Amoxicillin for humans

Doctors may prescribe amoxicillin to treat infections of the respiratory tract, ears, throat, skin, and urinary tract.

https://medlineplus.gov/druginfo/meds/a685001.html#brand-name-1 Amoxicillin (Oral Route).

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Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Amoxicillin is one of the most commonly used antibiotics in the primary care setting.

It is an amino-penicillin, created by adding an extra amino group to penicillin, to battle antibiotic resistance.

Amoxicillin covers a wide variety of gram-positive bacteria, with some added gram-negative coverage compared to penicillin. Similar to penicillin, it covers most Streptococcus species and has improved coverage of Listeria monocytogenes and Enterococcus .

It also has coverage over Haemophilus influenzae , some Escherichia coli , Actinomyces , Clostridial species, Salmonella , Shigella , and Corynebacteria .

Amoxicillin is FDA approved for the treatment of genitourinary tract infections, ear, nose, and throat infections, lower respiratory tract infections, Helicobacter pylori infections, pharyngitis, tonsillitis, and skin and skin structure infections. It is recommended as the first-line treatment by the Infectious Disease Society of America (IDSA), for acute bacterial rhinosinusitis and as one of the treatments for community-acquired pneumonia.[1] For this, it is often in combination with a macrolide antibiotic.

The Centers for Disease Control and Prevention (CDC) recommends its use for post-exposure prophylaxis for anthrax inhalation.[2] It also has other off-label uses, such as erysipeloid, Lyme disease (if doxycycline contraindications exist), and infectious endocarditis prophylaxis, as well as prophylaxis in patients with prosthetic joints undergoing dental procedures.

It can be effective in periodontitis in combination with metronidazole and is one of the first-line treatments for group A streptococcus pharyngitis.

Amoxicillin is in the class of beta-lactam antibiotics. Beta-lactams act by binding to penicillin-binding proteins that inhibit a process called transpeptidation, leading to activation of autolytic enzymes in the bacterial cell wall.

This process leads to lysis of the cell wall, and thus, the destruction of the bacterial cell.

This type of activity is referred to as bactericidal killing. Amoxicillin administration can also be in combination with a beta-lactamase inhibitor.

Some examples of these are clavulanic acid and sulbactam.

These beta-lactamase inhibitors work by binding irreversibly to the catalytic site of an organism’s penicillinase enzyme, which causes resistance to the original beta-lactam ring. These drugs do not have inherent bactericidal activity; however, when coupled with amoxicillin, they may broaden spectrum amoxicillin to organisms that produce the penicillinase enzyme.[3] Administration. Bactericidal antibiotics, such as amoxicillin, often are most effective in a “time-dependent” manner, rather than a “concentration-dependent” manner.

Time-dependent refers to the time that serum concentrations exceed the minimum-inhibitor-concentration for the microorganism.

Therefore, they are often dosed more frequently, rather than the concentration-dependent drugs, which can be dosed, for example, daily.

The more “around-the-clock” dosing provides less variation in peak and trough serum levels. Amoxicillin is an oral antibiotic; whereas, ampicillin can be given orally, intravenously, or intramuscularly.

Amoxicillin comes in immediate-release or extended-release tablets.

If given in suspension, it may be mixed and administered with formula, milk, water, fruit juice, ginger ale, or

other

Amoxicillin is sometimes preferred over penicillin in children because of its taste. It is important to note that it is excreted by in the majority of people by the kidney, and some renal adjustment and extra caution may be necessary for renal insufficiency.

It is reported to be partially dialyzable, and therefore, immediate-release tablets can be an option for dosing after hemodialysis.

There are no guidelines for hepatic dosing or geriatric dosing. It was a pregnancy category B drug under the old FDA classification system, which means there have been no studies demonstrating clear risk.

It has

also

Superinfections, as with fungi or Clostridium difficile colitis, are also important complications.

Crystalluria, nephritis, and hemolytic anemia can happen with prolonged administration. Of note, patients who take amoxicillin may have less diarrhea than those who take ampicillin, which may lead to better absorption in the gut.

Another significant complication to be aware of is hypersensitivity reactions. Amoxicillin can lead to type-I, II, III, or IV reactions. It is important to differentiate between a type-I and type-IV hypersensitivity reaction because one may be more dangerous than the other. A type-I reaction is an IgE-mediated hypersensitivity to a sensitized patient that triggers widespread histamine release leading to an urticarial like pruritic rash or even more severe systemic symptoms, such as anaphylaxis.

A type-IV hypersensitivity reaction does not get mediated by histamine release, and is more papular or morbilliform and often not itchy. Professionals suggest that almost all patients that receive amoxicillin inadvertently for infectious mononucleosis

develop

These types of reactions are not known to lead to anaphylaxis. Any previous anaphylactic reaction or serious skin reaction (for example, Stevens-Johnson syndrome) to amoxicillin or any other beta-lactam is a significant contraindication to amoxicillin.

These reactions may have crossover sensitivity with cephalosporins or carbapenems. It is important to note that newer data has suggested a much lower cross-reactivity with cephalosporins and carbapenems than once suspected.

Another important consideration is to determine if the patient’s allergic rash is a type-I or a type-IV hypersensitivity reaction.

Occasionally patients will report a childhood allergy to amoxicillin, which is, in fact, a type-IV-mediated hypersensitivity reaction, often in the setting of infectious mononucleosis; this is not a contraindication to giving repeat amoxicillin. A type-1 mediated hypersensitivity reaction is, however, a contraindication given that a repeat exposure puts the patient at risk for anaphylaxis.

Skin testing has been approved to help assist in hypersensitivity to penicillins. Reports are that the risk of an allergic reaction in a patient with a positive skin test is roughly four percent, whereas a negative skin test has a relatively high sensitivity in ruling out a type-I hypersensitivity reaction.[4] Monitoring. It is essential to be aware of hypersensitivity reactions, and the patient should understand to notify their physician of any rashes.[4] Mild diarrhea is often toleratable.[5] However, prolonged diarrhea with fever and abdominal pain should prompt evaluation by a clinician. In a patient on a short-term course of amoxicillin, no specific laboratory monitoring parameters are suggested. During prolonged administration, such as for osteomyelitis, it is essential to monitor renal and hepatic function as well as hematologic function periodically throughout treatment. Amoxicillin is a common antibiotic that is often prescribed by nurse practitioners, primary care providers, and internists.

The drug is very safe, but it is essential always to get a proper history of allergy before prescribing the medication.[4][6] Despite its safety record and frequency of use, amoxicillin still requires the efforts of an interprofessional healthcare team. The clinician (MD, DO, NP, PA) will initiate therapy, but a pharmacist should verify the dosing and duration are correct for the infection being treated and verify that there are no drug interactions that could impede treatment. Nursing can counsel on administration, verify compliance, reinforce along with the pharmacist to take the entire course, and not stop when they start to feel better. Any issues the nurse or pharmacist encounters need to go to the prescriber immediately. These examples of interprofessional team stewardship will improve the likelihood of positive patient outcomes.

To access free multiple choice questions on this topic, click here.

Braff, Amoxicillin in the Treatment of Gonorrhea, The Journal of Infectious Diseases , Volume 129, Issue Supplement_2, June 1974, Pages S254–S255, https://doi.org/10.1093/infdis/129.Supplement_2.S254.

Amoxicillin was used to treat uncomplicated gonorrhea in 48 males and females. Males received 500 mg every 8 hr (total, three doses), and females received 250 mg every 8 hr (total, 12 doses).

A matched group of patients was treated with 4.8 million units of procaine penicillin and 1 g of probenecid in a single dose.

The overall cure rate was 94% after amoxicillin treatment and 96% for after procaine penicillin treatment.

There were no statistical differences between the cure rate in males and that in females. The minimal inhibitory concentration of amoxicillin was.

amoxicillin gonococcal infection exanthema follow-up amoxicillin for earache penicillin g, procaine probenecid minimum inhibitory concentration measurement single-dose regimen.

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To purchase short term access, please sign in to your Oxford Academic account above. Kristina Duda, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention. Michael Menna, DO, is board-certified in emergency medicine.

He is an attending emergency medicine physician at White Plains Hospital in White Plains, New York and also works at an urgent care center and a telemedicine company that provides care to patients across the country. Treatment Over the Counter Prevention Symptoms Common Cold Flu Related Illnesses.

If you or your child has ever needed to take an antibiotic for a bacterial infection, there's a good chance the medication prescribed was either amoxicillin or Augmentin (amoxicillin clavulanate). A common assumption about these two medications is that Augmentin is simply a stronger version of amoxicillin but that isn't quite accurate. Augmentin contains a second active ingredient, which makes it more appropriate for treating certain infections than others.

The same holds true for amoxicillin and, to make the distinctions between the drugs even hazier, there are a few infections that both treat equally effectively.

Ultimately, the antibiotic a doctor prescribes will depend on the type of illness being treated and the bacteria responsible for it. Amoxicillin is often the first antibiotic prescribed for common bacterial infections, particularly those that cause illness in children, such as ear, nose, and throat infections, including tonsillitis. This antibiotic also is the first drug of choice for: Urinary tract infections Helicobacter pylori associated with ulcers Lyme disease. (Note that although amoxicillin can kill many of the same bacteria as penicillin, it is less effective than penicillin against Streptococcus pneumococcus, the bacteria commonly associated with meningitis and systemic bacteremia.) The side effects of amoxicillin tend to be relatively mild, which is another reason it's often prescribed for kids. The most common ones include rash, vaginal itching, and a dark or "hairy tongue.

? ??Digestive side effects such as nausea and vomiting can occur, but are much more common with Augmentin.

As with penicillin, there is a risk of an allergic reaction to amoxicillin in those predisposed to it. Symptoms include rash, itching, swelling of the face, tongue, and/or throat, trouble breathing, and dizziness. It's vital a doctor take a medical history before prescribing amoxicillin to determine if a patient has a known history of allergy to antibiotics. Augmentin is amoxicillin combined with a beta-lactamase inhibitor called clavulanate, an ingredient that blocks the enzymes that contribute to antibiotic resistance. ? ? The addition of a beta-lactamase blocker to amoxicillin allows Augmentin to overcome resistance to harder-to-treat bacteria, broadening the spectrum of infections it can treat.

It is for this reason that Augmentin is referred to as a broad-spectrum antibiotic .

Augmentin can treat the same bacteria as amoxicillin, but also is effective against certain harder-to-treat infections, ? ? including: Sinus infections Ear infections Bacterial infections associated with COPD Skin abscesses Diabetic foot. It should be noted there are a few infections for which amoxicillin and Augmentin are prescribed equally: Pyelonephritis (kidney infections) Erysipelas, a type of skin infection Chronic strep "carriers" The most common side effect of Augmentin is diarrhea. Some people may also experience nausea, vomiting, yeast infections, and rash. If you have an

infection

? ? Antibiotics used indiscriminately may destroy "good" bacteria along with "bad," thereby altering the body's natural flora and allowing even worse bacteria to proliferate. Another, even more pressing concern is that using broad-spectrum antibiotics can lead to antibiotic resistance.

Resistance develops when an antibiotic you are using are unable to fully eradicate a bacteria in your body, ? ? often because you stopped treatment before you were supposed to. When this happens, a few mutated bacteria may survive, some of which may be naturally resistant to the antibiotic you were taking. Because you didn't "hit the infection hard enough," these survivors now have the opportunity to multiply and become the dominant strain. As such, the next time you develop an infection, the antibiotic will not work anywhere near as well.

If this happens with broad-spectrum

antibiotic

Complete the entire course even if you feel better. Take an antibiotic only if your doctor deems it necessary.

Whether you're prescribed amoxicillin, Augmentin, or another antibiotic, it's not so much the "strength" of the drug you should be concerned about; it's all about the safety, efficacy, and appropriateness of treatment. People are sometimes surprised, and even taken aback, when they are given amoxicillin for a serious infection such as pneumonia.

But in many cases that may be all that is needed to resolve the infection.

If you don't believe that the antibiotic being prescribed is "strong enough," speak with your doctor.

This is especially true if you have a new doctor or don't see a doctor all that often.

If you've had recurrent infections in the past for which amoxicillin hasn't helped, let the doctor know. The more your doctor knows about your previous antibiotic use, the better choices he or she can make.

Amoxicillin Doesn't Help amoxicillin over the counter for humans Some Respiratory Infections.

The next time you develop a lower respiratory tract infection, don't expect amoxicillin, the go-to antibiotic for these infections, to wipe it out.

According to a new study, amoxicillin isn’t any better than a placebo at treating the symptoms of a lower respiratory tract infection or preventing them from worsening. Amoxicillin is typically used to treat lower respiratory tract infections such as pneumonia and acute bronchitis.

British researchers treated 1,038 patients who had an acute lower respiratory tract infection with amoxicillin three times per day for seven days.

A second group of 1,023 patients who also had a lower respiratory tract infection were treated with a placebo for the same period. The patients were age 18 or older and hailed from 12 European countries. All had had a cough for less than 28 days and were not suspected of having pneumonia.

Doctors assessed everyone's symptoms at the start of the study and study participants kept a daily diary, recording symptoms such as the severity of their cough, the presence of phlegm, shortness of breath, wheezing, a blocked or runny nose, chest pain, muscle aches, headaches, disturbed sleep and fever.