteriuria in pregnant women;
  • acute pyelonephritis;
  • typhoid and paratyphoid fever;
  • tooth abscess with spreading cellulite;
  • infections of the prosthetic joints;
  • eradication of Helicobacter pylori;
  • Lyme disease (borreliosis);
  • prevention of endocarditis.

Official guidelines for the proper use of antibacterial drugs should be taken into account.

How to take Amoxil?

The antibiotic is taken orally, before or after meals.

The dose of Amoxil depends on the sensitivity of the infectious agent, the severity of the disease and the localization of the infectious process.

To ensure the following dosage regimen for children under 12 years of age, it is preferable to take the drug granules for the preparation of a suspension for oral administration, 250 mg/5 ml.

Adults and children over 13 years old and/or weighing more than 40 kg:

  • The usual dose is 250 mg-500 mg 3 times a day or 500 mg-1000 mg 2 times a day. To treat sinusitis, community-acquired pneumonia and other severe infections, it is recommended to prescribe 500 mg-1000 mg 3 times a day. The maximum daily dose is 6 g.

Children from 3 to 5 years old and/or weighing from 15 kg to 19 kg:

  • The usual dose is 250 mg 2 times a day. In cases where there is a high probability of infection caused by resistant Streptococcus pneumoniae, higher doses are recommended – 500 mg 2-3 times a day.

Children from 5 to 13 years old and/or weighing from 19 kg to 40 kg:

  • The usual dose is 250 mg 3 times a day. In cases where the likelihood of infection caused by resistant Streptococcus pneumoniae is high, higher doses are recommended – 500-1000 mg 3 times a day. The maximum daily dose for children is 100 mg/kg/day.

Lyme disease (borreliosis) – early stage:

  • Adults and children over 13 years old and/or weighing more than 40 kg: 500-1000 mg 3 times a day up to a maximum daily dose of 4 g, divided into several doses, for 14 days (10-21 days);
  • Children from 3 to 5 years old and/or weighing from 15 kg to 19 kg: 250 mg 3 times a day;
  • Children from 5 to 13 years old and/or weighing from 19 kg to 40 kg: The usual dose is 500 mg 2-3 times a day.

Eradication of Helicobacter pylori in patients with gastric ulcer or duodenal ulcer (always in combination with other drugs):

  • Adults: 1000 mg 2 times a day in combination with proton pump inhibitors (eg. omeprazole, lansoprazole) and another antibiotic (eg. clarithromycin, metronidazole) for 7 days;
  • Children over 13 years old and/or weighing more than 40 kg: 1000 mg 2 times as part of combination therapy;
  • Children from 3 to 5 years old and/or weighing from 15 kg to 19 kg: 250-500 mg 2 times a day;
  • Children from 5 to 13 years old and/or weighing from 19 kg to 40 kg: 500-1000 mg 2 times a day.

Prevention of bacterial endocarditis:

  • Adults and children over 13 years old and/or weighing more than 40 kg: The recommended dose is 2 g 0.5-1 hour before surgery;
  • Children from 3 to 5 years old and/or weighing from 15 kg to 19 kg: 750-1000 mg before the procedure;
  • Children from 5 to 13 years old and/or weighing from 19 kg to 40 kg: 1000-2000 mg before the procedure.

Patients with renal failure:

  • Patients with creatinine clearance (CC) more than 30 ml/min do not need a dose adjustment. With CC less than 30 ml/min, an increase in the interval between doses or a decrease in subsequent doses is recommended.

Side effects

In some cases, Amoxil can cause the following side effects:

  • Mucocutaneous candidiasis;
  • Reversible leukopenia (including neutropenia or agranulocytosis), reversible thrombocytopenia and hemolytic anemia, increased bleeding time and prothrombin time;
  • Severe allergic reactions, including angioedema, anaphylaxis, serum sickness, allergic vasculitis;
  • Jarisch-Herxheimer reaction;
  • Hyperkinesia, dizziness, convulsions;
  • Diarrhea, nausea;
  • Vomiting;
  • Antibiotic-associated colitis (including pseudomembranous and hemorrhagic colitis);
  • Hepatitis and cholestatic jaundice, elevated ALT and/or ACT;
  • Rash;
  • Hives, itching;
  • Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous and exfoliative dermatitis, acute generalized exanthematous pustulosis;
  • A drug reaction with eosinophilia and systemic symptoms (DRESS) may cause flu-like symptoms with a rash, fever, swollen lymph nodes, and abnormal blood test results, including increased white blood cell counts (eosinophilia) and liver enzymes;
  • Crystalluria, interstitial nephritis.

If you have any adverse reactions, tell your doctor about it. This also applies to any adverse reactions that are not listed in this list.

You can also report adverse reactions to the information database on adverse reactions (actions) to medicinal products, including reports of the ineffectiveness of medicinal products. By reporting adverse reactions, you can help provide more information on the safety of this medicine.

Contraindications

Do not take Amoxil if you have:

  • hypersensitivity to amoxicillin, any antibiotic of the penicillin series or any auxiliary component in the composition of the drug;
  • a history of severe immediate hypersensitivity reactions (eg. anaphylaxis) caused by the use of other beta-lactam drugs (eg. cephalosporins, carbapenems or monobactams).

Overdose

An overdose of Amoxil can cause nausea, vomiting, diarrhea and imbalance in water and electrolyte balance. Crystalluria can lead to kidney failure. Patients with impaired renal function or patients taking large doses may experience seizures. There is no specific antidote. Treatment is symptomatic. Control over water-electrolyte balance is recommended. Hemodialysis is effective for the elimination of amoxicillin. To treat seizures, the use of benzodiazepines is indicated.

Pregnancy and breastfeeding

Animal studies have not shown any direct or indirect reproductive toxicity of amoxicillin.

Observations of a limited contingent of pregnant women taking amoxicillin did not reveal an increased risk of congenital malformations. The use of Amoxil in pregnant women is possible only if the expected benefit significantly outweighs the potential risk to the mother and fetus.

The medicine passes into breast milk in small quantities with a possible risk of sensitization. Therefore, the infant is at risk of developing diarrhea and fungal infection of the mucous membranes, so breastfeeding may need to be interrupted. The drug should be used during breastfeeding only after the health care provider has assessed the risks and benefits.

There are no data on the effect of amoxicillin on human fertility. According to animal studies, the drug does not affect fertility.

Interaction with other drugs

  • Probenecid. Joint use is not recommended since probenecid causes a decrease in the secretion of amoxicillin by the renal tubules. Simultaneous use can lead to an increase in the level of amoxicillin and an increase in its residence time in the blood;
  • Allopurinol. Joint use can cause skin allergic reactions;
  • Tetracyclines. Tetracyclines and other bacteriostatic drugs may interfere with the bactericidal effect of amoxicillin;
  • Oral anticoagulants. Oral anticoagulants and penicillin antibiotics are widely used in practice without reports of their interaction.;
  • Methotrexate. Penicillins reduce the excretion of methotrexate, which increases its potential toxicity.

Precautions

Treatment should be continued for another 48-72 hours after symptoms have disappeared.

Before starting treatment, the patient’s anamnesis is carefully studied for previous hypersensitivity reactions to penicillins, cephalosporins and other β-lactam antibiotics. In some cases, penicillin caused severe, sometimes fatal (including anaphylactoid and severe cutaneous adverse reactions) hypersensitivity reactions. If an allergic reaction occurs, stop taking Amoxil and consult a doctor for alternative treatment.

The drug is used to treat only infections caused by pathogenic microorganisms with a known or highly probable sensitivity to this antibiotic. In particular, this applies to the use of amoxicillin in patients with urinary tract infections and severe infections of the ear, throat and nose.

When taking high doses of amoxicillin, it is recommended to ensure adequate fluid intake and sufficient urine output to reduce the possibility of crystalluria. Patients with bladder catheters should be monitored regularly for urinary patency.

The drug should not be prescribed to patients with infectious mononucleosis, lymphocytic leukemia since they often develop an erythematous rash while taking amoxicillin.

In the course of long-term therapy, it is necessary to monitor the state of the function of the hematopoietic organs, liver and kidneys.

Prolonged use can cause superinfection due to the growth of microflora insensitive to amoxicillin, which requires a corresponding change in antibacterial therapy.

The antibiotic may cause antibiotic-associated colitis in both mild and life-threatening forms. Therefore, when diarrhea develops during or after treatment with amoxicillin, it is important to remember the possibility of such a disease. If antibiotic-associated colitis occurs, you should cancel the drug and consult a doctor. Taking medications with anti-peristaltic action is contraindicated.

Patients with impaired renal function or receiving high doses of amoxicillin or those who have predisposing factors (for example, a history of epileptic seizures, epilepsy, or meningeal disorders) can experience seizures.

Special studies have not been conducted about the influence of Amoxil on driving. However, possible side reactions (allergic reactions, dizziness, convulsions) can affect the ability to drive and operate other mechanisms.