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Amoxil (amoxicillin) is a semi-synthetic antibiotic-aminopenicillin with a wide range of effects. It has a bactericidal effect, inhibiting the synthesis of the cell wall of bacteria sensitive to the drug.

Pharmacology

The following types of microorganisms are sensitive to Amoxil:

  • gram-positive aerobes Corinebacteriumdiphteriae, Enterococcusfaecalis, Listeriamonocytogenes, Streptococcusagalactiae, Streptococcusbovis, Streptococcuspyogenes;
  • gram-negative aerobes Helicobacterpylori;
  • anaerobes: Peptostreptococci;
  • others: Borrelia;
  • variably sensitive (acquired resistance may make treatment difficult): Corinebacteriumspp., Enterococcusfaecium, Streptococcuspneumoniae, Streptococcusviridans, Escherichiacoli, Haemophilusinfluenzae, Haemophilusparainfluenzae, Moraxellacatarrhalppus, Prera.

Resistant species include Staphylococcusaureus, Acinetobacter, Citrobacter, Enterobacter, Klebsiella, Legionella, Morganella morganii, Proteusvulgaris, Providencia, Pseudomonas, Serratia, Bacteroidesfragilis, Chlamidia, Mycoplasma, Ricketts.

Indications for use

  • Respiratory infections;
  • Infections of the genitourinary system;
  • Infections of the digestive tract;
  • Skin infections of soft tissues.

Dosage and administration

The drug is taken regardless of the meal. The tablet can be swallowed whole or chewed with a glass of water. In the case of infectious and inflammatory diseases of mild to moderate severity, it is recommended to take:

  • adults and children over 10 years: 500-750 mg 2 times a day or 500 mg 3 times a day;
  • children 3 to 10 years old – at a dose of 250 mg 3 times a day;
  • children 1 to 3 years old – 250 mg 2 times a day or 125 mg 3 times a day.

Typically, the daily dose of the drug for children is 30 mg / kg / day, distributed in 2-3 doses.

To get a dosage of 250 mg, the tablet should be divided in half. In case of mild to moderate infections, the drug is taken within 5-7 days. However, in the case of infections caused by streptococcus, the treatment should last at least 10 days. In the treatment of chronic diseases and local infectious lesions, the dose of the drug should be determined by the clinical picture of the disease. The treatment should be continued for 48 hours after the disappearance of the symptoms of the disease.

Contraindications

Amoxil is not used in the following cases:

  • an allergy to the components of the drug or other antibiotics;
  • cholestatic jaundice;
  • violations of the liver caused by the use of amoxicillin in the past;
  • infectious mononucleosis;
  • lymphocytic leukemia.

This medicine is used with caution in diseases of the gastrointestinal tract, pseudomembranous colitis in the past, liver failure, when taking anticoagulants, and severe renal impairment.

Overdose

Symptoms of an overdose: digestive disorders, disturbances in water-electrolyte balance.

Seizures may occur in people with renal failure.

Overdose treatment: correction of water-electrolyte disturbances. In case of recent administration (up to 4 hours), gastric lavage is indicated, enterosorbents should be used. Amoxicillin is eliminated by hemodialysis.

Side effects

  • Immune system: angioedema, allergic vasculitis, anaphylactic reactions;
  • Gastrointestinal system: diarrhea, gastritis, nausea, antibiotic-associated colitis (including hemorrhagic colitis, pseudomembranous colitis), hairy and black tongue, stomatitis.
  • Liver, biliary tract: cholestatic jaundice, hepatitis, increased activity of ALT / AST, alkaline phosphatase, bilirubin in the blood;
  • Skin, subcutaneous tissue: redness, rash, itching, urticaria, exfoliative dermatitis, a syndrome similar to serum sickness, Stevens-Johnson syndrome, acute exanthematous pustulosis, epidermal necrolysis;
  • Blood, lymphatic system: reversible leukopenia, thrombocytopenia / thrombocytosis, agranulocytosis, an increase in prothrombin time, bleeding time, hemolytic anemia, eosinophilia;
  • Kidneys, urinary tract: crystalluria, nephritis, hematuria;
  • Nervous system: agitation, dizziness, convulsions, hyperactivity, headache, aseptic meningitis, insomnia, anxiety, behavior change;
    Infectious diseases: candidiasis of the skin, mucous membranes, the growth of microorganisms insensitive to antibiotics.

Pregnancy and breastfeeding

Studies have not revealed teratogenic effects (impaired embryo development). Use in a pregnant woman may increase the risk of necrotizing enterocolitis (inflammation and dying of the mucosa of the small and large intestines) in newborns. Therefore, the use of the drug during pregnancy should be avoided, especially in the first trimester.

This medicine is excreted in breast milk. Accordingly, diarrhea (loose, frequent stools) and fungal infection of the mucous membranes can develop in a baby.

Interaction with other drugs and other types of interactions

The simultaneous use of amoxicillin and oral contraceptives is associated with cases of bleeding and a decrease in the effectiveness of contraceptives. The simultaneous use with allopurinol does not increase the frequency of skin reactions, unlike the combination of allopurinol with ampicillin. Bacteriostatic drugs such as tetracycline antibiotics, macrolides, chloramphenicol can neutralize the bactericidal effect of amoxicillin. Amoxicillin and aminoglycosides can be used together (synergistic effect).

Application features

Patients with severe allergic reactions are likely to experience adverse reactions. Cross-hypersensitivity and cross-resistance between penicillins and cephalosporins may exist. Superinfection can occur (as with other broad-spectrum antibiotics). Severe diarrhea, characteristic of pseudomembranous colitis are considered as the basis for taking appropriate measures.

You should be careful with Amoxil in the event of hemorrhagic colitis or hypersensitivity reactions. When using large doses of the drug, it is necessary to use a sufficient amount of liquid to prevent crystalluria, which can be caused by amoxicillin. Serious and sometimes fatal cases of hypersensitivity (anaphylactic reactions) are observed in patients undergoing penicillin therapy (such reactions are frequent in patients who have had cases of hypersensitivity). Treatment with Amoxil, in this case, must be discontinued and replaced with another appropriate treatment. Treatment of the symptoms of an anaphylactic reaction may be required, for example, immediate administration of adrenaline, steroids (intravenously) and emergency treatment of respiratory failure.

For patients who have impaired renal function with creatinine clearance below 10 ml/min, the dose of the drug is reduced by 15-50%.

The impaired liver function does not affect the half-life of the drug.

Data on the effect on the reaction rate when driving vehicles or working with other mechanisms have not been established, but the possibility of developing undesirable effects on the part of the nervous system should be taken into account.