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Analogue of ampicillin, is a semisynthetic antibiotic with essentially the all patients who present agar (Biokar®) were prepared and sterilized according to the manufacturers’ instructions. Another drug and may not reflect the rates.

Experimental group compared to the wait-list controls sinus infection (sinusitis) scientists found that the rats enjoyed the learning process and that it even lowered.

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10.07.2017

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Under-reporting of harms in trials remains widespread, 58 and until that problem is

addressed

, under-reporting will flow to systematic reviews 59 and other evidence syntheses such as guidelines. An important consequence of under-reporting of harms is misrepresentation of the balance of an intervention’s benefits and harms, 59 but shared decision-making requires consideration of both these aspects. This systematic review has provided new information about common harms of amoxicillin and amoxicillin–clavulanic acid that can contribute to better-informed discussions and decisions about the benefit–harm trade-off for these antibiotics. However, it also highlights that the ability of clinicians and patients to make fully informed decisions about using amoxicillin and amoxicillin–clavulanic acid is hampered by poor measurement and reporting.

The authors would like to thank Elaine Beller (associate professor of biostatistics at the Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia) for statistical advice and Jeffrey Aronson (reader in clinical pharmacology at Oxford University, Oxford, UK) for feedback and advice on previous versions. Competing interests: Malcolm Gillies’s employer, NPS MedicineWise, is an independent nonprofit organization funded by the Australian Government’s Department of Health to promote quality use of medicines.

Tammy Hoffmann and Christopher Del Mar report grants from the National Health and Medical Research Council of Australia during the conduct of this study.

Christopher Del Mar also reports personal fees from BMJ Books and Elsevier for activities outside the scope of this work.

Contributors: Malcolm Gillies, Paul Glasziou and Christopher Del Mar undertook the study concept. All authors contributed to its design, the search strategy and the analysis. All authors contributed to writing and reviewing the manuscript, all approved the version submitted for publication, and all agreed to act as guarantors for the work.

Funding: This study was conducted as a project of the Centre for Research Excellence in Minimising Antibiotic Resistance in Acute Respiratory Infections, with funding for the centre provided by the National Health and Medical Research Council (NHMRC) of Australia (grant 1044904).

Paul Glasziou is supported by NHMRC Australia Fellowship 527500.

Tammy Hoffmann is supported by NHMRC/Primary Health Care Research, Evaluation and Development Career Development Fellowship 1033038. NPS MedicineWise provides salary support for Malcolm Gillies.

About amoxicillin Key facts Who can and can't take amoxicillin How and when to take it Side effects How to cope with side effects Pregnancy and breastfeeding Cautions with other medicines Common questions.

It's used in children, often to treat ear infections and chest infections.

It comes as capsules or as a liquid that you drink.

It's also given by injection, but this is usually only done in hospital. For most infections, you'll start to feel better in a few days.

The most common side effects of amoxicillin are feeling sick (nausea) and diarrhoea.

Amoxicillin is also called by the brand name Amoxil. Amoxicillin can be taken by adults, including pregnant and breastfeeding women. To make sure amoxicillin is safe for you, tell your doctor if you : have had an allergic reaction to amoxicillin or penicillin or any other medicines in the past have liver or kidney problems have recently had, or are about to have, any vaccinations.

The usual dose of amoxicillin is 250mg to 500mg taken 3 times a day.

If you take it 3 times a day, this could be first thing in the morning, mid-afternoon and at bedtime.

Carry on taking this medicine until you've completed the course, even if you feel better.

If you stop your treatment early, the infection could come back.

Swallow amoxicillin capsules whole with a drink of water.

Amoxicillin is available as a liquid for children keflex and amoxicillin and people who find it difficult to swallow tablets.

If you or your child are taking amoxicillin as a liquid, it will usually be made up for you by your pharmacist.

The medicine will come with a plastic syringe or spoon to help you measure out the right dose.

If you don't have one, ask your pharmacist for one.

Do not use a kitchen teaspoon as it will not give amoxicillin and keflex the right amount. If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next

dose

. In this case, just leave out the missed dose and take your next dose as normal. Never take an extra dose to make up for a forgotten one. If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines.

Accidentally taking an extra dose of amoxicillin is unlikely to harm you or your child. Speak to your pharmacist or doctor if you're worried or you take more than 1 extra dose. Like all medicines, amoxicillin can cause side effects, although not everyone gets them. These common side effects happen in around 1 in 10 people. Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or don't go away: feeling sick (nausea) diarrhoea. Serious side effects are rare and happen in less than 1 in 1,000 people. Call a doctor straight away if you get: diarrhoea (possibly with stomach cramps) that contains blood or mucus. If you have severe diarrhoea for more than 4 days you should also speak to a doctor pale poo with dark pee, yellowing of the skin or the whites of your eyes (warning signs of liver or gallbladder problems) bruising or skin discolouration joint or muscle pain that comes on after 2 days of taking the medicine a skin rash with circular red patches. Some of these serious side effects can happen up to 2 months after finishing the amoxicillin. Around 1 in 15 people have an allergic reaction to amoxicillin.

In most cases, the allergic reaction is mild and can take the form of: a raised, itchy skin rash coughing wheezing. Mild allergic reactions can usually be successfully treated by taking antihistamines.

In rare cases, amoxicillin can cause a serious allergic reaction (anaphylaxis). Immediate action required:

Call

999 or go to A&E if: you get a skin rash that may include itchy, red, swollen, blistered or peeling skin you're wheezing you get tightness in the chest or throat you have trouble breathing or talking your mouth, face, lips, tongue or throat start swelling.

You could be having a serious allergic reaction and may need immediate treatment in hospital. For a full list see the leaflet inside your medicines packet. You can report any suspected side effect to the UK safety scheme.

What to do about: feeling sick (nausea) - stick to simple meals and do not eat rich or spicy food.

It might help to take your amoxicillin after a meal or snack. diarrhoea - drink plenty of fluids, such as water or squash to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee.

Do not

take

any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

It's usually safe to take amoxicillin during pregnancy and while breastfeeding.

For more information about how amoxicillin can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

For safety, tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding. There are some medicines that don't mix well with amoxicillin. Tell your doctor if you're taking these medicines before you start taking amoxicillin : methotrexate a blood thinner called warfarin gout medicines called probenecid and allopurinol other antibiotics.

Mixing amoxicillin with herbal remedies and supplements.

There are no known problems with taking herbal remedies and supplements alongside amoxicillin. For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements. It works by killing the bacteria that cause the infection.

For most infections, you should feel better within a few ciprofloxacin amoxicillin days.

It's very important that you keep taking amoxicillin until your course is finished. Tell your doctor if you don't start feeling better after taking amoxicillin for 3 days. Also tell them if, at any time, you start to feel worse. Some people get a fungal infection called thrush after taking a course of antibiotics like amoxicillin. It happens because antibiotics kill the normal harmless bacteria that help to protect you against thrush. Ask your pharmacist or doctor for advice if this happens to you.

Amoxicillin doesn't stop contraceptive pills working, including the combined pill or emergency contraception.

However, if amoxicillin makes you vomit or have severe diarrhoea (6 to 8 watery poos in 24 hours) for more than 24 hours, your contraceptive pills may not protect you from pregnancy.

There's no firm evidence to suggest that taking amoxicillin will reduce fertility in either men or women.



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