2010/06/14

Amoxicillin

The international name:
Amoxicillin (Amoxicillin)

Group Affiliation:
The antibiotic, penicillin, semisynthetic

Description of the active substance (INN):
Amoxicillin

Dosage form:
granules for suspension for oral administration, capsules, powder for oral drops [for children], powder for solution for intravenous and intramuscular injection, powder for suspension for n

Mode of action:
Semi-synthetic penicillin, bactericidal effect, has a wide range of actions. Violates the synthesis of peptidoglycan (the reference polymer cell wall) in the period of division and growth, causes lysis of bacteria. It is active against aerobic gram-positive microorganisms: Staphylococcus spp. (With the exception of strains producing penicillinase), Streptococcus spp. and aerobic gram-negative organisms: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp., Salmonella spp., Klebsiella spp. Strains, penicillinase-producing, resistant to the action of amoxicillin.

Indications:
Bacterial infections caused by susceptible pathogens: respiratory infections (bronchitis, pneumonia) and ENT-organs (sinusitis, pharyngitis, tonsillitis, acute otitis media), urogenital system (pyelonephritis, pyelitis, cystitis, urethritis, gonorrhea, endometritis, cervicitis), abdominal infections (peritonitis, cholangitis, cholecystitis), infection of skin and soft tissues (erysipelas, impetigo, secondarily infected dermatoses), leptospirosis, listeriosis, Lyme disease (Lyme disease), gastrointestinal tract (dysentery, salmonellosis, Salmonella carrier) meningitis, endocarditis (prophylaxis), sepsis.

Contraindications:
Hypersensitivity (including to other penicillins, cephalosporins, carbapenems). C care. Polyvalent hypersensitivity to xenobiotics, infectious mononucleosis, a history of gastrointestinal disease (especially colitis, associated with the use of antibiotics), kidney failure, pregnancy, lactation.

Adverse effects:
Allergic reactions: possible urticaria, flushing of the skin, erythematous rash, angioedema, rhinitis, conjunctivitis, rarely - fever, arthralgia, eosinophilia, exfoliative dermatitis, erythema multiforme exudative (including Stevens-Johnson syndrome); reaction, similar to serum disease and in rare cases - anaphylactic shock. On the part of the digestive system: dysbacteriosis, change in taste, vomiting, nausea, diarrhea, stomatitis, glossitis, a moderate increase in activity of "liver" enzymes, rare - pseudomembranous enterocolitis, the nervous system: agitation, anxiety , insomnia, ataxia, confusion, behavioral change, depression, peripheral neuropathy, headache, dizziness, epileptic reaction. Laboratory indicators: leukopenia, neutropenia, thrombocytopenic purpura, and anemia. Other: shortness of breath, tachycardia, interstitial nephritis, vaginal candidiasis, superinfection (particularly in patients with chronic diseases or low resistance of the organism). Overdosage. Symptoms: nausea, vomiting, diarrhea, disruption of water and electrolyte balance (as a consequence of vomiting and diarrhea). Treatment: gastric lavage, activated charcoal, saline laxatives, drugs for the maintenance of water and electrolyte balance; hemodialysis.

Dosage and administration:
Inside, before or after ingestion, the tablet can be swallowed whole, divided into parts or chewed with a glass of water, or dissolve in water to form syrup (20 ml) or suspensions (100 ml). Adults and children over 10 years (body weight over 40 kg) each appoint 0.5 g 3 times a day in severe infections - 0.75-1 g 3 times a day. Children are nominated in the form of the suspension: at the age of 5-10 years - 0.25 g; 2-5 years - 0.125 g; under 2 years - 20 mg / kg 3 times a day in severe infections - 60 mg / kg 3 times a day. preterm and neonatal dose reduced and / or increase the interval between techniques. The treatment course - 5-12 days. In acute uncomplicated gonorrhea appoint 3 g single dose, the treatment of women should receive a second dose given. In acute infectious diseases of the digestive tract (paratyphoid fever, typhoid fever), biliary tract, gynecological infectious diseases of adults - 1.5-2 g 3 times daily or 1-1.5 g 4 times a day. leptospirosis When adults - 0.5-0.75 g 4 times a day for 6-12 days. salmonellonositelstve When adults - 1.5-2 g 3 times a day for 2 -4 weeks. For the prevention of endocarditis with small surgical interventions for adults - 3-4 g for 1 h before the procedure. If you want to be reappointed after a dose of 8-9 h. In children, the dose is reduced by 2 times. In patients with impaired renal function in spacecraft 15-40 ml / min interval between doses increased to 12 h and spacecraft below 10 ml / min dose reduced at 15-50%, with anuria - the maximum dose of 2 g / day.

Cautions:
In exchange treatment is necessary to monitor the state functions of blood, liver and kidneys. Perhaps the development of superinfection due to growth is insensitive to it of the microflora, which requires a corresponding change in antimicrobial therapy. In appointing the patients with sepsis may develop bacteriolysis reaction (reaction Jarisch-Herxheimer) ( rare). Patients who have an increased sensitivity to penicillin, there may be cross-allergic reactions to other beta-lactam antibiotics. In the treatment of mild diarrhea in the background of a course of treatment should be avoided antidiarrhoeal drugs that reduce intestinal motility; can use kaolin or attapulgitsoderzhaschie antidiarrhoeal drugs. Patients with severe diarrhea should consult a doctor. Treatment must continue even 48-72 hours after disappearance of clinical signs of disease. With simultaneous use of oral contraceptives estrogensoderzhaschih and amoxicillin should be possible to use other or additional methods of contraception.

Interaction:
Pharmaceutical incompatible with aminoglycosides (to avoid mutual inactivation can not be mixed). Antacids, glucosamine, laxatives, drugs, food, aminoglycosides slow and reduce the absorption, ascorbic acid increases absorption. Bactericidal antibiotics (including aminoglycosides, cephalosporins, vancomycin, rifampicin) have sinergidnoe action; bacteriostatic drugs (macrolides, chloramphenicol, Lincosamides, tetracyclines, sulfonamides) - antagonistic. Increases efficiency of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index); estrogensoderzhaschih reduces the effectiveness of oral contraceptives, drugs, in the process of metabolism that produce Pabco, ethinyl estradiol - the risk of bleeding "breakthrough." Amoxicillin reduces clearance and increases toxicity of methotrexate, increases the absorption of digoxin. diuretics, allopurinol, oxyphenbutazone, fenilbutazon, NSAIDs and other drugs that block tubular secretion, increase the concentration of amoxicillin in the blood. Allopurinol improves risk of developing skin rashes.