Description

Amoxicillin 500mg – 20 tablets

Pharmacological action
An antibiotic of group semisynthetic penicillins a wide spectrum of action. It is a 4-hydroxyl analogue of ampicillin. It has a bactericidal effect. Active against aerobic gram-positive bacteria: Staphylococcus spp. (with the exception of strains producing penicillinase), Streptococcus spp.; aerobic gram-negative bacteria: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp., Salmonella spp., Klebsiella spp.

Microorganisms producing penicillinase are resistant to amoxicillin.

In combination with metronidazole, it is active against Helicobacter pylori. Amoxicillin is believed to inhibit the development of Helicobacter pylori resistance to metronidazole.

There is cross-resistance between amoxicillin and ampicillin.

The spectrum of antibacterial action expands with the simultaneous use of amoxicillin and beta-lactamase inhibitor clavulanic acid. This combination increases the activity of amoxicillin against Bacteroides spp., Legionella spp., Nocardia spp., Pseudomonas (Burkholderia) pseudomallei. However, Pseudomonas aeruginosa, Serratia marcescens and many other gram-negative bacteria remain resistant.

Pharmacokinetics
When ingested, amoxicillin is rapidly and completely absorbed from the gastrointestinal tract, not destroyed in the acidic environment of the stomach. Cmax of amoxicillin in the blood plasma is reached after 1-2 h. When increasing doses of 2 times the concentration also increased by 2 times. In the presence of food in the stomach does not reduce the overall absorption. In/in,/m introduction and ingestion in the blood achieved similar concentrations of amoxicillin.

The binding of amoxicillin to plasma proteins is about 20%.

It is widely distributed in tissues and body fluids. High concentrations of amoxicillin in the liver are reported.

T1 / 2 of the plasma is 1-1.5 no. About 60% of the dose taken orally is excreted unchanged in the urine by glomerular filtration and tubular secretion; at a dose of 250 mg, the concentration of amoxicillin in the urine is more than 300 µg/ml.A certain amount of amoxicillin is determined in the feces.

In newborns and the elderly T1/2 may be longer.

In renal failure T1/2 may be 7-20 no.

In small quantities amoxicillin penetrates through BBB in inflammation of the meninges.

Amoxicillin is removed by hemodialysis.

Indications
For use in the form of monotherapy and in combination with clavulanic acid: infectious and inflammatory diseases caused by sensitive microorganisms, including bronchitis, pneumonia, angina, pyelonephritis, urethritis, gastrointestinal infections, gynecological infections, infectious diseases of the skin and soft tissues, listeriosis, leptospirosis, gonorrhea.

For use in combination with metronidazole: chronic gastritis in the acute phase, gastric ulcer and duodenal ulcer in the acute phase associated with Helicobacter pylori.

Dosage regimen
Individual. For oral single dose for adults and children over 10 years (body weight over 40 kg) is 250-500 mg, in severe disease, up to 1 g. For children 5-10 years single dose of 250 mg; age 2 to 5 years – 125 mg; for children under 2 years of daily dose is 20 mg/kg For adults and children interval between doses 8 hours in the treatment of acute uncomplicated gonorrhea – 3 g once (in combination with probenecid). In patients with impaired renal function in CC 10-40 ml / min interval between doses should be increased to 12 h; when QC is less than 10 ml / min, the interval between doses should be 24 hours.

When parenteral use in adults/m – 1 g 2 times / day,/(with normal renal function) – 2-12 g/day. Children/m-50 mg/kg/day, a single dose – 500 mg, frequency of administration – 2 times/day;/in – 100-200 mg/kg / day. Patients with impaired renal function, dose and interval between injections should be adjusted in accordance with the values of QC.