Amoxicillin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: PO Acute bacterial sinusitis; Acute otitis media; Ear, nose and/or throat infections; Genitourinary infections; Cystitis; Pyelonephritis; Skin and soft tissue infections Individualise dosing based on expected susceptible pathogens, severity and site of infection, age, weight and renal function of the patient. 250-500 mg 8 hourly or 500-1,000 mg 12 hourly. For severe infections: 750-1,000 mg 8 hourly. Dental abscesses 3 g, repeated once after 8 hours. Uncomplicated acute urinary tract infections 3 g, repeated once after 10-12 hours. Uncomplicated gonorrhoea In patients with susceptible non-penicillinase producing N. gonorrhoeae strains: 3 g as a single dose in combination with probenecid. Acute exacerbations of chronic bronchitis; Asymptomatic bacteriuria in pregnancy 250-500 mg 8 hourly or 750-1,000 mg 12 hourly. For severe infections: 750-1,000 mg 8 hourly. Acute streptococcal pharyngitis and tonsillitis 500 mg 8 hourly or 750-1,000 mg 12 hourly. For severe infections: 750-1,000 mg 8 hourly for 10 days. Community-acquired pneumonia 500-1,000 mg 8 hourly. Typhoid and paratyphoid fever 500-2,000 mg 8 hourly. Prophylaxis of endocarditis 2 g as single dose 30-60 minutes prior to procedure. H. pylori eradication associated with peptic ulcer disease In combination with PPI and another antibiotic: 750-1,000 mg bid for 7-14 days depending on therapy regimen. Lyme disease Early stage: 500-1,000 mg 8 hourly for 14 days (range: 10-21 days). Max: 4,000 mg/day in divided doses. Late stage: 500-2,000 mg 8 hourly for 10-30 days. Max: 6,000 mg/day in divided doses. IV/IM Ear, nose and/or throat infections; Acute exacerbations of chronic bronchitis; Community-acquired pneumonia; Cystitis; Pyelonephritis; Skin and soft tissue infections 500 mg 8 hourly. Severe infections: May increase to 1,000 mg 6 hourly. Alternatively, 750-2,000 mg 8 hourly or 2,000 mg 12 hourly. Doses may be given via slow IV inj, IV infusion or IM inj. Max: 12 g/day (IV); 4 g/day (IM); 1 g (single IM dose). Endocarditis Treatment in combination with another antibiotic if needed: 1-2 g 4-6 hourly via slow IV inj, IV infusion, or IM inj. Max: 12 g/day (IV); 4 g/day (IM); 1 g (single IM dose). Prophylaxis in patients at highest risk of infective endocarditis: 2 g as single IV dose 30-60 minutes prior to procedure. Bacterial meningitis In combination with another antibiotic if needed: 1-2 g 4-6 hourly via slow IV inj, IV infusion, or IM inj. Max: 12 g/day (IV); 4 g/day (IM); 1 g (single IM dose). Consideration must be given to local treatment guidelines.
Administration
Amoxicillin: May be taken with or without food. May be taken w/ meals for better absorption & to reduce GI discomfort.
Contraindications
Hypersensitivity or history of severe allergic reactions (e.g. anaphylaxis, Stevens-Johnson syndrome) to amoxicillin or other β-lactams (e.g. penicillins, cephalosporins, carbapenems, monobactams). Infectious mononucleosis (suspected or confirmed).
Special Precautions
Patient with reduced urine output, history of seizures, treated epilepsy or meningeal disorders; lymphatic leukaemia. Atopic individuals. Renal and hepatic impairment. Children. Pregnancy and lactation. Monitoring Parameters Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor renal, hepatic, and haematologic (e.g. CBC with differential) functions periodically with prolonged therapy; electrolyte balance. Assess patient for infection throughout therapy; signs or symptoms of anaphylaxis (during initial dose), opportunistic infections, and antibiotic-associated diarrhoea.
Adverse Reactions
Significant: Convulsion (high doses), Jarisch-Herxheimer reaction (in treatment of Lyme disease). Rarely, crystalluria (high parenteral doses); prolonged prothrombin time. Blood and lymphatic system disorders: Rarely, thrombocytopenia, leucopenia. Gastrointestinal disorders: Nausea, diarrhoea, vomiting; tooth discolouration (brown, yellow, grey) particularly in children. Investigations: Elevated liver enzymes, changes in blood counts (prolonged therapy). Nervous system disorders: Headache, dizziness, agitation. Psychiatric disorders: Reversible hyperactivity, anxiety, insomnia, confusion, behavioural changes. Reproductive system and breast disorders: Vulvovaginal infection. Skin and subcutaneous tissue disorders: Rash, urticaria, pruritus.
Potentially Fatal: Hypersensitivity reactions including anaphylaxis, anaphylactoid and severe cutaneous adverse reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms); C. difficile-associated diarrhoea or pseudomembranous colitis. Rarely, cholestatic hepatitis.
Drug Interactions
Decreased renal tubular secretion resulting in increased and prolonged serum concentration with probenecid. Increased risk of allergic reactions (e.g. rashes) with allopurinol. Tetracyclines, chloramphenicol, macrolides, and sulfonamides may interfere with the bactericidal effect of amoxicillin. May prolong prothrombin time or increase INR when used with oral anticoagulants (e.g. warfarin, acenocoumarol). May reduce the excretion and increase the toxicity of methotrexate. May reduce the efficacy of oral contraceptives (e.g. estrogen/progesterone combination).
CIMS Class
ATC Classification
J01CA04 - amoxicillin ; Belongs to the class of penicillins with extended spectrum. Used in the systemic treatment of infections.
Disclaimer: This information is independently developed by CIMS based on amoxicillin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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