Anti biotics

Amoxicillin is stable in the presence of gastric acid and is rapidly absorbed after oral administration.

The effect of food on the absorption of amoxicillin from amoxicillin tablets and suspension has been partially investigated. The 400 and 875 mg formulations have been studied only when administered at the start of a light meal. However, food effect studies have not been performed with the 200 and 500 mg formulations. Amoxicillin diffuses readily into most body tissues and fluids, with the exception of brain and spinal fluid, except when meninges are inflamed. The half-life of amoxicillin is 61.3 minutes. Most of the amoxicillin is excreted unchanged in the urine; its excretion can be delayed by concurrent administration of probenecid. In blood serum, amoxicillin is approximately 20% protein-bound.

Orally administered doses of 250 and 500 mg amoxicillin capsules result in average peak blood levels 1-2 hours after administration in the range of 3.5-5.0 mg/ml and 5.5-7.5 mg/ml, respectively.

Mean amoxicillin pharmacokinetic parameters from an open, two-part, single-dose crossover bioequivalence study in 27 adults comparing 875 mg of amoxicillin with 875 mg of amoxicillin; clavulanate potassium showed that the 875 mg tablet of amoxicillin produces an AUC(0-¥) of 35.4 ± 8.1 mg·h/ml and a Cmax of 13.8 ± 4.1 mg/ml. Dosing was at the start of a light meal following an overnight fast.

Amoxicillin is indicated in the treatment of infections due to susceptible (ONLY b-lactamase-negative) strains of the designated microorganisms in the conditions listed below:

Infections of the ear, nose, and throat due to Streptococcus spp. (a- and b-hemolytic strains only), Streptococcus pneumoniae, Staphylococcus spp., or H. influenzae. Infections of the genitourinary tract due to E. coli, P. mirabilis, or E. faecalis.

Infections of the skin and skin structure due to Streptococcus spp. (a- and b-hemolytic strains only), Staphylococcus spp., or E. coli.Infections of the lower respiratory tract due to Streptococcus spp. (a- and b-hemolytic strains only), Streptococcus pneumoniae, Staphylococcus spp., or H. influenzae. Gonorrhea, acute uncomplicated (ano-genital and urethral infections) due to N. gonorrhoeae (males and females).

Therapy may be instituted prior to obtaining results from bacteriological and susceptibility studies to determine the causative organisms and their susceptibility to amoxicillin.

Indicated surgical procedures should be performed.
H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence

Triple Therapy
Amoxicillin/Clarithromycin/Lansoprazole
Amoxicillin, in combination with clarithromycin plus lansoprazole as triple therapy, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or 1 year history of a duodenal ulcer) to eradicate H. pylori. Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

Dual Therapy
Amoxicillin/Lansoprazole
Amoxicillin, in combination with lansoprazole delayed-release capsules as dual therapy, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or 1 year history of a duodenal ulcer) who are either allergic or intolerant to clarithromycin or in whom resistance to clarithromycin is known or suspected.

Amoxicillin capsules, chewable tablets, and oral suspensions may be given without regard to meals. The 400 mg suspension, 400 mg chewable tablet, and the 875 mg tablet have been studied only when administered at the start of a light meal. However, food effect studies have not been performed with the 200 and 500 mg formulations.

Neonates and Infants Aged 12 Weeks (3 Months)
Due to incompletely developed renal function affecting elimination of amoxicillin in this age group, the recommended upper dose of amoxicillin is 30 mg/kg/day divided q12h.

General
It should be recognized that in the treatment of chronic urinary tract infections, frequent bacteriological and clinical appraisals are necessary. Smaller doses than those recommended above should not be used. Even higher doses may be needed at times. In stubborn infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy.

Keep in cool, dry place and protect from moisture and light. Store at a temperature of 25°C.