Amoxicillin
General
- Type: Amino-Penicillin
- Dosage Forms: oral solution, capsule, tablet, chewable tablet, extended release tablet
- Dosage Strengths: oral solution: 125, 200, 250, 400mg/5 mL; capsule: 250, 500mg; tablet: 500, 875mg; chewable tablet: 125, 250mg; extended release tablet: 775mg
- Routes of Administration: PO
- Common Trade Names: Amoxil; Moxatag, Trimox
Adult Dosing
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Chlamydia trachomatis | 500mg PO q8h x 7 days; For pregnant patients | Chlamydial Cervicitis/Urethritis |
| Dental abscess | 1000mg PO x 1, then 500mg PO q8h x 3 days; If I&D | Dental Abscess |
| Endocarditis | 2g or 50mg/kg | Dental Procedure Prophylaxis |
| Lyme disease | 500mg PO q8h x 14-21 days | Lyme Disease |
| Periorbital cellulitis | 875 mg BID | Outpatient |
| Pneumonia (main) | 1 g three times daily | Outpatient, Healthy |
| Salmonella | Not 1st line treatment; Acute; Immunocompetent; 500mg PO q8h x 3-7 days; Immunocompromised; 1000mg PO q8h x 3-14 days; Chronic carrier; 1000mg PO q8h x 3 months | Salmonella |
| Sinusitis | 1000mg PO q8h x 10 days | Sinusitis |
| Streptococcal pharyngitis | 50 mg/kg once daily (maximum = 1000 mg) for 10 days | Penicillin Options |
| Typhoid fever | Not 1st line treatment; 50-100mg/kg/day PO divided q6-8h x 14 days; First Dose: 12.5mg-33.3mg/kg PO x 1 | Typhoid Fever |
Pediatric Dosing
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Acute otitis media | 30mg/kg/day PO divided q12h x 10 days | Initial, <2 months |
| Acute otitis media | 80-90mg/kg/day PO divided q12h x 10 days | Initial, 2mo-5yr |
| Acute otitis media | 80-90mg/kg/day PO divided q12h x 5-10 days | Initial, 6-12yr |
| Dental abscess | 50mg/kg/day PO divided TID x 7-10 days (max 1.5g/day) | Pediatric Outpatient |
| Endocarditis | 50mg/kg PO (max 2g) 1hr before procedure | Pediatric Dental Prophylaxis |
| Helicobacter pylori | 50mg/kg/day PO divided BID x 7-14 days; Max: 2000mg/day | H. pylori |
| Lyme disease | 50mg/kg/day PO divided q8h x 14-21 days; First Dose: 16.6mg/kg PO x1; Max: 500mg/dose | Early Lyme Disease |
| Periorbital cellulitis | 45-90 mg/kg per day divided every 12 hours | Outpatient |
| Pharyngitis | 50mg/kg PO q24h x 10 days'"`UNIQ--ref-0000003F-QINU`"'; Max: 1000mg/day | Strep Pharyngitis |
| Pneumonia (peds) | 45mg/kg/dose BID x 5-7 days PO | Outpatient |
| Salmonella | 50-100mg/kg/day PO divided q8-12h; Acute: x 3-7 days; Acute Immunocompromised: 10-14 days; Chronic: 3 months | Salmonella (>3mo) |
| Sinusitis | 90mg/kg/day PO divided q8-12h x 10 days; Max: 1000mg/dose | Sinusitis |
| Streptococcal pharyngitis | 50mg/kg PO once daily x 10 days (max 1000mg) | Pediatric First Line |
| Typhoid fever | Not 1st line treatment; 50-100mg/kg/day PO divided q6-8h x 14 days | Typhoid Fever (>3mo) |
Special Populations
- Pregnancy Rating: B
- Lactation: Use caution
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Anaphylaxis
- Hypersensitivity vasculitis
- SJS/TEN
- Pseudomembranous colitis
Common
- Diarrhea, nausea/vomiting
- Rash
- Headache
- AST/ALT elevation
- Mucocutaneous candidiasis
- Serum sickness-like reactions
- Anemia, leukopenia, thrombocytopenia, eosinophilia
- Hyperactivity, anxiety, insomnia, confusion behavioral changes
- Tooth discoloration
Pharmacology
- Half-life: 3.7 hr (neonates), 1-2 hr (infants and children), 0.7 - 1.4 hr (adults)
- Metabolism: Hepatic
- Excretion: Urine
- Mechanism of Action: Inhibits bacterial cell wall synthesis
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- ↑ Sanford Guide to Antimicrobial Therapy 2014
