Amoxicillin

Amoxicillin: May be taken with or without food. May be taken w/ meals for better absorption & to reduce GI discomfort.

Hypersensitivity or history of severe allergic reactions (e.g. anaphylaxis, Stevens-Johnson syndrome) to amoxicillin or other β-lactams (e.g. penicillins, cephalosporins, carbapenems, monobactams). Suspected or confirmed infectious mononucleosis.

Patient with reduced urine output, history of seizures, treated epilepsy or meningeal disorders; lymphatic leukaemia. Atopic individuals. Renal and hepatic impairment. Neonates and children. Pregnancy and lactation. Monitoring Parameters Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Evaluate the patient's allergy history before treatment initiation. Monitor renal, hepatic, and haematologic (e.g. CBC with differential) functions periodically with prolonged therapy; electrolyte balance. Assess the patient for opportunistic infection throughout therapy; signs and symptoms of anaphylaxis (during initial dose), skin rash, and antibiotic-associated diarrhoea.

Significant: Erythematous or morbilliform rash (particularly in patients with infectious mononucleosis), Jarisch-Herxheimer reaction (in treatment of Lyme disease); aseptic meningitis, convulsion (during high doses or in renal impairment), gastrointestinal effects (e.g. diarrhoea, nausea, vomiting), fungal or bacterial superinfection (prolonged use). Rarely, prolonged prothrombin time; crystalluria (mostly with high parenteral doses in patients with reduced urine output). Blood and lymphatic system disorders: Anaemia, neutropenia, thrombocytopenia, leucopenia, agranulocytosis. Gastrointestinal disorders: Tooth discolouration (brown, yellow, or grey staining) particularly in children. Rarely, black hairy tongue. Hepatobiliary disorders: Cholestatic jaundice, hepatitis. Infections and infestations: Very rarely, mucocutaneous candidiasis. Investigations: Moderately increased AST and ALT. Nervous system disorders: Dizziness. Rarely, hyperkinesia. Psychiatric disorders: Insomnia, reversible hyperactivity, anxiety, confusion, behavioural changes. Renal and urinary disorders: Very rarely, interstitial nephritis. Respiratory, thoracic and mediastinal disorders: Bronchospasm, acute severe dyspnoea and allergic pneumonitis (large IV doses). Skin and subcutaneous tissue disorders: Rash, urticaria, pruritus.
Potentially Fatal: Hypersensitivity reactions including anaphylaxis, anaphylactoid and severe cutaneous adverse reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms); Clostridioides difficile-associated diarrhoea, Clostridioides difficile colitis.

Decreased renal tubular secretion resulting in increased and prolonged serum concentration with probenecid. Increased risk of allergic reactions (e.g. rashes) with allopurinol. Tetracyclines, chloramphenicol, macrolides, and sulfonamides may interfere with the bactericidal effect of amoxicillin. May prolong prothrombin time or increase INR when used with oral anticoagulants (e.g. warfarin, acenocoumarol). May reduce the excretion and increase the toxicity of methotrexate. May reduce the efficacy of oral contraceptives (e.g. estrogen/progesterone combination).

Penicillins

J01CA04 - amoxicillin ; Belongs to the class of penicillins with extended spectrum. Used in the systemic treatment of infections.