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What-is-amoxicilina

What can Amoxicilina do for you?

Posted on  February 26, 2021, Edited by Jason, Category  

What is amoxicilina?

1. Definition

Amoxicilina is one of the most commonly used semi-synthetic penicillin broad-spectrum beta lactam antibiotics. It is a white powder with a half-life of approximately 61.3 minutes. It is stable under acidic conditions, and the gastrointestinal absorption rate reaches 90%. Amoxicilina has a strong bactericidal effect and a strong ability to penetrate cell membranes.

Amoxicilina is currently one of the most widely used oral semi-synthetic penicillins. Its preparations include capsules, tablets, granules, dispersible tablets, etc., and are often combined with clavulanic acid to make dispersible tablets. Amoxicilina and clavulanate potassium is suitable for lower respiratory tract infections, otitis media, and sinusitis caused by beta lactamase producing Haemophilus influenzae and Moraxella catarrhalis.

The product is white or almost white crystalline powder; the taste is slightly bitter. Amoxicilina is slightly soluble in water and almost insoluble in ethanol.

2. Purpose

Amoxicilina has a strong bactericidal effect and a strong ability to penetrate cell walls. It is one of the most widely used oral penicillins, and its preparations include capsules, tablets, granules, dispersible tablets and so on. Patients with penicillin allergy and penicillin skin test positive should be kept from this medicine.

3. Pharmacological effects

Amoxicilina is a semi-synthetic broad-spectrum penicillin. Its antibacterial spectrum and antibacterial activity are basically the same as ampicillin, but its acid resistance is stronger than ampicillin, and its bactericidal effect is stronger and faster than the latter, but it cannot be used for the treatment of meningitis. The half-life is approximately 61.3 minutes. Amoxicilina is stable under acidic conditions, with a gastrointestinal absorption rate of 90%. It is absorbed more quickly and completely than ampicillin. It has similar effects except for Shigella that is less effective than ampicillin.

Amoxicilina has a strong bactericidal effect and a strong ability to penetrate cell walls. After oral administration, the lactam group in the drug molecule is immediately hydrolyzed to form a peptide bond, which is quickly combined with the transpeptidase in the bacteria to inactivate it, cutting off the only way that the bacteria rely on the transpeptidase to synthesize glycopeptides to build the cell wall, making the bacteria cells quickly become spherical bodies and rupture and dissolve, and the bacteria eventually swell and die due to the loss of the cell wall and the continuous penetration of water.

It has strong antibacterial and bactericidal effects on most pathogenic G+ bacteria and G-bacteria (including cocci and bacilli). Among them, amoxicilina has good antibacterial activity towards Streptococcus pneumoniae, Streptococcus hemolyticus, aerobic gram-positive cocci such as Staphylococcus faecalis and Enterococcus faecalis, Escherichia coli, Proteus mirabilis, Salmonella, Haemophilus influenzae, Neisseria gonorrhoeae and other aerobic gram-negative bacteria that do not produce beta lactamase and Helicobacter pylori. Hemodialysis can remove some drugs, but peritoneal dialysis has no effect on removing this product.

Amoxicilina uses

Amoxicilina-uses
Amoxicilina-uses

1. Indications

Amoxicilina can be used to treat typhoid fever, other Salmonella infections and typhoid carriers. The treatment of urinary tract infections caused by sensitive bacteria that do not produce beta lactamase has also achieved good results. For patients with lower urinary tract infections and non-enzyme-producing Neisseria gonorrhoeae urethritis and cervicitis, a single oral dose of 3 g is sufficient to obtain satisfactory results.

Ear, nose, throat infections, respiratory tract infections and skin and soft tissue infections caused by Streptococcus pneumoniae, Staphylococcus aureus which does not produce penicillinase, Streptococcus hemolyticus and Haemophilus influenzae which does not produce β-lactamase are all indications. Leptospirosis can also use amoxicillin. This product can also be used for urogenital infections caused by sensitive Escherichia coli, Proteus mirabilis and Enterococcus faecalis. This product, combined with clarithromycin and lansoprazole, has a good effect on the treatment of Helicobacter pylori infection.

2. Amoxicillin Dosage

Adults and children weighing more than 40 kg take 1 to 2 capsules (0.25 ~ 0.5 g) each time, once every 6 to 8 hours, and the daily dose does not exceed 4 g (16 capsules); children weighing less than 40 kg should weigh 20 ~ 40mg/kg/day, taken in 2 to 3 times; 30mg/kg/day for infants under three months of age, taken in divided doses, once every 12 hours; patients with severe renal impairment need to adjust the dosage. People with 10~30ml/kg endogenous creatinine clearance rate take 0.25-0.5g every 12 hours. This product can be taken on an empty stomach or after meals, and can be taken with milk and other foods. Patients with Neisserial gonococcal urethritis can take orally 3g once.

Animal reproduction experiments showed that amoxicillin at 10 times the human dose did not harm the fertility and fetus of rats and mice. However, there is still a lack of adequate controlled studies in humans. Since animal reproduction tests cannot fully predict human response, pregnant women should only use this product when it is really necessary. Since a small amount of amoxicillin can be secreted in breast milk, and it may cause allergies to the baby.

Amoxicillin side effects

Amoxicillin-side-effects
Amoxicillin-side-effects

Amoxicilina is not an anti-inflammatory drug, but a semi-synthetic penicillin antibiotic commonly used clinically. It has a strong antibacterial effect and is widely used in clinical practice. It is compatible with omeprazole, ranitidine and erythromycin. The combined use of drugs such as Helicobacter pylori, peptic ulcer, gastric ulcer, endocarditis, chronic bronchitis and other diseases has high application value and good curative effect, and can significantly improve the clinical symptoms of patients and relieve their pain.

However, as an antibiotic, after use, it will cause patients to have convulsions, dizziness, blurred vision, anemia and other adverse reactions, which will have a certain impact on the treatment effect. Therefore, you must consult a doctor when you need to take the medicine, never prescribe the medicine yourself, and be sure to follow the doctor's advice when using it.   

1. Adverse Reaction

  • Symptoms of allergic reactions: drug fever, urticaria, skin rash and asthma can occur, especially in patients with infectious mononucleosis, and anaphylactic shock is rare.
  • Digestive system symptoms: diarrhea, nausea, vomiting and other symptoms are common, and gastrointestinal reactions such as pseudomembranous colitis are occasionally seen.
  • Blood system symptoms: eosinophilia, leukopenia, thrombocytopenia, anemia, are rare.
  • Skin and mucosal reactions: occasionally maculopapular rash, exudative erythema multiforme, Lyell syndrome, exfoliative dermatitis.
  • After amoxicillin enters the human body, about 30% of the drug is metabolized by the liver, and about 70% of the drug is metabolized by the kidney, and then excreted with the urine. Amoxicilina can enter the kidney cells to play its role, so it can damage the kidney cells of the patient, thereby impairing its kidney function.

    With age, the renal function of middle-aged and elderly people gradually declines. If such patients use excessive amoxicillin for treatment, it can increase the burden on their kidneys, slow down the excretion of drugs from the body, and form solid crystals in their urine, which can block their urethra and make the urethra ruptures and hemorrhages, leading to symptoms such as blood in the urine and renal colic. Be sure to pay attention to the dosage when taking medicine for middle-aged and elderly people.
  • Studies have found that patients with no history of mental illness are prone to central nervous system adverse reactions such as blurred vision, anxiety, insomnia, dizziness, depression and even inexplicable excitement during long-term treatment with amoxicillin. The appearance of these adverse reactions can seriously affect the normal work and life of patients. When the above-mentioned adverse reactions occur in patients treated with amoxicillin, the drug should be stopped immediately or intermittently.
  • Some patients may also have symptoms of autoimmune hemolytic anemia after medication, and the clinical manifestations are fatigue. Drugs such as prednisone and vitamin B12 can be given to relieve symptoms. Some patients may also have symptoms of lip erosion after medication, manifested as lip swelling and itching. If this symptom occurs, the medication should be stopped immediately, and the patient’s lips should be rinsed with normal saline. Erythromycin ointment can be given to the lips, which is effective to relieve symptoms. Some patients may experience different degrees of abdominal pain, diarrhea and even pseudomembranous colitis within 24 hours of taking amoxicillin. If the patient has serious adverse reactions of the digestive system during or after treatment, the drug should be stopped immediately.

2. Cautions

The national health department stipulates that a penicillin skin test must be performed before using amoxicillin, and those with a positive reaction are not allowed to use it. In addition, penicillin sodium and penicillin potassium are also penicillin antibiotics, and skin tests must be done before use. If it is inconvenient to do a skin test, you can take one-third of a capsule first. If there is no adverse reaction, you can take it normally. If you feel unwell, go to the hospital as soon as possible.

  • People who are allergic to one type of penicillin may be allergic to other penicillins, or may be allergic to penicillamine or cephalosporin. Penicillin skin test must be done before medication.
  • It is forbidden for patients with infectious mononucleosis, lymphocytic leukemia, cytomegalovirus infection and lymphoma.
  • People with a history of asthma, eczema, hay fever, urticaria and other allergic diseases and people with herpes virus infection, especially patients with infectious mononucleosis (which can increase the risk of skin adverse reactions) should use it with caution.
  • Using copper sulfate-containing sheet reagents (R) and Fehling's solution to measure urine sugar may cause false positive reactions; a small number of patients may experience elevated serum transaminases, eosinophilia, and leukopenia after medication.
  • Pregnant and lactating women and children under 3 months should use it with caution. After the application for pregnant women in the third trimester, the concentration of estrogen in the plasma can be reduced, but it has no effect on free estrogen and progesterone. This product can be excreted through milk, and the baby can be sensitized by the nursing mother.

Amoxicillin has a variety of dosage forms, including injections, capsules, tablets, granules, etc. However, no matter which dosage form, it has high requirements for the storage environment. It should be shaded, sealed, and stored in a cool, dark and dry place. Even if the storage conditions are appropriate, chemical changes such as decomposition and polymerization of amoxicillin may still occur during storage, forming new allergic substances. In the hot and humid season, the rate of deterioration and failure will accelerate.

In addition, amoxicillin and aminoglycoside drugs (such as gentamicin, kanamycin), ciprofloxacin, pefloxacin and other drugs are contraindicated and cannot be placed in the same container. The use of amoxicillin capsules must be in accordance with the doctor's advice. Taking it as a family medicine by yourself is blind and dangerous. In the process of taking amoxicillin, if allergic reactions such as rashes occur, or serious adverse reactions of the digestive system, such as diarrhea, vomiting, etc., the drug must be stopped immediately.

3. Drugs Interactions

  • Probenecid can delay the renal excretion of amoxicillin (competitively reduce the renal tubular secretion of amoxicillin), prolong its serum half-life, and increase the blood concentration of this product.
  • When amoxicillin is used in combination with aminoglycoside drugs, it can enhance the in vitro bactericidal effect of amoxicillin on Streptococcus faecalis at sub-inhibitory concentrations.
  • When amoxicillin is used in combination with beta lactamase inhibitors such as clavulanic acid, the antibacterial effect is significantly enhanced. Clavulanic acid can not only enhance the sensitivity of β-lactamase-producing strains to amoxicillin to varying degrees, but also enhance the effect of amoxicillin on certain non-sensitive strains, including Bacteroides, Legionella, and Nocardia Bacteria and pseudomallei.
  • Chloramphenicol, macrolides, Juanamines and tetracycline can interfere with the antibacterial effect of this product in vitro, but its clinical significance is unknown.
  • When amoxicillin is used in combination with contraceptives, it can interfere with the enterohepatic circulation of the contraceptives, thereby reducing their efficacy.
  • Allopurine inhibitors of uric acid synthesis can increase the risk of adverse skin reactions to amoxicillin.
  • When amoxicillin is combined with methotrexate, this product can reduce the renal clearance rate of methotrexate, thereby increasing the toxicity of methotrexate.
  • Food can delay the absorption of amoxicillin, but food does not significantly reduce the total amount of drug absorption.
  1. Food can delay the absorption of amoxicillin, but food does not significantly reduce the total amount of drug absorption.

Conclusion

Amoxicilina is a semi-synthetic penicillin antibiotic and is widely used. But because amoxicillin is also a kind of penicillin, the adverse reactions and precautions of penicillin are also applicable to amoxicillin.

BALLYA provides a betalactam test (amoxicillin belongs to beta lactam antibiotics) to tell you if there are beta lactams residues in dairy products you eat every day.

References

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