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


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


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


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


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


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===Typhoid Fever===
===Typhoid Fever===
''Not 1st line treatment''
''Not 1st line treatment''
*50-100 mg/kg/day PO divided q6-8h x 14 days
*50-100mg/kg/day PO divided q6-8h x 14 days
*First Dose: 12.5mg-33.3 mg/kg PO x 1
*First Dose: 12.5mg-33.3mg/kg PO x 1


==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]]===
===[[Otitis Media]]===
*'''<2 months'''
{{OM amox peds treatment}}
**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]]===
===Community Acquired [[Pneumonia]]===
*90 mg/kg/day PO divided q12h x 5-10 days
*90mg/kg/day PO divided q12h x 5-10 days
*First Dose: 45 mg/kg PO x 1
*First Dose: 45mg/kg PO x 1
**Max
**Max
***3 months - 4 years: 500 mg/dose
***3 months - 4 years: 500mg/dose
***>5 years: 4000 mg/day
***>5 years: 4000mg/day


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


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


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


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


===Salmonella (>3mo)===
===Salmonella (>3mo)===
*50-100 mg/kg/day PO divided q8-12h
*50-100mg/kg/day PO divided q8-12h
**Acute: x 3-7 days  
**Acute: x 3-7 days  
**Acute Immunocompromised: 10-14 days
**Acute Immunocompromised: 10-14 days
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===[[Typhoid Fever]] (>3mo)===
===[[Typhoid Fever]] (>3mo)===
''Not 1st line treatment''
''Not 1st line treatment''
*50-100 mg/kg/day PO divided q6-8h x 14 days
*50-100mg/kg/day PO divided q6-8h x 14 days


==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
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==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 17:42, 18 July 2025

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

Strep Pharyngitis

  • 1000mg PO q24h x 10 days

Otitis Media

  • 1000mg PO q8h x 10 days

Sinusitis

  • 1000mg PO q8h x 10 days

Dental Abscess

  • 1000mg PO x 1, then 500mg PO q8h x 3 days
  • If I&D

Chlamydial Cervicitis/Urethritis

  • 500mg 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

  • 50-100mg/kg/day PO divided q6-8h x 14 days
  • First Dose: 12.5mg-33.3mg/kg PO x 1

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

Otitis Media

  • <2 months
    • 30mg/kg/day PO divided q12h x 10 days
    • First Dose: 15mg/kg PO x 1
  • 2 months - 5 years
    • 80-90mg/kg/day PO divided q12h x 10 days
    • First Dose: 40-45mg/kg PO x 1
    • Max: 1000mg/dose
  • 6-12 years
    • 80-90mg/kg/day PO divided q12h x 5-10 days
    • First Dose: 40-45mg/kg/day PO x 1
    • Max: 1000mg/dose

Community Acquired Pneumonia

  • 90mg/kg/day PO divided q12h x 5-10 days
  • First Dose: 45mg/kg PO x 1
    • Max
      • 3 months - 4 years: 500mg/dose
      • >5 years: 4000mg/day

Strep Pharyngitis

  • 50mg/kg Po q24h x 10 days
  • Max: 1000mg/day

Sinusitis

  • 90mg/kg/day PO divided q8-12h x 10 days
  • Max: 1000mg/dose

H. pylori

  • 50mg/kg/day PO divided BID x 7-14 days
  • Max: 2000mg/day

Early Lyme Disease

  • 50mg/kg/day PO divided q8h x 14-21 days
  • First Dose: 16.6mg/kg PO x1
  • Max: 500mg/dose

Salmonella (>3mo)

  • 50-100mg/kg/day PO divided q8-12h
    • Acute: x 3-7 days
    • Acute Immunocompromised: 10-14 days
    • Chronic: 3 months

Typhoid Fever (>3mo)

Not 1st line treatment

  • 50-100mg/kg/day PO divided q6-8h x 14 days

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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