II. Preparations: Amoxicillin and Ampicillin
- Ampicillin
- Child: 50-200 mg/kg/day IV divided qid
- Amoxicillin
- Maximum dose: Maximum dose: 3-4 grams/day
- Adult: 875 to 1000 mg orally twice daily
- Child
- Low dose: 45 mg/kg/day divided twice daily
- High dose: 90 mg/kg/day divided twice daily
III. Preparations: Added Beta-Lactamase resistance
- Ampicillin Sulbactam (Unasyn)
- Adult: 1.5-3 grams IV every 6 hours
- Amoxicillin Clavulanate (Augmentin)
- Adult: 875 mg PO bid
- Child: 45 mg/kg/day divided PO bid
IV. Mechanism
- Same as for Natural Penicillins
- Penetrates outer membrane of some Gram Negatives
- Clavulanic acid and sulbactam bind Beta-Lactamases
V. Pharmacokinetics
- Keep Augmentin suspension refrigerated
- Clavulanate suspension breaks down at room Temperature
- Turns brown with breakdown
- Loses 90% of potency after 2 days at room Temperature
VI. Pathophysiology: Bacterial Resistance Mechanisms Overcome
- Beta-Lactamase Production
- Alteration of Penicillin binding Protein
VII. Activity Spectrum
- General
- Conditions
VIII. Adverse effects
- Similar to Natural Penicillins
- Maculopapular rash
- Onset 5-7 days after initiating medication
- Typically not IgE mediated (non-allergic)
- No immediate allergy (e.g. Urticaria), systemic symptoms or mucous membrane involvement
- Typically safe to use Amoxicillin in future if non-allergic rash alone
- Consider IgE Skin Testing if unclear rash etiology
- References
- Orman and Hayes in Herbert (2017) EM:Rap 17(7): 7-8
-
Diarrhea (modifications can decrease stools to 12%)
- Dose exactly by kilogram for children
- Avoid food before dose
- Consider eating yogurt with each dose
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Related Studies
| ampicillin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| AMPICILLIN 500 MG CAPSULE | Generic | $0.48 each |
| amoxicillin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| AMOXICILLIN 125 MG/5 ML SUSP | Generic | $0.02 per ml |
| AMOXICILLIN 200 MG/5 ML SUSP | Generic | $0.03 per ml |
| AMOXICILLIN 250 MG CAPSULE | Generic | $0.06 each |
| AMOXICILLIN 250 MG TAB CHEW | Generic | $0.27 each |
| AMOXICILLIN 250 MG/5 ML SUSP | Generic | $0.02 per ml |
| AMOXICILLIN 400 MG/5 ML SUSP | Generic | $0.02 per ml |
| AMOXICILLIN 500 MG CAPSULE | Generic | $0.07 each |
| AMOXICILLIN 500 MG TABLET | Generic | $0.13 each |
| AMOXICILLIN 875 MG TABLET | Generic | $0.14 each |
Ontology: Amoxicillin (C0002645)
| Definition (CHV) | a kind of antibiotics |
| Definition (CHV) | a kind of antibiotics |
| Definition (NCI_NCI-GLOSS) | A drug used to treat some bacterial infections. Amoxicillin is a form of penicillin that is made in the laboratory. It kills certain types of bacteria. It is a type of antibiotic. |
| Definition (NCI) | A broad-spectrum, semisynthetic aminopenicillin antibiotic with bactericidal activity. Amoxicillin binds to and inactivates penicillin-binding protein (PBP) 1A located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis. |
| Definition (MSH) | A broad-spectrum semisynthetic antibiotic similar to AMPICILLIN except that its resistance to gastric acid permits higher serum levels with oral administration. |
| Definition (PDQ) | A broad-spectrum, semisynthetic aminopenicillin antibiotic with bactericidal activity. Amoxicillin binds to and inactivates penicillin-binding protein (PBP) 1A located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42310&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42310&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C237" NCI Thesaurus) |
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | D000658 |
| SnomedCT | 323707004, 323699003, 27658006, 372687004 |
| LNC | LP15265-9, MTHU006036 |
| English | Amoxycillin, Hydroxyampicillin, Amoxycillin [generic addn], amoxicillin, Amoxycillin [2], Amoxycillin [generic additions], AMOX, amoxicillin (medication), AMOXICILLIN, Amoxicillin [Chemical/Ingredient], amoxycillin, Amoxicilline, Amoxicillin [generic additions], Amoxycillin [2] (product), Amoxicillin [2], Amoxycillin [generic additions] (product), p-Hydroxyampicillin, Amoxycillin product, Amoxicillin (product), Amoxicillin (substance), Amoxycillin [2] (substance), Amoxycillin [generic additions] (substance), Amoxicillin, Amoxicillin product |
| Swedish | Amoxicillin |
| Czech | amoxicilin |
| Finnish | Amoksisilliini |
| Russian | GIDROKSIAMPITSILLIN, AMOKSITSILLIN, АМОКСИЦИЛЛИН, ГИДРОКСИАМПИЦИЛЛИН |
| Japanese | アミノヒドロキシベンジルペニシリン, アモキシシリン, ヒドロキシアンピシリン |
| Croatian | AMOKSICILIN |
| Polish | Amoksycylina |
| Spanish | amoxicilina (2) (producto), amoxicilina (2), amoxicilina (agregados genéricos) (producto), amoxicilina (agregados genéricos), amoxicilina (sustancia), amoxicilina, p-hidroxiampicilina, Amoxicilina, Hidroxiampicilina |
| French | Amoxicilline |
| German | Amoxicillin, Hydroxyampicillin |
| Italian | Amoxicillina |
| Portuguese | Amoxicilina, Hidroxiampicilina |
Ontology: Ampicillin (C0002680)
| Definition (NCI) | A broad-spectrum, semi-synthetic, beta-lactam penicillin antibiotic with bactericidal activity. Ampicillin binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis. Ampicillin is stable against hydrolysis by a variety of beta-lactamases, therefore, can be used in wide range of gram-positive and -negative infections. |
| Definition (MSH) | Semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic. |
| Definition (CSP) | semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic. |
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | D000667 |
| SnomedCT | 31087008, 387170002 |
| LNC | LP15762-5, MTHU007962 |
| English | Aminobenzyl Penicillin, Aminobenzylpenicillin, Penicillin, Aminobenzyl, 4-Thia-1-azabicyclo(3.2.0)heptane-2-carboxylic acid, 6-((aminophenylacetyl)amino)-3,3-dimethyl-7-oxo-, (2S-(2alpha,5alpha,6beta(S*)))-, (2S,5R,6R)-6-((R)-2-Amino-2-phenylacetamido)-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo(3.2.0)heptane-2-carboxylic Acid, ampicillin (medication), ampicillin, Ampicillin [Chemical/Ingredient], aminobenzylpenicillin, ampicillins, Ampicillin, AMPICILLIN, Ampicillin (product), Ampicillin (substance) |
| Swedish | Ampicillin |
| Czech | ampicilin |
| Finnish | Ampisilliini |
| German | Aminobenzylpenizillin, Ampicillin, Penizillin, Aminobenzyl- |
| Russian | PENITSILLIN, AMINOBENZIL, AMPITSILLIN, АМПИЦИЛЛИН, ПЕНИЦИЛЛИН, АМИНОБЕНЗИЛ |
| Japanese | アミノベンジルペニシリン, アンピシリン, ペニシリン-アミノベンジル |
| Croatian | AMPICILIN |
| Polish | Penicylina aminobenzylowa, Ampicylina |
| Spanish | Aminobencilpenicilina, aminobenzilpenicilina, ampicilina (producto), ampicilina (sustancia), ampicilina, Ampicilina, Aminobencil Penicilina |
| French | Ampicilline |
| Italian | Ampicillina |
| Portuguese | Aminobenzilpenicilina, Ampicilina |
Ontology: Unasyn (C0147814)
| Concepts | Organic Chemical (T109) , Antibiotic (T195) |
| MSH | C035444 |
| English | Unasyn, Unasyn ADD-Vantage, unasyn |
Ontology: Augmentin (C0591132)
| Concepts | Organic Chemical (T109) , Antibiotic (T195) |
| MSH | D019980 |
| French | Augmentin |
| German | Augmentin |
| English | augmentin, Augmentin |
