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# Amoxicillin ## Overview Amoxicillin is a broad-spectrum penicillinase-susceptible penicillin antibiotic. It is bactericidal and works by inhibiting bacterial cell wall synthesis. ## Primary Indications * **Acute otitis media:** Often a first-line agent. * **Pharyngitis/Tonsillitis (Group A Streptococcus):** Effective treatment for Strep throat. * **Pneumonia:** Community-acquired pneumonia, particularly in outpatient settings. * **Uncomplicated urinary tract infections:** Can be used, though resistance patterns vary. * **Dental infections:** Prophylaxis and treatment. * **H. pylori eradication:** In combination with other agents. ## Adult Dosing * **Acute otitis media, pharyngitis, community-acquired pneumonia, UTIs:** 500 mg orally every 8 hours or 875 mg orally every 12 hours. * **H. pylori eradication:** Typically 1000 mg orally every 8 hours for 10-14 days as part of a multi-drug regimen. * **Maximum dose:** Generally 4000 mg daily, but higher doses may be used for specific indications (e.g., H. pylori). ## Pediatric Dosing Dosing is weight-based and depends on the indication. * **Acute otitis media, pharyngitis, pneumonia:** 25 mg/kg/day divided into two doses OR 45 mg/kg/day divided into two doses for more severe infections or resistant organisms. * Maximum dose: 875 mg per dose or 4000 mg/day. * **Dosing for H. pylori:** Specific pediatric guidelines vary and should be consulted based on age and weight. ## Dose Adjustments * **Renal Impairment:** Dose reduction is necessary for patients with severe renal impairment (CrCl < 30 mL/min). * CrCl 10-30 mL/min: Standard dose every 12 hours. * CrCl < 10 mL/min: Standard dose every 24 hours. * Hemodialysis: Administer standard dose then supplement with an additional dose during and at the end of dialysis. ## Contraindications * Known serious hypers