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Amoxycycline is an antibiotic belonging to the group of penicillins, beta-lactam antibiotics. It is the alpha-amino derivative of penicillin - the first antibiotic discovered by Alexander Fleming in 1928. Beta-lactam antibiotics account for about 70% of the antibiotics currently used in medicine.

Amoxycycline - action

Amoxicillin is an antibiotic,semi-synthetic penicillin. It has a bactericidal effect: it kills the bacterial cell by blocking the biosynthesis of its cell wall. Since the bacterial wall cannot be properly formed, the activation of autolytic enzymes takes place, followed by the death of the bacterial cell.

The bactericidal effect depends on the duration of the antibiotic's action. That is why it is important for the patient to ensure that the patient is taking medications at the same time of the day in accordance with the schedule specified by the doctor when determining the antibiotic therapy.

Amoxycycline is not effective:

  • against bacteria that do not have a cell wall
  • in the fight against intracellular parasites such as chlamydia and mycoplasma.

Some bacteria have developed a mechanism of resistance to beta-lactam antibiotics, for example: they produce enzymes (beta-lactamases) that break the beta-lactam bond in the antibiotic, rendering it inactivated. To increase the range of action of penicillins, they are often used together with another antibiotic, e.g. clavulanic acid. This compound inactivates some beta-lactamases (bacterial enzymes), thus depriving bacteria of the protective mechanism against the effects of amoxicillin.

Amoxycycline - indications

Amoxicillin is used to treat the following diseases:

  • acute bacterial sinusitis
  • acute otitis media
  • acute streptococcal tonsillitis and pharyngitis
  • exacerbation of chronic bronchitis
  • acute cystitis
  • asymptomatic bacteriuria during pregnancy
  • acute pyelonephritis
  • typhoid and paratyphoid
  • periodontal abscess with spreading cellulitis
  • joint prosthesis infection
  • Helicobacter pylori eradication - as part ofthree drug regimen
  • Lyme disease
  • mild to moderate exacerbation of COPD
  • prostatitis
  • diabetic foot
  • diverticulitis (drug of choice).
  • skin and soft tissue infections
  • acute uncomplicated gonorrhea
  • prevention of endocarditis.

Amoxicillin is one of the most frequently prescribed antibiotics by dentists. They recommend the use of a single dose of amoxicillin in antibiotic prophylaxis of surgical site infections in the oral cavity and maxillofacial area. Amoxicillin is also recommended in the treatment of odontogenic infections, periodontitis and peri-implant tissues. If the patient is allergic to penicillins, the dentist decides to administer clindamycin.

Amoxycycline - available forms of the drug

On the Polish market you can find amoxicillin in the form of:

  • tablets
  • capsules
  • powder for oral suspension
  • granules for oral suspension
  • powder for injection solution.

Amoxycycline - dosage

The doctor always decides about the dosage by prescribing an antibiotic. The dose is determined by the type of pathogen attacked by the body, its resistance to the antibiotic, the severity of the infection, the age, weight, and kidney function of the patient.

The duration of treatment is also determined according to the type of infection and the patient's response to amoxicillin. The duration of the therapy should be as short as possible while maintaining the effectiveness of the therapy.

Dose modifications do not need to be made in elderly patients.

Caution should be exercised in people with renal insufficiency and it may be necessary to modify the dose, therefore the patient should inform the doctor if he has impaired renal function.

Amoxycycline - contraindications

Amoxicillin should not be used if:

  • the patient is hypersensitive to the active substance or to penicillins
  • if the patient has been hypersensitive to any beta-lactam antibiotic in the past. In clinical trials, cases of a severe allergic reaction, which occasionally resulted in the death of the patient
  • take extra care while taking amoxicillin and inform your doctor about any episodes of antibiotic hypersensitivity.

Amoxycycline - warnings and interactions

Caution should be exercised if the patient has impaired renal function, receives high doses of the drug or suffers from epilepsywhile taking amoxicillin as it may cause seizures.

Antibiotic treatment may lead to the development of penicillin-insensitive microorganisms. They can cause inflammation of the large intestine, so if you develop diarrhea please contact your doctor. The patient should take probiotics during antibiotic therapy to reduce the chances of the development of abnormal bacterial flora and the growth of pathogens in the intestine.

Penicillins may affect the proper blood clotting, especially in patients who are taking anticoagulants. It may be necessary to adjust the dose of anticoagulants during antibiotic treatment.

To prevent the formation of amoxicillin crystals in the urine, the patient should drink a lot during therapy. If you have a catheter in the bladder, check the patency of the catheter regularly.

Amoxicillin should be taken with caution with the following medications:

  • probenecid
  • allopurol
  • tetracyclines
  • methotrexate

If the patient is taking any of the above, he / she should inform the attending physician about it.

Side effects of amoxicycline

Common side effects of amoccycline include:diarrhea, nausea, skin rash.

May occur uncommonly : vomiting, hives, itching.

Side effects that may occur rarely:skin candidiasis resulting from the bactericidal effect on the normal bacterial flora, black hairy tongue which is a very unsightly but harmless symptom in the event of black appearance rash on the tongue, contact your doctor or dentist, hepatitis or jaundice, Stevens-Johnson syndrome, acute generalized pustular eruption, vesicular exfoliative dermatitis.

Amoxycycline - Important Precautions

Penicillins are appreciated by doctors for their beneficial bactericidal effect, low toxicity, which allows the use of these antibiotics even in pregnant women and good penetration into organs. Unfortunately, penicillins, including amoxicillin, also have many disadvantages.

One of the most problematic is theirstrong allergenic property . Some patients are allergic to penicillins and other beta-lactam antibiotics.

Because these antibiotics are so often used, some strains of bacteria show resistance to their effects. More and more resistance mechanisms such as: changing the structure of proteins involved in synthesisthe bacterial cell wall or making it impermeable to penicillins means that therapy with amoxicillin alone is not effective for some bacteria.

Increasingly, attention is paid to the observance of the principles of good antibiotic therapy not only by the primary care physician but also by the patient himself. Doctors should not: prescribe antibiotics unnecessarily (e.g. when the disease is caused by a virus and not bacteria), delay antibiotic therapy when life is at risk, overuse broad-spectrum antibiotics, instead take appropriate culture material and select a targeted therapy based on its results.

However, patients should not force doctors to prescribe antibiotics, but trust their professional knowledge. The patient should not decide to self-medicate with the antibiotic found in the home medicine cabinet. Patients should also not terminate therapy early or take the antibiotic irregularly. All these activities, both by he alth care professionals and patients, increase the problem of antibiotic resistance among bacteria.

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