Amoxicillin
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Trade Name
Classification
Penicillin antibiotic; aminopenicillin, beta-lactam
Dosage/Route
- * Dosage:
- – Capsules: 250 mg, 500 mg
- – Tablets: 500 mg, 875 mg
- – Suspension: 125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL
- – IV (less common in U.S.): 500 mg, 1 g vials
- * Route: Oral (PO); intravenous (IV, rare)
Usual Dosage
- * Adults: 500 mg PO every 8 hours or 875 mg PO every 12 hours; max 4 g/day
- * Children (>3 months): 25-50 mg/kg/day PO divided q8-12h; max 3 g/day
- * Severe Infections: Higher doses (e.g., 80-90 mg/kg/day in kids for otitis media)
- * Duration: 5-14 days (e.g., 10 days for strep throat)
Mechanism of Action
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, disrupting peptidoglycan cross-linking. Bactericidal against susceptible gram-positive (e.g., Streptococcus) and some gram-negative bacteria (e.g., H. influenzae)
Side Effects & Adverse Effects
- * Side Effects: Nausea, diarrhea, rash
- * Adverse Effects:
- – Hypersensitivity (rash, anaphylaxis; boxed warning for penicillin allergy)
- – Clostridioides difficile-associated diarrhea (CDAD)
- – Rare: Hematologic (e.g., thrombocytopenia), hepatotoxicity
Nursing Management (Implications & Teachings)
- * Implications:
- – Assess for penicillin allergy (anaphylaxis history) before first dose
- – Monitor for diarrhea (CDAD risk) and rash (esp. in mononucleosis—non-allergic rash common)
- – Culture/sensitivity before starting if possible (confirm susceptibility)
- – Give on empty stomach (1 hr before/2 hr after meals) for best absorption
- * Teachings:
- – Finish full course; don’t skip doses
- – Report hives, swelling, or severe diarrhea
- – Take with water, not juice; shake suspension well
- – Use backup contraception (reduces oral contraceptive efficacy)
Indication for This Patient
- * Bacterial infections:
- – Upper respiratory (e.g., strep throat, sinusitis)
- – Ear infections (otitis media)
- – Lower respiratory (e.g., pneumonia)
- – UTI, skin infections (susceptible organisms)
- * H. pylori eradication (with PPI and other antibiotics)
Time
- * Timing: Every 8 or 12 hours (per dose schedule)
- * Onset: Symptom relief in 1-3 days; full effect after course completion
- * Duration: 5-14 days, depending on infection
