AMOXICILLIN

Class Therapy
Based on Anatomical Therapeutic Chemical (ATC) Classification System, Amoxicillin is
classified into Penicillin group (beta lactam antibacterials)
Website: http://www.whocc.no/atc_ddd_index/
Pharmaceutical dosage form and picture:
For example:
1. Dry Syrup Amoxicillin 125 mg/5 ml in bottle 60 ml

2. Syrup Forte 250 mg/5 ml in bottle 60 ml

3. Tablet 250 mg
4. Tablet 500 mg

Indication and Dosage:

Indication 1: Infections of the ear, nose, and throat due to Streptococcus species. (- and
-hemolytic isolates only), Streptococcus pneumoniae, Staphylococcus spp., or Haemophilus
influenzae.
Dosage :
Mild/Moderate infection : Adult doses: 500 mg every 12 hours or 250 mg every 8 hours
Children > 3 months: 25 mg/kg/day in divided doses every 12 hours
or 20 mg/kg/day in divided doses every 8 hours
Severe infection : Adult doses: 500 mg every 8 hours or 875 mg every 12 hours
Children > 3 months: 45 mg/kg/day in divided doses every 12 hours or 40
mg/kg/day in divided doses every 8 hours

Indication 2: Infections of the genitourinary tract due to Escherichia coli, Proteus mirabilis,
or Enterococcus faecalis.
Dosage :
Mild/Moderate infection : Adult doses: 500 mg every 12 hours or 250 mg every 8 hours
Children > 3 months: 25 mg/kg/day in divided doses every 12 hours
or 20 mg/kg/day in divided doses every 8 hours
Severe infection : Adult doses: 500 mg every 8 hours or 875 mg every 12 hours
Children > 3 months: 45 mg/kg/day in divided doses every 12 hours or 40
mg/kg/day in divided doses every 8 hours

Indication 3: Infections of the skin and skin structure due to Streptococcus spp. (- and hemolytic isolates only), Staphylococcusspp., or E. coli.
Dosage :
Mild/Moderate infection : Adult doses: 500 mg every 12 hours or 250 mg every 8 hours
Children > 3 months: 25 mg/kg/day in divided doses every 12 hours
or 20 mg/kg/day in divided doses every 8 hours
Severe infection : Adult doses: 500 mg every 8 hours or 875 mg every 12 hours
Children > 3 months: 45 mg/kg/day in divided doses every 12 hours or 40
mg/kg/day in divided doses every 8 hours

Indication 4: Infections of the lower respiratory tract due to Streptococcus spp. (- and hemolytic isolates only), S. pneumoniae,Staphylococcus spp., or H. influenzae.
Dosage : Mild to severe infection
Adult doses: 500 mg every 8 hours or 875 mg every 12 hours
Children > 3 months: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in
divided doses every 8 hours

Indication 5: Gonorrhea, acute uncomplicated (ano-genital and urethral infections in males

and females) due to Neisseria gonorrhoeae.
Dosage : Adult dose: 3 grams as single oral dose
Prepubertal children:
50 mg/kg Amoxicillin, combined with 25 mg/kg probenecid as a single dose.
Note: since probenecidis contraindicated in children under 2 years, do not
use this regimen in children under 2 years of age.

Additional explanation (not listed on students book yet):

Pharmacodynamic and pharmacokinetics profiles of amoxicillin
Pharmakokinetic Profile
Absorption
Amoxicillin is stable in the presence of gastric acid and is rapidly absorbed after oral
administration.
Administer orally without regard to meals
Orally administered doses of 250-mg and 500-mg amoxicillin capsules result in
average peak blood levels 1 to 2 hours after administration in the range of 3.5
mcg/mL to 5.0 mcg/mL (250 mg capsule amoxicillin) and 5.5 mcg/mL to 7.5 mcg/mL
(500 mg capsule amoxicillin), respectively.
Orally administered doses of amoxicillin suspension, 125 mg/5 mL and 250 mg/5 mL,
result in average peak blood levels 1 to 2 hours after administration in the range of
1.5 mcg/mL to 3.0 mcg/mL and 3.5 mcg/mL to 5.0 mcg/mL, respectively.
Distribution

Amoxicillin diffuses readily into most body tissues and fluids, with the exception of
brain and spinal fluid, except when meninges are inflamed.
In blood serum, amoxicillin is approximately 20% protein-bound.
Metabolism and Excretion
The half-life of amoxicillin is 61.3 minutes.
Approximately 60% of an orally administered dose of amoxicillin is excreted in the
urine within 6 to 8 hours.
Amoxicillin is excreted unchanged in the urine
Pharmacodynamic profile
Amoxicillin against susceptible bacteria during the stage of active multiplication. It acts
through the inhibition of cell wall biosynthesis that leads to the death of the bacteria.
Resistance to amoxicillin is mediated primarily through enzymes called beta-lactamases
that cleave the beta-lactam ring of amoxicillin, and make amoxicillin becomes inactive.
INFORMATION FOR THE PATIENT
For Indication 1: Infections of the ear, nose, and throat
a. The effect of the drug and how to explain to your patient
.I will give you antibiotics called amoxicillin to treat the infection of ear/nose/throat
(based on the cases). This drug will kill the bacteria, therefore you may notice any
improvement in the infection symptoms such as fever on 2-3 days after youve
started the therapy. However, you should continue the therapy until 5 days since
there is a time period in which bacteria becomes inactive but is not been killed yet.
By taking this drug regularly for 5 days, based on study, it will give a good
condition to kill the bacteria
b. Usage instruction
You should take this drug every 8 hours for example at 8 am, 2 pm and 10 pm. In
each administration, please take 1 tablet/1 teaspoon (based on the cases) This
drug may be taken before or after meal. However, in order to lower the side effect
in your stomach, you should take this drug after meal. Take this drug regularly for
5 days and try to not miss the schedule. If you miss the schedule, please do not
double the dose of the drug. For example, you miss taking the drug at 2 pm then
you take it at 4 pm, you should take the drugs at 12 am or 8 hour after you take
the last doses.
c. Warning
This drug also has side effects such as skin rash, diarrhea, stomach cramps, etc.
If you get any uncommon/unpleasant effect please stop the therapy and see me
again or go to the nearest doctor.

d. Follow up
If your body can tolerate this drug, please see me again after you take the last
tablet/doses
e. Some parameters which used during follow up
After you finish the therapy, I will check the condition of the infection site. It is
necessary to check the response of therapy.
For Indication 2 : Infections of the genitourinary tract
fill the table below as exemplified in table indication 1
a. The effect of the drug and how to explain to your patient

b. Usage instruction

c. Warning

d. Follow up

e. Some parameters which used during follow up

For Indication 3 (etc):

fill the table below as exemplified in table indication 1
f. The effect of the drug and how to explain to your patient

g. Usage instruction

h. Warning

i. Follow up

j. Some parameters which used during follow up

Yogyakarta, Agustus 2015

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