Pharmacological action

Antibiotic of the group of semi-synthetic penicillins a wide spectrum of action. Is a 4-hydroxyl analog of ampicillin. Has a bactericidal effect. Active against aerobic gram-positive bacteria: Staphylococcus spp. (Except for the strains produce penitsillinazou), Streptococcus spp; aerobic gram-negative bacteria: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp., Salmonella spp., Klebsiella spp.
Amoksicillino resistant microorganisms, producyrute penitsillinazou.
In combination with metronidazole it reveals activity towards Helicobacter pylori. Believe that amoxicillin inhibits the development of resistance of Helicobacter pylori to metronidazole.
Between amoxicillin and ampicillinom there is cross-resistance.
Spectrum antibacterial action is expanding in concurrent use of amoxicillin and inhibitor of beta-lactamases klavulanova acid. In this combination of increased activity of amoxicillin in respect of Bacteroides spp., Legionella spp., Nocardia spp., Pseudomonas (Burkholderia) pseudomallei. However, Pseudomonas aeruginosa, Serratia marcescens and many other gram-negative bacteria remain resistant.

Indications

For use as monotherapy and in combination with clavulanic acid:
infectious-inflammatory diseases caused by sensitive micro-organisms, including bronchitis, pneumonia, tonsillitis, pyelonephritis, urethritis, infections of the GASTROINTESTINAL tract, gynaecological infection, infectious diseases of the skin and soft tissues, leptospirosis, listeriosis, gonorrhea.
For use in combination with metronidazole: chronic gastritis in the phase of deterioration, saying disease stomach and duodenal ulcers in the phase of deterioration, associated with Helicobacter pylori.

The dosage

An Individual. For the reception inside a single dose for adults and children older than 10 years of age (weighing more than 40 kg) is 250-500 mg, in severe cases - up to 1 g. For children at the age of 5-10 years single dose of 250 mg; in the age of from 2 to 5 years - 125 mg; for children up to the age of 2 years of daily dose is 20 mg / kg. For adults and children interval between meals 8 hours. In the treatment of acute uncomplicated gonorrhea - 3 g once (in combination with probenecid). In patients with impaired renal function and the spacecraft 10-40 ml / min interval between meals should be increased to 12 hours; and the spacecraft is less than 10 ml / min interval between meals should be 24 hours.
In injecting application of adults in / m - 1 g 2 times a day, in / in (normal renal function) - 2-12 g / sut. Children in / m - 50 mg / kg / day, single dose of 500 mg, dosing frequency - 2 times a day; in / in - 100-200 mg / kg / day. Patients with impaired renal function, the dose and the interval between wvedeniami must be adjusted in accordance with the values ​​of QC.

Side effect

Allergic reactions: possible urticaria, erythema, swelling Kwinke, rhinitis, conjunctivitis; rare - fever, pain in the joints, eozinofilia; in isolated cases - anaphylactic shock.
Effects associated with himioterpevticeski action: it is possible a development of superinfections (especially in patients with chronic diseases or lower the resistance of the organism).
With long-term use at high doses: possible dizziness, ataxia, confusion, depression, peripheral neuropathy, seizures.
Mostly when used in combination with metronidazole: nausea, vomiting, anorexia, diarrhea, constipation, pain in epigastria, glossitis, stomatitis; rare: hepatitis, psevdomembranosny colitis, allergic reactions (urticaria, angioneuroticeski swelling), intersticialny jade, disorders of hematopoiesis.
Mostly when used in combination with clavulanic acid: possible holetsatical jaundice, hepatitis; rare: erythema multiforme, toxic epidermal necrolysis, exfoliativei dermatitis.

Contraindications

Infectious mononucleosis, lymphoblastic, severe infections of the digestive TRACT, accompanied by vomiting and diarrhea, respiratory infections, allergic diates, bronchial asthma, hay fever, hypersensitivity to penicillins and / or cephalosporins.
For use in combination with metronidazole, diseases of the nervous system; disorders of the blood, lymphatic leukemia, infectious mononucleosis; hypersensitivity to the derivative of nytroimidazole ..
For use in combination with clavulanic acid: the instructions in the history of the violations of the liver, jaundice, associated with the reception of amoxicillin in combination with clavulanic acid.

Pregnancy and lactation
Amoxicillin penetrates through the placenta, in small amounts excreted in breast milk.
When necessary, the use of amoxicillin during pregnancy should carefully weigh the expected benefits of therapy for the mother and the potential risk to the fetus.
Be wary of amoxicillin in the period of lactation (breastfeeding).

Special instructions

To apply caution in patients prone to allergic reactions.
Amoxicillin combined with metronidazole are not recommended for use in patients under 18 years of age; it should not be used in diseases of the liver.
On the background of combination therapy with metronidazole it is not recommended to consume alcohol.
Amoxicillin in the form of tablets, capsules, powder for the preparation of suspensions, granules for the preparation of suspensions included in the List of vital drugs.

Drug interaction

Amoxicillin may reduce the effectiveness of contraceptive for the reception inside.
In concurrent use of amoxicillin with bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) appears synergies; with bacteriostatic antibiotkami (including macrolides, chloramphenicol, lincosamides, tetracyclines, sulfanilamidami) - antagonism.
Amoxicillin increases the effects of anticoagulants suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index).
Amoxicillin reduces the effects of medicines, in the process of metabolism which a PABA.
Probenecid, dioretiki, allopurinol, fenilbutazon, NSAIDS reduce tubular secretion of amoxicillin, what may be accompanied by an increase in its concentration in blood plasma.
Antatsida, glucosamine, laxatives, aminoglycosides down and reduce, and ascorbic acid increases the absorption of amoxicillin.
The combined use of amoxicillin and clavulanic acid pharmacokinetics of both components does not change.