Amoxicillin

Normal Renal Function Upper respiratory tract infections; genito-urinary tract infections; skin and soft tissue infections. Adults - 250mg every eight hours. Children (under 20 kg) - 20mg/kg/day in equally divided doses every eight hours. In severe infections or those caused by less susceptible organisms, 500 mg every eight hours for adults and 40mg/kg/day in equally divided doses every eight hours for children may be needed. Lower respiratory tract infections. Adults - 500mg every eight hours. Children (under 20 kg) - 40mg/kg/day in equally divided doses every eight hours. Urethritis, gonococcal. Adults - 3g as single dose. Cases of gonorrhoea with a suspected lesion of syphilis should have darkfield examinations before receiving amoxicillin and monthly serological tests for a minimum of four months. Acute, uncomplicated lower urinary tract infections in non-pregnant adult female. Adults - 3g as single dose. Note: Experience in neonates is too limited to make any recommendations …

Amoxicillin is a penicillin and should not be given to patients with a history of hypersensitivity to beta-lactam antibiotics (eg. penicillins,

Serious, and occasionally fatal, hypersensitivity reactions (including anaphylaxis, anaphylactoid and severe cutaneous reaction) have been reported in patients receiving beta-lactam antibiotics. Hypersensitivity reactions can also progress to Kounis syndrome, a serious allergic reaction that can result in myocardial infarction (SEE SECTION 4.8 ADVERSE EFFECTS (UNDESIRABLE EFFECTS)). These reactions are more likely to occur in individuals with a history of pencillin hypersensitivity and in atopic individuals. Before commencing therapy with any pencillin careful enquiry should be made concerning previous hypersensitivity reactions to pencillins, cephalosporins or other allergens. If an allergic reaction occurs, appropriate therapy should be instituted and amoxicillin therapy discontinued. Serious anaphylactic reactions require immediate emergency treatment with adrenaline. Oxygen, intravenous steroids and airway management, including intubation should also be administered as …

Probenecid decreases the renal tubular secretion of amoxicillin. Concurrent use with amoxicillin may result in increased and prolonged blood levels of amoxicillin. The concurrent administration of allopurinol and ampicillin increases substantially the incidence of rashes in patients receiving both drugs as compared to patients receiving ampicillin alone. It is not known whether this potentiation of ampicillin rashes is due to allopurinol or the hyperuricemia present in these patients. Similar reactions can be expected with amoxicillin. In common with other antibiotics, amoxicillin may affect the gut flora, leading to lower oestrogen reabsorption and reduced efficacy of combined oral contraceptives. In the literature there are rare cases of increased international normalised ratio in patients maintained on acenocoumarol or warfarin and prescribed a course of amoxicillin. If coadministration is necessary, the prothrombin time or international normalised ratio should be carefully …

As with other penicillins, it may be expected that untoward reactions will be essentially limited to sensitivity phenomena. They are more likely to occur in individuals who have previously demonstrated hypersensitivity to penicillins. The following adverse reactions have been reported as associated with the use of amoxicillin: Cardiac disorders Kounis Syndrome: Not known Infections and infestations: Mucocutaneous candidiasis have been reported very rarely. Gastrointestinal: Nausea, vomiting, diarrhoea. Intestinal candidiasis and antibiotic associated colitis (including pseudomembranous colitis and haemorrhagic colitis) have been reported rarely. Black hairy tongue has been reported very rarely. Drug induced enterocolitis syndrome:not known (see section 4.4 SPECIAL WARNINGS AND PRECAUTIONS FOR USE) Skin and subcutaneous tissue disorders Linear IgA disease: Not known Hypersensitivity reactions: Erythematous maculopapular rash, pruritus and urticaria have been reported occasionally. …

Gastrointestinal effects such as nausea, vomiting and diarrhoea may be evident and symptoms of water/electrolyte imbalance should be treated symptomatically. During the administration of high doses of amoxicillin, adequate fluid intake and urinary output must be maintained to minimize the possibility of amoxicillin crystalluria. Amoxicillin crystalluria, in some cases leading to renal failure, has been observed (see section 4.4 Special warnings and precautions for use). Amoxicillin can be removed from the circulation by haemodialysis. For information on the management of overdose, contact the Poisons Information Centre on 13 11

Effects on fertility No data available. Use in pregnancy – Pregnancy Category A Animal studies with amoxicillin have shown no teratogenic effects. The product has been in extensive clinical use since 1972 and its suitability in human pregnancy has been well documented in clinical studies. Amoxicillin may be used in pregnancy when the potential benefits outweigh the potential risks associated with treatment. Australian categorisation definition of Category A: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the foetus having been observed. Use in Labour and Delivery: Oral ampicillin class antibiotics are generally poorly absorbed during labour. Studies in guinea pigs have shown that intravenous administration of ampicillin decreased the uterine tone, frequency of contractions, height of contractions and duration of contractions. …