Please check your internet connection and try again.
## Overview
* **Drug:** Amoxicillin
## Primary Indications
* Bacterial infections, including otitis media, pharyngitis, sinusitis, pneumonia, skin and soft tissue infections, urinary tract infections, and *H. pylori* eradication.
## Adult Dosing
* **General Infections:** 250 mg to 500 mg orally every 8 hours, or 875 mg orally every 12 hours.
* **Severe Infections:** Up to 875 mg orally every 8 hours.
* ***H. pylori* Eradication (part of regimen):** 1000 mg orally every 12 hours with clarithromycin and a proton pump inhibitor (PPI).
## Pediatric Dosing
* **General Infections:** 20 mg/kg/day to 45 mg/kg/day orally in 3 divided doses.
* Maximum pediatric dose generally not to exceed the maximum adult dose.
* **Otitis Media, Sinusitis, Lower Respiratory Tract Infections:** 40 mg/kg/day to 45 mg/kg/day orally in 3 divided doses.
* For severe infections or specific organisms, doses up to 90 mg/kg/day divided into 2 or 3 doses may be used.
* **Dosing based on weight is preferred.**
## Dose Adjustments
* **Renal Impairment:**
* **CrCl > 30 mL/min:** No dosage adjustment necessary.
* **CrCl 10-30 mL/min:** 500 mg orally every 12 hours (or 250 mg every 8 hours for standard doses).
* **CrCl < 10 mL/min:** 500 mg orally every 24 hours (or 250 mg every 8 hours for standard doses).
* **Hemodialysis:** 500 mg orally every 24 hours, with an additional dose during and at the end of dialysis.
## Contraindications
* Hypersensitivity to amoxicillin, penicillins, or any component of the formulation.
* History of cholestatic jaundice or hepatic dysfunction associated with prior amoxicillin use.
## Adverse Effects
* **Common:** Diarrhea, nausea, rash, vomiting.
* **Serious:** Anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis, *Clostridioides difficile*-associated diarrhea, interstitial nephritis, hepatitis, cholestatic jaundice, seizures (rare, usually with high doses or renal impairment).
## Key Drug Interactions
* **Probenecid:** May increase and prolong serum levels of amoxicillin.
* **Allopurinol:** Increased incidence of rash, particularly in patients with renal impairment.
* **Oral Contraceptives:** May decrease effectiveness.
* **Warfarin:** Potentially altered therapeutic effect (increased INR), monitor PT/INR.
* **Methotrexate:** May decrease methotrexate clearance, increasing toxicity.
## Monitoring
* Signs and symptoms of bacterial infection resolution.
* Signs and symptoms of hypersensitivity reactions.
* Bowel function (for diarrhea).
* Liver function tests and renal function tests (especially with prolonged use or in patients with pre-existing impairment).
## Clinical Pearls
* Amoxicillin can be taken with or without food.
* Administer with a full glass of water.
* Shake oral suspension well before each use. Use calibrated dosing device.
* Ensure adequate hydration to minimize risk of crystalluria.
* Consider the possibility of cross-reactivity in patients with penicillin allergies.
***
**Disclaimer:** This information is intended as a quick reference and does not replace comprehensive drug information resources or professional judgment. Always consult the most current prescribing information and relevant clinical guidelines before making treatment decisions.
