The first drug for the treatment of bacterial diseases - penicillin - became the progenitor of other antimicrobial agents. More recently, the antibiotic Amoxicillin was obtained, one of the most therapeutically active drugs of this kind. But before starting therapy, you need to know about all the features of taking an antibiotic and the possible consequences.
Material Content:
- 1 Composition and forms of antibiotic release
- 2 Pharmacological properties and indications for use
- 3 Nosological classification
- 4 Instructions for use Amoxicillin for children and adults
- 5 Amoxicillin during pregnancy and lactation
- 6 Can I drink alcohol while taking the drug
- 7 Drug Interactions with Other Drugs
- 8 Contraindications, side effects and overdose
- 9 Antibiotic Analogs
Composition and forms of antibiotic release
Amoxicillin is presented on the market as tablets or capsules, another option is granules for creating syrup (suspension).
The main activity is shown by amoxicillin trihydrate, of which 250 mg or 500 mg in the preparation. Tablets also include the following additional components: polysorbate-80, talc, magnesium stearate, starch.
There are capsules with a similar composition, but their principle of action and dose do not differ from those indicated for tablets. In addition to the main active ingredient, azorubine, titanium and iron dioxides, magnesium stearate, and cellulose are present in the composition.
Granules for the preparation of a suspension contain 250 mg of the main component, in addition to it, simethicone, benzoate, sodium citrate and saccharin of this metal, guar gum, flavorings are present.
Pharmacological properties and indications for use
Amoxicillin belongs to the group of semisynthetic penicillins, the closest "relative" is Ampicillin, but the presence of a hydroxyl residue provides high acid resistance, due to which the substance does not break down in the stomach under the influence of an acidic environment. Another difference is high bioavailability (95%). The amino group (a combination of NH2 atoms) expands the list of indications characteristic of penicillins, which makes Amoxicillin a broad-spectrum antibiotic.
The principle of the bactericidal agent is based on the blocking of the transpeptidase, an enzyme that is involved in the formation of peptidoglycan, the substance that makes up the walls of a microbial cell. During division, the bacterium without the necessary component is destroyed.
The list of bacteria that are vulnerable to amoxicillin includes streptococci, gonococci, staphylococci, shigella and salmonella. The exception is penicillinase-producing microbes. The substance neutralizes the effect of the antibiotic, making the bacterium resistant to its influence.
The rate of binding to blood proteins is low - 17%, but the drug is quickly distributed throughout the body. Reception of a standard dose - 125 mg - leads to the achievement of the maximum level of a substance in plasma in 1.5-2 hours. Absorption is fast, its speed is not subject to changes in food intake.
Metabolism occurs in the liver, but the drug is excreted by the kidneys. 50-65% of the drug is excreted in a "pure" form. More than 80% of inactive metabolites are found in urine, less than 20% in bile. The half-life is from 1 to 1.5 hours. In newborns or premature infants, this indicator rises to 4 hours, in patients who have impaired renal function, up to 8 hours.
Amoxicillin is prescribed when the first signs of bacterial diseases are detected, which are presented below.
Nosological classification
According to the International Classification of Diseases (ICD-10), the indications of Amoxicillin include the diseases indicated in the table.
| Affected organ system | Disease name | ICD-10 code |
|---|---|---|
| Digestive system | Typhoid fever | A01.0 |
| Salmonella enteritis | A02.0 | |
| Other salmonella infections | A02 | |
| Bacterial diarrhea and dysentery | A09 | |
| Peritonitis | K65 | |
| Cholangitis | K83.0 | |
| Cholecystitis | K81 | |
| Gastric / duodenal ulcer | K25 / K26 | |
| Skin and muscle tissue | Erysipelas | A46 |
| Lyme Disease | A69.2 | |
| Impetigo | L01 | |
| Skin lesion | L98.9 | |
| Nervous system and brain | Bacterial meningitis | G00 |
| Listeriosis | A32.9 | |
| Respiratory system | Acute sinusitis | J01 |
| Chronic sinusitis | J32 | |
| Acute pharyngitis | J02.9 | |
| Acute tonsillitis | J03.9 | |
| Chronic tonsillitis | J35.0 | |
| Bronchitis | J40 | |
| Pneumonia | J18 | |
| ENT organs | Otitis media | H66 |
| Excretory system and genitals | Tubulointerstitial nephritis | N12 |
| Cystitis | N30 | |
| Urethral syndrome | N34 | |
| Inflammatory diseases of the uterus | N71 | |
| Inflammatory diseases of the cervix | N72 | |
| Gonococcal infection | A54 | |
| Gonococcal inflammatory diseases of the female pelvic organs | N74.3 | |
| Systemic infections | Leptospirosis icteric-hemorrhagic | A27.0 |
| Leptospirosis | A27.9 | |
| Septicemia | A32.9 | |
| Post-traumatic wound infection | T79.3 | |
| Surgical practice | Z100 |
Instructions for use Amoxicillin for children and adults
Taking Amoxicillin requires you to first familiarize yourself with the instructions - different doses are provided for different age groups. Particular attention should be paid to the method of preparation of the suspension and clearly follow all the steps and dosage indicated. This minimizes possible side effects and allows you to quickly get rid of the disease in the absence of other aggravating factors.
Amoxicillin tablets
For each age group, a separate single dose of the drug is provided. It is also adjusted for the disease.
For adults, the dose is 250-500 mg, for patients from 5 to 10 years - 250 mg, from 2 to 5 years - 125 mg, up to 2 years is calculated according to the scheme: 20 mg per 1 kg of weight.
Severe forms of bacterial diseases require a single dose of 1000 mg of the active substance, acute gonorrhea - 3000 mg.
The maximum amount of amoxicillin that can be taken per day is 6000 mg.
Amoxicillin 500 mg tablets according to the instructions should be taken every 8 hours. If the patient complains of renal dysfunction, this interval must be increased to 12 hours, if the diagnosis is acute renal failure, you need to limit yourself to one dose per day.
Amoxicillin Suspension
Amoxicillin 250 mg suspension is intended for children, but a dosage system has also been developed for adults.
To prepare, use the instructions:
- Pour 75 ml of water into a bottle with granules. To simplify the procedure, a special mark is present on the plastic surface.
- Stir the contents or close the bottle tightly and shake.
Dosages for different ages are presented in the indicated table.
| Patient age | The amount of active component |
|---|---|
| Up to 2 years | 125 mg |
| 2-5 years old | 125-250 mg |
| 5-10 years | 250-500 mg |
| Over 10 years old | 500 mg |
You need to take an antibiotic 3 times a day; treatment is required within one or two weeks. After the disappearance of the symptoms of the disease, treatment is necessary for a couple of days in order to prevent a relapse.
If the disease is severe, you can increase a single dose to 1 g of the drug. Do not exceed a dose of 6 g per day.
For the convenience of measuring volume, a measuring spoon is provided to the vial, in which a standard daily dose of 500 mg of amoxicillin is placed.
Correction for patients with impaired excretory system is carried out according to the same methodology as indicated in the instructions for use of antibiotic tablets.
Amoxicillin during pregnancy and lactation
If necessary, the doctor can prescribe a similar therapy, but only at a later stage of pregnancy - in the second or third trimester.
Amoxicillin tends to get into mother’s milk, which can provoke a strong allergic reaction or dysbiosis in the baby.
Can I drink alcohol while taking the drug
Treatment with bactericidal agents involves a strict ban on the use of alcoholic beverages.
The smallest side effect of this combination is the weakening effect of amoxicillin. As a result, the symptoms of the disease can worsen and cause significant harm to the body.
Antibiotics have a detrimental effect on the gastrointestinal tract - intestinal microflora are disturbed and the digestive process malfunctions. Ethanol - the main component of alcohol - is extremely active in both the acidic environment of the stomach and the alkaline intestine. Against the background of a general weakening of the digestive system under the influence of antimicrobial agents, the negative effect of alcohol can result in gastric ulcers, heterogeneous colitis.
Processing of toxins, including as a result of exposure to the body of alcohol and antibiotics, occurs in the liver under the influence of acetaldehyde dehydrogenase - a special enzyme. Amoxicillin is able to inhibit its synthesis, which, in turn, increases the load on the liver. And the combined use of drugs and alcohol provokes complex forms of cirrhosis or even liver necrosis.
Drug Interactions with Other Drugs
The following is the effect of amoxicillin on the body when taken together with other drugs.
| A drug | Amoxicillin Interactions |
|---|---|
| Laxatives, antacids, aminoglycosides | Slowing down the absorption of the antibiotic, reducing the effect of the drug |
| Alopurinol | High probability of developing an allergy |
| Oral contraceptives | The decrease in the effectiveness of these drugs |
| Bacteriostatic antibiotics (e.g. tetracycline) | Decreased Amoxicillin Effectiveness |
| Bactericidal antibiotics (cephalosporin, vancomycin, rifampicin, etc.) | Synergistic effect (a significant increase in the effect of two drugs) |
| Diuretics | Increased Amoxicillin Exposure |
| Methotrexate | An increase in the toxicity of this drug, a possible poisoning with methotrexate |
| Anticoagulants | Decreased Vitamin K production, high chance of internal bleeding |
| Vitamin C | Increased absorption of amoxicillin |
Contraindications, side effects and overdose
The drug is contraindicated in patients who have:
- a high risk of an allergic reaction against a background of hypersensitivity to the drug, other substances of the penicillin series, one of the components of the tablets or suspension;
- diathesis, hay fever (seasonal allergy);
- bacterial mononucleosis;
- gastrointestinal tract disorders, especially colitis, that developed after taking other antibiotics;
- liver failure;
- early pregnancy.
Caution must be exercised in the treatment of patients who have a form of renal failure, people who have pathologies in platelet production.
The following adverse reactions are possible during drug treatment:
- changes in taste perception, glossitis, liver dysfunction, dyspeptic disorders, stomatitis, dysbiosis, pseudomembranous enterocolitis;
- rhinitis, redness of the skin, itching, less commonly - exudative erythema, fever, aching muscles and joints, angioedema, dermatitis, anaphylactic shock;
- anxiety, insomnia with nightmares accompanying it, irritability, headaches, asthenia (chronic fatigue syndrome), ataxia (inconsistency in movements), depression, peripheral neuropathy (causeless tingling, burning and numbness of limbs);
- lack of red blood cells, neutrophils, white blood cells, eosinophilia (increased levels of eosinophils), thrombocytopenic purpura (destruction of platelets in the blood);
- tachycardia, vaginal candidiasis in women, superinfection (especially with low resistance of the body), nephritis.
An overdose takes the form of complex dyspeptic disorders (vomiting and nausea, diarrhea). There is no specific treatment - only symptomatic therapy with activated carbon, gastric lavage, hemodialysis.
Antibiotic Analogs
The closest analogues of Amoxicillin are antibiotics based on the same active substance or on similar components of the penicillin series.
Augmentin is a British drug. The main component is amoxicillin. The main difference is the presence of clavulanic acid, it does not allow bacteria resistant to antimicrobial agents to produce penicillinase. As a result, the effectiveness of the drug increases, even in relation to bacteria that were previously resistant to antibiotics.
The next option, but of Dutch origin, is Flemoxin Solutab. Available only in tablet form, but is an exact copy of Augmentin.
From Palestinian manufacturers, Amoxicar and Amoxicar Plus are on the market. The first is standard amoxicillin, almost in its “pure” form. The second is an improved version, which includes additional elements that make the drug more effective.
The Austrian version of amoxicillin is represented by various trade names Ospamox, Amoxiclav.
The Belarusian version - Amoklav-1000 - is an antibiotic enriched with reinforcing additives, the Ukrainian version is Amclav, standard amoxicillin without these additions, the Russian one is Amosin, a copy of Amoxicillin.
For the treatment of microbial diseases, which are always difficult, an effective drug with bactericidal properties is needed. Amoxicillin is an effective antibiotic of the penicillin series. But before using it, it is important to take into account all the indications, features of the application and possible negative effects.
