Existing forms of release and composition
This drug is produced in the form of tablets, capsules or granules. All forms of release are intended for oral administration, since the active substance enters the body through the gastrointestinal tract.
Amoxicillin is available in the form of granules intended for the preparation of an oral suspension.
Capsules and tablets are dosed at 250 and 500 mg. The granulated form is intended for preparing a suspension for children.
The active ingredient is amoxicillin trihydrate in various proportions, which depend on the form of release.
Composition and mechanism of action
The drug belongs to the penicillins. In its action it is closest to Ampicillin, but is more universal.
Systemic antibacterial effect is achieved thanks to amoxicillin trihydrate. This substance is active against the following microorganisms:
- staphylococci;
- streptococci;
- meningococci;
- gonococci;
- peptococci;
- shigella;
- Klebsiella;
- clostridia;
- Proteus;
- salmonella;
- borrelia;
- intestinal, pseudomonas and hemophilus influenzae;
- chlamydia, mycoplasma;
- whooping cough sticks;
- campylobacter;
- rhinobacteria;
- spirochetes.
The antibiotic affects all pathogenic microorganisms that are sensitive to Ampicillin. It is effective against various anaerobic bacteria, but has no effect on viruses.
Amoxicillin for children can be used in the treatment of Helicobacter pylori, but only as part of complex therapy.
Amoxicillin for children affects the cellular structure of the bacterium, leading to its death. It accumulates in the blood within 1-2 hours after administration. It is excreted by the kidneys and liver within 6-8 hours.
Excipients in the composition depend on the form of release. The tablets contain starch, magnesium stearate, talc, titanium dioxide and hypromellose may be present. The granules contain flavorings (raspberry or strawberry) and sweeteners. The capsules contain magnesium stearate, cellulose, gelatin and dyes.
pharmachologic effect
Amoxicillin has bactericidal and antibacterial effects. It is an aminobenzyl penicillin, which produces a bactericidal effect due to inhibition of bacterial cell wall synthesis.
Pharmacokinetics
The bioavailability of amoxicillin varies in proportion to the dosage and can range from 75 to 90%. When taken orally 500 mg, its concentration in plasma ranges from 6 to 11 mg/l. After taking the drug, Cmax is formed in the blood plasma within 2 hours.
15-25% of amoxicillin binds to plasma proteins. Characterized by rapid penetration into lung tissue, bronchial secretions, urine, bile and middle ear fluid. If the meninges are not inflamed, then the density of the active substance in the cerebrospinal fluid can reach 20% of its density in plasma. The substance can cross the placenta and pass into breast milk in small doses.
From 60 to 80% of the active substance of the drug is excreted from the body by the kidneys in the same form in which it entered it.
No more than 25% of this dose is involved in metabolism, forming inactive penicillic acid. From 60 to 80% of the active substance is excreted from the body by the kidneys in the same form in which it entered it. This process lasts an average of 7 hours. A small dose of the substance is excreted in the bile.
Action and effectiveness of the drug
Amoxicillin is a broad-spectrum antibiotic recommended for use in pediatrics.
Amoxicillin is a semisynthetic antibiotic belonging to the penicillin group. It is characterized by a wide spectrum of action and high acid resistance. The active substance of the same name has a bactericidal effect - it disrupts the formation of bacterial cell walls during the period of growth and division, which leads to their destruction.
The effectiveness of the antibiotic has been proven by numerous clinical studies. Amoxicillin is the drug of choice, that is, it is preferred in the treatment of bacterial infections in pediatrics. Despite the fact that the drug has been used for decades, it remains highly active against many pathogens and is not inferior to representatives of the groups of macrolides, fluoroquinolones and ketolides.
What does amoxicillin help with?
The drug is prescribed for children for the following diseases:
- Respiratory tract diseases.
- Chronic pyelonephritis.
- Purulent sore throat (chronic).
- Various forms of bronchitis.
- Pharyngitis, laryngitis.
- Furunculosis.
Amoxicillin overcomes the histohematic barrier well, effectively creating a therapeutic concentration.
It is most effective in treating infectious diseases of the following body systems:
- genitourinary system;
- Gastrointestinal tract (except for the lower intestine);
- skin infections (furunculosis, dermatitis);
- upper respiratory tract (pharyngitis, acute otitis media, tonsillitis, bronchitis, pulmonary abscess).
It is prescribed for the treatment of all types of gonorrhea, salmonellosis, and Lyme disease. For such diseases, self-medication is prohibited. The required dose of the drug in the form of a trihydrate can be prescribed by a doctor based on test results.
In case of severe infection, Amoxicillin should be used in combination with clavulanic acid. In this case, administration can be carried out both in the form of tablets and in the form of injections.
It is difficult to conclude what Amoxicillin is most effective for. It all depends on the individual characteristics of the body, the severity of the disease and the correct dosage.
Indications for use
For use as monotherapy and in combination with clavulanic acid: infectious and inflammatory diseases caused by sensitive microorganisms, including:
- bronchitis,
- pneumonia,
- angina,
- pyelonephritis,
- urethritis,
- gastrointestinal infections,
- gynecological infections,
- infectious diseases of the skin and soft tissues,
- listeriosis,
- leptospirosis,
- gonorrhea.
For use in combination with metronidazole:
- chronic gastritis in the acute phase, peptic ulcer of the stomach and duodenum in the acute phase, associated with Helicobacter pylori.
Contraindications
Contraindications include:
- Hypersensitivity to the components of the drug.
- Allergy to penicillin and cephalosporin antibiotics (cross-allergy).
- Infectious mononucleosis.
- Lymphocytic leukemia.
A number of main contraindications also include:
- Age less than 3 years.
- I trimester of pregnancy.
- Lactation period.
- Severe renal failure.
- Dysfunction of the digestive system.
- Bronchial asthma.
- Antibiotic-associated colitis (history).
When taking amoxicillin and clavulanic acid in parallel, in addition to the listed contraindications, liver function disorders may occur.
You should know that amoxicillin, like other antibiotics, is used in the treatment of only those infections that were caused by bacterial activity. For viral infections (herpes, influenza, ARVI), using it is not only useless, but even harmful.
Amoxicillin Express, 1000 mg, dispersible tablets, 20 pcs.
Hypersensitivity reactions
Before starting treatment with amoxicillin, attention should be paid to a history of hypersensitivity reactions to penicillins, cephalosporins or other beta-lactam antibiotics.
Severe and sometimes fatal hypersensitivity reactions (including anaphylactic reactions and severe skin reactions) have been reported in patients receiving penicillin therapy. The development of these reactions is more likely in people with a history of hypersensitivity to penicillins and in people with atopy. If an allergic reaction occurs, discontinue treatment with amoxicillin and institute appropriate alternative treatment.
Acute coronary syndrome associated with hypersensitivity (Kounis syndrome)
In rare cases, hypersensitivity reactions (acute coronary syndrome associated with hypersensitivity) have been reported during treatment with amoxicillin. If this reaction occurs, amoxicillin should be discontinued and appropriate treatment should be prescribed.
Insensitive microorganisms
For some types of infections, before prescribing amoxicillin, it is necessary to first establish the pathogen and its sensitivity to the drug, or make sure that the pathogen is likely to be treatable with amoxicillin. This particularly applies to patients with urinary tract infections and severe ear, nose and throat infections.
Convulsions
Convulsions may occur in patients with renal failure, in patients receiving high doses of the drug, as well as in patients with predisposing factors - a history of seizures, treatment for epilepsy or meningitis, etc.
Kidney failure
In patients with renal impairment, the dose should be adjusted according to the degree of renal impairment.
Skin reactions
The occurrence of generalized erythema with fever, accompanied by pustules, at the initial stage of treatment may be a symptom of OHEP (see section “Side effects”). In this case, amoxicillin should be discontinued, and its subsequent use will be contraindicated in any situation.
The use of amoxicillin should be avoided in patients who are suspected of having infectious mononucleosis, since a measles-like rash (exanthema) may occur due to the use of amoxicillin for this disease.
Jarosz-Herxheimer reaction
The Jarisch-Herxheimer reaction has been observed following the use of amoxicillin in patients with Lyme disease. This reaction is associated with the bactericidal effect of amoxicillin on the causative agent of Lyme disease, the spirochete Borrelia burgdorferi. Patients should be advised that this reaction is a common side effect of antibiotic treatment for Lyme disease and usually goes away on its own.
Excessive growth of non-susceptible microorganisms
Long-term use of the drug can sometimes lead to excessive growth of microorganisms that are not sensitive to amoxicillin (superinfection).
When using almost all antibacterial drugs, the development of colitis associated with taking antibiotics is possible. Its severity can range from mild to severe (life-threatening). Therefore, it is important to consider the possibility of this diagnosis in patients who develop diarrhea during or after antibiotic use. If diarrhea develops, the patient should immediately stop taking amoxicillin, consult a doctor and begin appropriate treatment. Medicines that inhibit peristalsis are contraindicated in this situation.
Long-term treatment
During long-term therapy, it is necessary to periodically monitor the function of the hematopoietic organs, kidneys and liver. Increased activity of liver enzymes and changes in the number of blood cells were reported.
Anticoagulants
Rare cases of increased prothrombin time have been reported in patients receiving amoxicillin. When prescribing the drug simultaneously with anticoagulants, appropriate monitoring should be carried out, and the dose of oral anticoagulants may need to be adjusted to maintain the required level of blood clotting.
Crystalluria
In patients with reduced diuresis, crystalluria was very rarely observed, mainly during parenteral therapy. When using high doses of amoxicillin, it is recommended to maintain adequate fluid intake and diuresis to reduce the likelihood of developing crystalluria associated with amoxicillin use. In patients with a catheterized bladder, catheter patency should be checked regularly.
Impact on diagnostic tests
Increased levels of amoxicillin in serum and urine may interfere with some laboratory tests. Due to high concentrations of amoxicillin in urine, chemical methods often give false-positive results.
When determining glucose in urine during treatment with amoxicillin, it is recommended to use enzymatic glucose oxidase tests.
The use of amoxicillin may affect the results of the quantitative determination of estradiol in urine in pregnant women.
Impact on the ability to drive vehicles and operate machinery
Studies of the effect of amoxicillin on the ability to drive vehicles or operate other machinery have not been conducted. However, side effects may occur (for example, allergic reactions, dizziness, convulsions) that affect the ability to drive vehicles or use other machinery.
How to take amoxicillin
The therapeutic course and dose are determined individually.
To prepare 100 ml of suspension, you need to add purified water to the mark line (or 74 ml) into the bottle with granules and shake.
Adults and children over 10 years of age and weighing more than 40 kg take 2 scoops (500 mg each) 3 times a day. In case of severe disease, the dose is increased to 1 g (4 scoops) 3 times a day. The maximum daily dose is 6 g.
For diabetes
The suspension contains sucrose, which must be taken into account by patients suffering from diabetes.
For patients with diabetes during the treatment of infectious diseases of the genitourinary tract, Amoxicillin clavulanate 500/125 mg orally 3 times a day is indicated. The duration of treatment is 5 days.
Amoxicillin can be taken with or without food.
Before or after meals
Food does not affect the absorption of the drug. Accordingly, it can be taken regardless of meals.
How many days to drink
The course of therapy takes from 5 days to 2 weeks. The drug must be taken for at least 2-3 days after the symptoms of the disease disappear.
Side effects of amoxicillin
The drug is most often well tolerated. In some cases, the following side effects may occur:
- conjunctivitis;
- fever;
- changes in blood composition, anemia;
- candidiasis;
- colpitis;
The active substance may lead to a decrease in the synthesis of vitamin K.
The use of the drug may lead to a decrease in the prothrombin index.
Gastrointestinal tract
Disturbances such as nausea, dysbacteriosis, dyspepsia, diarrhea, and stomatitis may occur.
central nervous system
Side effects on the central nervous system may include headaches, insomnia, increased excitability, anxiety, and confusion.
From the respiratory system
On the part of the respiratory system, a side effect such as rhinitis is noted.
From the cardiovascular system
An adverse reaction in the form of tachycardia may occur.
Allergies
The drug can provoke various types of allergies, which include hyperemia, swelling, urticaria, dermatitis, and anaphylactic shock.
Side effects
Side effects of Amoxicillin in children more often appear when the dosage is exceeded or prolonged use. The most common allergy symptoms are:
- skin rashes;
- allergic dermatitis;
- Quincke's edema;
- hives;
- rhinitis;
- anaphylactic shock.
If you take Amoxicillin for too long, your child will develop headaches and seizures. Neurological disorders such as insomnia, increased agitation and anxiety are possible. Unpleasant consequences of antibacterial treatment, such as stomatitis, dysbacteriosis, and diarrhea, may develop.
An overdose is fraught with stool upset and vomiting. If the dose is exceeded, you should immediately rinse your stomach and take the sorbent.
special instructions
When taking the drug, you must follow the instructions and recommendations of your doctor. This product is not intended for prophylactic use. If treatment rules are not followed, bacteria can adapt to the effects of the drug. Its subsequent use will be ineffective.
How to give to children
Most often, the suspension is prescribed to children under 10 years of age.
Children under 2 years old and weighing up to 10 kg - 0.5 scoop 3 times a day (or at the rate of 20 mg/kg body weight per day for 3 doses). Children from 2 to 5 years old weighing from 10 to 20 kg - 0.5 - 1 measuring spoon (125 - 250 mg / 5 ml) 3 times a day. At 5 - 10 years old with a body weight of 20 to 40 kg, you should take 1 - 2 measuring spoons (250 - 500 mg) 3 times a day. The average daily dose for children from 2 to 10 years is 20-40 mg/kg body weight per day in 3 doses.
For newborns and children up to 3 months, the highest daily dose is 30 mg/kg body weight per day in 2 doses every 12 hours.
Use during pregnancy and lactation
During pregnancy, the drug is prescribed strictly according to indications, taking into account the harm it can cause to the fetus. Studies of the effects on the child’s body during intrauterine development have not been conducted; therefore, caution must be exercised when taking the drug.
During lactation, doctors do not recommend taking this drug, as it enters the baby’s body through breast milk and can cause severe allergic reactions and stomach upset.
Interaction with other drugs
It is prohibited to combine metronidazole with amoxicillin during therapy in childhood. The manufacturer of the drug indicates that it can be used no earlier than 3 years, but in practice pediatricians use the drug to treat younger children.
It is prohibited to take this drug simultaneously with the following substances and drugs:
- Oral contraceptives containing estrogen.
- Bactericidal antibiotics (cycloserine, rifampicin, vancomycin, etc.).
- Bacteriostatic drugs (tetracyclines, lincosamides, macrolides, etc.).
- Anticoagulants (the effectiveness of indirect anticoagulants is reduced).
- NSAIDs (acetylsalicylic acid, indomethacin, phenylbutazone, etc.).
- Aminoglycosides.
- Kaolin.
- Allopurinol and antacids.
Alcohol compatibility
It is forbidden to use the drug in parallel with alcohol intake, as they are incompatible and have a negative effect on the liver, which can be fatal. After completing the course of treatment, you must refrain from drinking alcohol for 7–10 days.
Manufacturer
The drug is produced in various countries, including Russia, the USA, Israel, Germany, Austria, Canada, India, Egypt, etc.
