Amoksiцillin

When ATH:
J01CA04

Characteristic.

Semisynthetic antibiotic penicillin group of broad-spectrum. Kislotostabilen. Destroyed penicillinase.

Amoksiцillin. Molecular weight 365,41.

Amoksiцillina sodium. Molecular weight 387,89.

Amoksicillina trigidrat. Solubility (mg / ml): in water 4,0; methanol 7,5; in absolute alcohol 3,4; insoluble in hexane, benzene, ethyl acetate, acetonitrile. Molecular weight 419,45.

Pharmacological action.
Broad-spectrum antibacterial, bactericide.

Application.

Bacterial infections, caused by susceptible pathogens: respiratory tract infections and otolaryngology (bronchitis, pneumonia, sore throat, acute otitis media, pharyngitis, sinusitis), genitourinary system (uretrit, cystitis, pyelitis, pyelonephritis, endometritis, cervicitis), skin and soft tissue (mug, impetigo, secondarily infected dermatitis), abdominal infections and infections of the digestive tract (peritonitis, cholecystitis, kholangit, typhoid fever, dysentery, salmonellosis, Salmonella carrier); leptospirosis, Listeriosis, meningitis, sepsis, Lyme disease (ʙorrelioz), gonorrhea; éradikaciâ Helicobacter pylori (in a combination therapy); endocarditis prophylaxis and surgical infection.

Contraindications.

Hypersensitivity (incl. other penicillins), kissing disease.

Restrictions apply.

Polyvalent hypersensitivity to xenobiotics, allyergichyeskii diatyez, bronchial asthma, pollen disease, Lymphocytic Leukemia, digestive diseases in history (especially colitis, associated with the use of antibiotics), renal failure.

Pregnancy and breast-feeding.

When pregnancy is possible, if the benefit to the mother outweighs the potential risk to the fetus (adequate and well-controlled studies in pregnant women were not conducted).

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

Precautions during breastfeeding (penicillins penetrate into breast milk).

Side effects.

Allergic reactions: dermahemia, rhinitis, conjunctivitis, exfoliative dermatitis, erythema multiforme exudative, Stevens-Johnson syndrome, anaphylactic shock, maculopapular rash, itch, hives, angioedema, reaction, similar to serum sickness.

From the digestive tract: nausea, vomiting, change in taste, diarrhea, pain in the anus, stomatitis, glossitis.

From the nervous system and sensory organs: excitation, anxiety, insomnia, confusion, behavior change, headache, dizziness, convulsive reaction.

Cardio-vascular system and blood (hematopoiesis, hemostasis): tachycardia, tranzitornaya anemia, trombotsitopenicheskaya purpura, eozinofilija, leukopenia, neutropenia and agranulocytosis.

Other: labored breathing, joint pain, interstitial nephritis, a moderate increase in transaminase levels in the blood; complications, caused by chemotherapeutic action, -goiter, superimposed infection (especially in patients with chronic diseases or low resistance of the organism), oral candidiasis or vaginal, psevdomembranoznыy or gemorragicheskiy colitis.

Cooperation.

It reduces the effect of oral contraceptive drugs estrogensoderjath, reduces clearance and increases the toxicity of methotrexate. Bactericidal antibiotics (incl. aminoglikozidy, cephalosporins, cycloserine, vancomycin, rifampicin), metronidazole is a synergistic effect; bacteriostatic drugs (makrolidы, chloramphenicol, lincosamides, tetracikliny, sulfonamides) — antagonistic effect. Improves the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, It reduces the synthesis of vitamin K and prothrombin index). NSAIDs, incl. acetylsalicylic acid, Indomethacin, oksifenʙutazon, phenylbutazone, sulfinpirazon, Diuretic, allopurinol, probenecid and other drugs, inhibit tubular secretion, slow excretion and increase in the blood concentration of amoxicillin. Allopurinol increases the risk of skin rashes. Antacids reduce the absorption.

Overdose.

Symptoms: nausea, vomiting, diarrhea, disruption of water and electrolyte balance (a consequence of vomiting and diarrhea); with long-term use at high doses is neurotoxic reactions and thrombocytopenia (these effects are reversible and disappear after drug withdrawal).

Treatment: gastric lavage, appointment of activated carbon, laxatives, Correction fluid and electrolyte balance; hemodialysis.

Dosing and Administration.

Inside, / m, I / bolus and infusion. Before the appointment should determine the sensitivity of abjection. The dosage regimen is determined individually depending on the severity of the infection. Adults and children over 10 years (weighing more than 40 kg) - Inside, by 500 mg 3 once a day (up to 0.75-1 g 3 times a day in severe infections); The maximum daily dose - 6 g, children administered as a suspension, dose depends on the age, body weight and severity of the infection. Daily dose for children is 30 mg / kg (to 60 mg / kg), the reception frequency is 2-3 times.

In acute uncomplicated gonoree- 3 g once (women are advised to re-introduction).

Patients with Cl creatinine below 10 mL/min dose reduced by 50%-15, When anurii dose should not exceed 2 g per day. The average rate is 5-7 days (with streptococcal infections — not less than 10 days).

/ M, in / bolus and infusion. When a single dose, exceeding 2 g, the drug is introduced into / in the drip. The daily dose distribute 2-3 introduction. Length / in the 5-7 days, with subsequent transition, if necessary, on a / m administration or reception of the drug inside. The duration of treatment depends on the type and severity of the disease and is 5-14 days or more.

Under dose for adults is 1-2, 2011, enter every 8-12 hours (3-6 g/d). Under dose for adults with the/m introduction should not exceed 1 g. The maximum daily dose for adults - 6 g. Newborns, and children under preterm 1 year appointed a daily dose 100 mg / kg, children of other age groups, 50 mg / kg. Under dose for children with the/m introduction is not above 0,5 g. In severe infections the dose for adults and children can be increased by 1.5-2 times, In this case, the drug is administered in / in. Daily dose distribution in 2-3 introduction at intervals of 8-12 h.

In renal insufficiency, the treatment regimen is adjusted, reducing the dose or prolonging the interval between infusions (24-48). When Cl creatinine 10-30 mL/min daily dose drug is injected 1 g, then - on 0,5 g every 12 no; if Cl creatinine less than 10 ml / min - 1 g, then 0,5 g every 24 no. In patients unable to anurii daily dose should not exceed 2 g. Patients, hemodialysis, assign advanced 2 g product: 0,5 g during hemodialysis and 0,5 g after the end.

Precautions.

Treatment necessarily continue 48-72 h after the disappearance of clinical signs of disease, When strep infection is 10 days.

In exchange treatment is necessary to control the state functions of blood, liver and kidneys.

Perhaps the development of superinfection due to growth insensitive to the drug microflora. In the case of superinfection requires removal of amoxicillin and a corresponding change in antibiotic therapy. When treating patients with bacteremia may develop reactions bacteriolysis (Jarisch-Herxheimer).

Patients, with hypersensitivity to penicillins, possible cross-allergic reaction cephalosporin antibiotic.

In the treatment of mild diarrhea at the background of the course of therapy should be avoided antidiarrhoeal drugs, reduce peristalsis; You can use kaolin- or attapulgitsoderzhaschie antidiarrheals. In severe diarrhea, seek medical advice.

With simultaneous use of oral contraceptives and estrogensoderjath amoxicillin should be, possibly, use additional methods of contraception.

Cooperation