November 29, 2022

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Today’s episode will be on amoxicillin brand name amoxyl so amoxicillin has a lot of different indications um unfortunately i’m not going to go over all of them i’m going to try and cover the the main indications that you most commonly see it used in it’s used in the ear nose and throat infections and urinary tract infections and h pylori eradication and lower

Respiratory tract infections including pneumonia it’s used in acute bacterial rhinocytositis and it’s also used in skin and skin structure specifically the soft tissue infections just to briefly touch upon some of the off-label uses is it’s used in anthrax in prophylaxis in a splenia in endocarditis it’s used in treating lyme disease periodontitis and prosthetic

Joint infections so there are many different dosage forms for amoxicillin the main ones are capsules suspension for reconstitution tablets and chewable tablets capsules come in 250 milligram and 500 milligram suspensions come in 125 milligrams per 5 milliliters and 250 milligrams per 5 milliliters and 400 milligrams per 5 milliliters tablets come in 500 milligrams

And in 875 milligrams the chewable tablets come in 125 milligram and 250 milligram tablets so dosing in adults and geriatrics the general dosing is typically between 500 milligrams and 1 000 milligrams every 8 to 12 hours specifically in ear infections it’s 500 milligrams every 8 hours or 875 milligrams every 12 hours for a duration of five to seven days in the

Treatment of pneumonia specifically community acquired outpatient and as empiric therapy amoxicillin is given at one thousand milligrams three times daily for five days minimum in treating acute bacterial rhino sinusitis 500 milligrams is given every eight hours or 875 milligrams every 12 hours for five to seven days in the eradication of h pylori one gram is

Given twice daily in combination with clarithromycin 500 milligrams twice daily and a standard or double dose of some type of protein pump inhibitor and that’s given for 14 days an ssti 500 milligrams given three times daily or 875 milligrams twice daily for five days 14 days can be the extended duration for patients where there’s a slow response or if there’s

A severe infection or some type of immunosuppression specifically in streptococcal pharyngitis group a specifically 500 milligrams given twice daily or 1000 milligrams daily for 10 days and treating utis 500 milligrams every 8 hours or 875 milligrams every 12 hours for four to seven days five days of acute and uncomplicated and simple so in dosing in pediatrics

The general dosing for infants that are less than or equal to three months in mild to moderate infections the dosing is dosed off weight the dose is 25 to 50 milligrams per kilogram per day divided into doses every 8 hours and that’s according to red book the max dosing is 30 milligrams per kilogram per day at least according to the manufacturer in regards

To infants greater than three months and children and adolescents if they have some type of mild to moderate infection it’s also dosed by weight the dosing is 25 to 50 milligrams per kilogram per day divided into doses every 8 hours with a max 500 milligrams per dose according to red book the other dosing it’s also based on weight it’s 20 to 40 milligrams per

Kilogram per day divided into doses every 12 hours with a max of 875 milligrams per dose at least according to the manufacturer on that as well for infants greater than three months and in children and adolescents with severe infections the dosing range is now between 80 and 100 milligrams per kilogram per day divided every 8 hours with a max of 500 milligrams

Per dose and that’s according to red book so when treating the pediatric population with ear infections between infants that are greater than or equal to two months and for children the dosing is between 80 and 90 milligrams per kilogram per day divided every 12 hours so the the duration of therapy varies for those that are under 2 years old or of their severe

Symptoms the duration is for 10 days if there are mild to moderate symptoms the duration is between five and seven days for ages between two and five years for mild or moderate it’s seven days for children that are greater than or equal to six years with mild to moderate symptoms the duration is between five and seven days the suggested max dose is four thousand

Milligrams per day so in treating the pediatric population with pneumonia specifically community acquired outpatient and empiric for infants that are greater than or equal to three months in children and adolescence they are treated empirically at 90 milligrams per kilogram per day divided every 12 hours with a max 4 000 milligrams per day in treating children

With acute rhino sinusitis for those that are greater than or equal to two years old and in adolescence when uncomplicated and mild to moderate the lower end of the dosing is 45 milligrams per kilogram per day divided every 12 hours the higher end is 80 and 90 milligrams per kilogram per day divided every 12 hours with a max of 2 000 milligrams per dose mechanism

Of action and pharmacology amoxicillin works through the inhibition of bacterial cell wall synthesis it binds to penicillin binding proteins or pbps which inhibit final cell wall synthesis and then that allows autolytic enzymes to cause the bacteria to lyse the absorption of amoxicillin is pretty rapid it’s distributed through a lot of different tissues such

As liver lungs prostate muscle middle ear sinuses and bone there’s poor penetration into the cerebrospinal fluid or the csf amoxicillin is excreted in the urine 60 of it is in the urine peak serum levels is typically between the first one or two hours with a half-life between 60 and 90 minutes side effects there’s nausea vomiting and diarrhea headache and skin rash

So there’s a few things to be kind of cautious about the main one is the penicillin hypersensitivity reactions or essentially that anaphylactic shock that could occur to people that are allergic to penicillins the other concern is for c diff the concern is also for fungal super infections so essentially fungal and bacterial super infections drug interactions so

Acetaminophen may increase penicillin serum concentrations penicillins may increase methotrexate serum concentrations penicillin may increase warfarin’s anticoagulant effects monitoring parameters it may interfere with urinary glucose tests as well as the other things to monitor is renal function and hepatic functions patient counseling information so obviously

It’s used to treat some type of infection another important thing to mention to them is that they have to complete the full course another important thing to be aware of is in pregnancy it does cross the placenta but the risk category has been a risk factor b

Transcribed from video
#5: amoxicillin (Amoxil) | Treating CAP, UTI, SSTI, & Other Infections | Drug Cards Daily By Drug Cards Daily