Amoxicillin: Difference between revisions

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==General==
==General==
*Type: Amino-[[Penicillin]]
*Type: [[Is PenicillinType::Amino]]-[[Is DrugClass::Penicillin]]
*Dosage Forms: 250, 500, 875; 125, 200, 250, 400/5 mL
*Dosage Forms: oral solution, capsule, tablet, chewable tablet, extended release tablet
*Common Trade Names: Amoxil; Moxatag
*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==
==Adult Dosing==
===General===
===General===
*500-875 mg PO q12
*500-875mg PO q12


===[[Strep Pharyngitis]]===
*1000 mg PO q24h x 10 days


===[[Otitis Media]]===
*1000 mg PO q8h x 10 days


===[[Sinusitis]]===
*1000 mg PO q8h x 10 days


===[[Dental Abscess]]===
*1000 mg PO x 1, then 500 mg PO q8h x 3 days
*If [[I&D]]


===[[Chlamydial]] [[Cervicitis]]/[[Urethritis]]===
*500 mg PO q8h x 7 days
*For pregnant patients


===[[Lyme Disease]]===
*500mg PO q8h x 14-21 days


===[[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


===Typhoid Fever===
 
''Not 1st line treatment''
===Indications by Disease===
*50-100 mg/kg/day PO divided q6-8h x 14 days
{{#ask: [[Has DrugName::Amoxicillin]] [[Has Population::Adult]]
*First Dose: 12.5mg-33.3 mg/kg PO x 1
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
===General===
===General===
*'''<3mo:''' 20-30 mg/kg/day PO divided q12h
*'''<3mo:''' 20-30mg/kg/day PO divided q12h
**First Dose: 10-15 mg/kg PO x 1
**First Dose: 10-15mg/kg PO x 1
**Max: 30 mg/kg/day
**Max: 30mg/kg/day
*'''>3mo:''' 25-45 mg/kg/day PO divided q12h
*'''>3mo:''' 25-45mg/kg/day PO divided q12h
**First Dose: 12.5-22.5 mg/kg PO x 1
**First Dose: 12.5-22.5mg/kg PO x 1
**Max: 875 mg/dose
**Max: 875mg/dose


===[[Otitis Media]]===
*'''<2 months'''
**30 mg/kg/day PO divided q12h x 10 days
**First Dose: 15 mg/kg PO x 1
*'''2 months - 5 years'''
**80-90 mg/kg/day PO divided q12h x 10 days
**First Dose: 40-45 mg/kg PO x 1
**Max: 1000 mg/dose
*'''6-12 years'''
**80-90 mg/kg/day PO divided q12h x 5-10 days
**First Dose: 40-45 mg/kg/day PO x 1
**Max: 1000 mg/dose


===Community Acquired [[Pneumonia]]===
*90 mg/kg/day PO divided q12h x 5-10 days
*First Dose: 45 mg/kg PO x 1
**Max
***3 months - 4 years: 500 mg/dose
***>5 years: 4000 mg/day


===[[Strep Pharyngitis]]===
*50 mg/kg Po q24h x 10 days
*Max: 1000 mg/day


===[[Sinusitis]]===
*90 mg/kg/day PO divided q8-12h x 10 days
*Max: 1000 mg/dose


===H. pylori===
*50 mg/kg/day PO divided BID x 7-14 days
*Max: 2000 mg/day


===Early [[[Lyme Disease]]===
*50 mg/kg/day PO divided q8h x 14-21 days
*First Dose: 16.6 mg/kg PO x1
*Max: 500 mg/dose


===Salmonella (>3mo)===
*50-100 mg/kg/day PO divided q8-12h
**Acute: x 3-7 days
**Acute Immunocompromised: 10-14 days
**Chronic: 3 months


===[[Typhoid Fever]] (>3mo)===
===Indications by Disease===
''Not 1st line treatment''
{{#ask: [[Has DrugName::Amoxicillin]] [[Has Population::Pediatric]]
*50-100 mg/kg/day PO divided q6-8h x 14 days
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*Lactation:
*Lactation: Use caution
*Renal Dosing
*Renal Dosing
**Adult
**Adult
Line 114: Line 73:
==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
 
*Anaphylaxis
*Hypersensitivity vasculitis
*SJS/TEN
*Pseudomembranous colitis
===Common===
===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==
==Pharmacology==
*Half-life:  
*Half-life: 3.7 hr (neonates), 1-2 hr (infants and children), 0.7 - 1.4 hr (adults)
*Metabolism:  
*Metabolism: Hepatic
*Excretion:  
*Excretion: Urine
*Mechanism of Action:
*Mechanism of Action: Inhibits bacterial cell wall synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||I
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||'''S'''
|-
| ||[[Enterococcus faecium]]||I
|-
| ||[[MSSA]]||R
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||R
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||R
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||R
|-
| ||[[H. influenzae]]||I
|-
| ||[[E. coli]]||I
|-
| ||[[Klebsiella]] sp||R
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||R
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||I
|-
| ||[[Shigella]] sp||I
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||R
|-
| ||[[Providencia sp.]]||R
|-
| ||[[Morganella sp.]]||R
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||R
|-
| ||[[Citrobacter sp.]]||R
|-
| ||[[Aeromonas sp]]||R
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||R
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||R
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
<references/>


<references/>
<references/>
[[Category:Drugs]]
[[Category:Pharmacology]] [[Category:ID]]

Latest revision as of 11:07, 20 March 2026

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

General

  • 500-875mg PO q12





Indications by Disease

DiseaseDoseContext
Chlamydia trachomatis500mg PO q8h x 7 days; For pregnant patientsChlamydial Cervicitis/Urethritis
Dental abscess1000mg PO x 1, then 500mg PO q8h x 3 days; If I&DDental Abscess
Endocarditis2g or 50mg/kgDental Procedure Prophylaxis
Lyme disease500mg PO q8h x 14-21 daysLyme Disease
Periorbital cellulitis875 mg BIDOutpatient
Pneumonia (main)1 g three times dailyOutpatient, Healthy
SalmonellaNot 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 monthsSalmonella
Sinusitis1000mg PO q8h x 10 daysSinusitis
Streptococcal pharyngitis50 mg/kg once daily (maximum = 1000 mg) for 10 daysPenicillin Options
Typhoid feverNot 1st line treatment; 50-100mg/kg/day PO divided q6-8h x 14 days; First Dose: 12.5mg-33.3mg/kg PO x 1Typhoid Fever

Pediatric Dosing

General

  • <3mo: 20-30mg/kg/day PO divided q12h
    • First Dose: 10-15mg/kg PO x 1
    • Max: 30mg/kg/day
  • >3mo: 25-45mg/kg/day PO divided q12h
    • First Dose: 12.5-22.5mg/kg PO x 1
    • Max: 875mg/dose





Indications by Disease

DiseaseDoseContext
Acute otitis media30mg/kg/day PO divided q12h x 10 daysInitial, <2 months
Acute otitis media80-90mg/kg/day PO divided q12h x 10 daysInitial, 2mo-5yr
Acute otitis media80-90mg/kg/day PO divided q12h x 5-10 daysInitial, 6-12yr
Dental abscess50mg/kg/day PO divided TID x 7-10 days (max 1.5g/day)Pediatric Outpatient
Endocarditis50mg/kg PO (max 2g) 1hr before procedurePediatric Dental Prophylaxis
Helicobacter pylori50mg/kg/day PO divided BID x 7-14 days; Max: 2000mg/dayH. pylori
Lyme disease50mg/kg/day PO divided q8h x 14-21 days; First Dose: 16.6mg/kg PO x1; Max: 500mg/doseEarly Lyme Disease
Periorbital cellulitis45-90 mg/kg per day divided every 12 hoursOutpatient
Pharyngitis50mg/kg PO q24h x 10 days'"`UNIQ--ref-0000003F-QINU`"'; Max: 1000mg/dayStrep Pharyngitis
Pneumonia (peds)45mg/kg/dose BID x 5-7 days POOutpatient
Salmonella50-100mg/kg/day PO divided q8-12h; Acute: x 3-7 days; Acute Immunocompromised: 10-14 days; Chronic: 3 monthsSalmonella (>3mo)
Sinusitis90mg/kg/day PO divided q8-12h x 10 days; Max: 1000mg/doseSinusitis
Streptococcal pharyngitis50mg/kg PO once daily x 10 days (max 1000mg)Pediatric First Line
Typhoid feverNot 1st line treatment; 50-100mg/kg/day PO divided q6-8h x 14 daysTyphoid 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]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium I
MSSA R
MRSA R
CA-MRSA R
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae R
N. meningitidis S
Moraxella catarrhalis R
H. influenzae I
E. coli I
Klebsiella sp R
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp I
Shigella sp I
Proteus mirabilis S
Proteus vulgaris R
Providencia sp. R
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus R
Citrobacter sp. R
Aeromonas sp R
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica R
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi R
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces S
Bacteroides fragilis R
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum S
Peptostreptococcus sp. S

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

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014


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