Antimicrobials
Amoxicillin
Guidelines for use
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1. Clinical Uses
- Treatment of bacteremia, urinary tract infection, pneumonia
- Prevention of intrapartum group B streptococcal infection in infants (alternative to Penicillin G)
- Prophylaxis of infective endocarditis associated with certain procedures
2. Precautions
- The potential for allergic cross-reactivity exists among penicillins, cephalosporins and carbapenems
- Pregnancy: not expected to increase risk of major congenital malformations. Amoxicillin/clavulanic acid should be avoided in women at risk of pre-term delivery due to increased risk of neonatal necrotising enterocolitis.
- Breastfeeding: considered safe during breastfeeding. Monitor nursing infant for GI symptoms.
3. Adverse Effects
- Nausea, abdominal pain, vomiting, diarrhea
- Skin rash (may be a unique reaction to ampicillin/amoxicillin – no cross-reactivity with beta-lactams – common in patients with infectious mononucleosis, CMV infection, or leukemia)
- Hypersensitivity reactions (beta-lactam type) including anaphylaxis
- Phlebitis at site of IV infusion
- Rarely: interstitial nephritis, blood dyscrasias, elevated liver enzymes, seizures (drug accumulation in renal insufficiency)
4. Dosage
- Usual dosage for treatment of minor infections: 500 mg PO q8h (on an empty stomach)
- In Gram negative bacteremia, for patients with normal renal function, doses of up to 1 g PO q8H may be considered
Last updated: August 18, 2016
