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Antimicrobials

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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