Amoxicillin

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Amoxicillin

Amoxicillin (INN

International Nonproprietary Name

An International Nonproprietary Name is the official non-proprietary or generic name given to a pharmaceutical substance, as designated by the World Health Organization ....
) or amoxycillin (BAN

British Approved Name

A British Approved Name is the official non-proprietary or generic name given to a pharmaceutical substance, as defined in the British Pharmacopoeia....
) is a moderate-spectrum, bacteriolytic, ß-lactam antibiotic

Beta-lactam antibiotic

?-lactam antibiotics are a broad class of antibiotics that include penicillin derivatives, cephalosporins, monobactams, carbapenems, and Beta-lactamase inhibitors, that is, any antibiotic agent that contains a beta-lactam nucleus in its molecular structure....
used to treat bacterial infection

Infection

An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host resources to multiply ....
s caused by susceptible microorganism

Microorganism

A microorganism or microbe is an organism that is microscopic . The study of microorganisms is called microbiology, a subject that began with Anton van Leeuwenhoek's discovery of microorganisms in 1675, using a microscope of his own design....
s. It is usually the drug of choice within the class because it is better absorbed, following oral administration, than other ß-lactam antibiotics.

Amoxicillin is susceptible to degradation by ß-lactamase

Beta-lactamase

Beta-lactamases are enzymes produced by some bacteria and are responsible for their antibiotic resistance to beta-lactam antibiotics like penicillins, cephalosporins , cephamycins, and carbapenems ....
-producing bacteria, and so may be given with clavulanic acid

Clavulanic acid

Clavulanic acid is a beta-lactamase inhibitor sometimes combined with penicillin group antibiotics to overcome certain types of antibiotic resistance....
to decrease its susceptibility.

icillin acts by inhibiting the synthesis of bacterial cell wall

Cell wall

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Mode of action

Amoxicillin acts by inhibiting the synthesis of bacterial cell wall

Cell wall

A cell wall is a tough, flexible and sometimes fairly rigid layer that surrounds some types of cell . It is located outside the cell membrane and provides these cells with structural support and protection, and also acts as a filtering mechanism....
. It inhibits cross-linkage between the linear peptidoglycan polymer chains that make up a major component of the cell wall

Cell wall

Gram-positive

Gram-positive Bacteria are those that are stained dark blue or violet by Gram staining. This is in contrast to Gram-negative bacteria, which cannot retain the crystal violet stain, instead taking up the counterstain and appearing red or pink....
bacteria.

Formulations

Amoxicillin in trihydrate form is available as capsules, chewable and dispersable tablets plus syrup and pediatric suspension for oral use, and as the sodium salt for intravenous administration. It is one of the most common antibiotics prescribed for children, and the liquid forms are helpful where the patient might find it difficult to take tablets or capsules. It has three ionizable groups. A once daily dosing form (Moxatag) was approved by the FDA in January 2008.

Side effects

Side effect

Adverse drug reaction

An adverse drug reaction or adverse drug event is an expression that describes the unwanted, negative consequences associated with the use of given medications....
s are as those for other beta-lactam antibiotic

Beta-lactam antibiotic

Nausea

Nausea is the sensation of unease and discomfort in the stomach with an urge to vomit....
, vomiting, and easy fatigue. Loose bowel movements (diarrhea) also may occur.

The onset of an allergic reaction to amoxicillin can be very sudden and intense - emergency medical attention must be sought as quickly as possible. The initial onset of such a reaction often starts with a change in mental state; skin rash with intense itching (often beginning in fingertips and around groin area and rapidly spreading) and sensations of fever, nausea and vomiting. Any other symptoms that seem even remotely suspicious must be taken very seriously.

Non-allergic amoxicillin rash

Somewhere between 3% to 10% of children taking amoxicillin (or ampicillin

Ampicillin

Ampicillin is a beta-lactam antibiotic antibiotic that has been used extensively to treat bacterium infections since 1961. It is considered part of the aminopenicillin family and is roughly equivalent to amoxicillin in terms of spectrum and level of activity....
) show a late-developing (>72 hours after beginning medication and having never taken penicillin-like medication previously) non-itchy rash, sometimes referred to as the "amoxicillin rash." The rash is described as maculopapular or morbilliform (measles-like

Measles

Measles is a infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses....
), and starts on the trunk and can spread from there. This rash is unlikely to be a true allergic reaction, and is not a contra-indication for future amoxicillin usage, nor should current regimen necessarily be stopped. However, as mentioned above, this common amoxicillin rash and a dangerous allergic reaction cannot easily be distinguished by inexperienced persons, and therefore a health professional should be consulted if a rash develops. (Pichichero, 2005; Schmitt 2005)

A non-allergic amoxicillin rash may also be an indicator of infectious mononucleosis

Infectious mononucleosis

EBV infectious mononucleosis is an infectious, viral disease which most commonly occurs in adolescents and young adults. It is characterized by fever, sore throat and fatigue , along with several other possible signs and symptoms....
: Some studies indicate that approximately 80-90% of patients with acute Epstein Barr virus infection treated with amoxicillin or ampicillin

Ampicillin

Proprietary preparations

The patent for amoxicillin has expired. Thus amoxicillin is marketed under many trade names including: Actimoxi, Alphamox, AMK, Amoksibos, Amoxiclav Sandoz, Amoxil, Amoxin, Amoksiklav, Amoxibiotic, Amoxicilina, Apo-Amoxi, Bactox, Betalaktam, Cilamox, Curam, Dedoxil, Dispermox, Duomox, Enhancin, Gimalxina, Geramox, Hiconcil, Isimoxin, Klavox, Lamoxy, Moxilen, Moxypen, Moxyvit, Nobactam, Novamoxin, Ospamox, Panklav, Pamoxicillin, Panamox, Polymox, Samthongcillin, Senox, Sinacilin, Trimox, Tolodina, Wymox, Yucla, Zerrsox and Zimox.

Footnotes

External links

(Very similar to Schmitt 2005 content)