Amoxicillin

C. diff Risk

Low

Oral Bioavailability

Good (70 to 90%)

Approximate Cost

<$

Dosing

10 to 29 mL/minute/1.73 m220 mg/kg, PO, 2xdaily

Peritoneal dialysis20 mg/kg, PO, daily

Hemodialysis20 mg/kg, PO, daily, give after dialysis

<10 mL/minute/1.73 m220 mg/kg, PO, daily

General Information

Acceptable Uses

Treatment

  • Pharyngitis, due to Group A streptococcus

  • Otitis media, acute (AOM)

  • Pneumonia, community acquired

  • Skin and soft tissue infections, due to susceptible organisms

  • Urinary tract infections, due to susceptible organisms

  • Exit-site or tunnel infections in patients with peritoneal dialysis catheters

  • Combination therapy of Helicobacter pylori

  • Anthrax

Prophylaxis

  • Pneumococcal infection in sickle cell or asplenic patients

  • UTI

  • Postexposure prophylaxis of anthrax

  • Bacterial endocarditis in high risk patients undergoing dental treatment

  • Peritonitis in PD patients undergoing dental treatment

Unacceptable Uses

Treatment of gonorrhea due to resistance

First Line Indications

  • Treatment of pharyngitis due to Group A streptococcus

  • Otitis media

Adverse Effects

  • Allergy/rash (immediate or delayed), cytopenias

Major Interactions

  • Allopurinol: May enhance the potential for allergic or hypersensitivity reactions to Amoxicillin

  • Tetracyclines: May diminish the therapeutic effect of Penicillins

Oral Liquids

400mg/5ml suspension

Tablet/Capsule Strengths

250mg capsule
500mg capsule

Pharmacology

Antimicrobial class: Aminopenicillin, beta-lactam

Pregnancy category: B

Average serum half life: Neonates, full-term: 3 to 4 hours
Infants and children: 1 to 2 hours

Biliary penetration: Detectable levels but lower than serum

CSF penetration: Poor penetration, except when meninges inflamed (14%)

Lung penetration: Good penetration

Urine penetration: Excreted in the urine

Route of Elimination: Renal excretion (60% unchanged drug)

Comments: Amoxicillin is the PO equivalent of ampicillin