Anti-Bacterial

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Amoxycillin

Amoxycillin is bacterial by virtue of it’s ability to inhibit synthesis of the bacterial cell wall. The benzyl ring in the side chain extends the anti microbial action to gram negative bacteria. Bacteria susceptible to amoxicillin include alpha and beta haemolytic streptococci, strep pneumoniae, strep faecalis, bacillus anthracis, clostridium spp. Except C.difficile, some non-betalactamase staphylococci, B.pertussis, Branhamella, Neisseriae, Haemophilus, E.coli,Proteus, Salmonella, Shigella. Mycobacteria and viruses are not susceptible to amoxicillin. Among fungi actinomyces are sensitive.

Indications & Dosage:

Oral – General Dosage – Adults – 250-500mg every 8 hours.
Children – Under 20 kg 20-40mg/kg/day in divided doses. Greater than 20 kg as for adults.
Respiratory Tract Infections:
General Dose
Bronchiectasis Associated with Cystic Fibrosis:
1g/20kg twice daily along with flucloxacillin at similar doses.
Otitis Media:
125mg to 750mg – for 3-10 days for Children
Gonorrhoea :
Single Dose for 3 g for adults. Prepubertal children -50mg/kg + probenrcid 25 mg/kg as a single dose.
Helicobacter Pylori Infection with Peptic Ulcer: 1500 mg in 2-3 divided doses along with nitromidazole and proton-pump in 1 week triple regimen.

IV: Meningitis: 1g every 8 hours given IV.
Children?1/2 of this dose.

IM: Genito – Urinary infections.
50-100mg/kg/day in 3 divided doses.

Composition (Amoxycillin Tablet):

Each Capsule Contains

Amoxycillin B.P. 250mg., Amoxycillin B.P. 125mg.

AmoxycillinB.P. 500mg., Amoxycillin B.P. 125mg.

Each Kid-Tablet Contains

Amoxycillin B.P. 125mg.

Composition : (Amoxycillin Syrup 60ml)

Each 5ml Syrup Contains

Amoxycillin 125mg.

Syrup Base q.s.

Safety Alert:

CL: Hypersens to penicillins

SP: Renal and hepatic disease, lactation, infectious mononucleosis

INT POT-HAZ: None Reported

ADR POT-LT: Very rarely anaphylactic shock may occour.

Amoxycillin Clavulanic Acid

Potassium clavulanic acid is a beta-lactamase resistant betalactam. By inhibiting beta-lactamases produced by some micro-organisms, potassium clavulanate makes them suspectible to amoxicillin which itself is hydrolysed by beta lactamases. Among gram negative pathogens some strains of E.coli,proteus mirabilis, klebsiella pneumoniae, proteus vulgaris.
Gram-negative pathogens such as enterobacter spp., serratia marcescens, citrobacter, morganella, providencia spp. P.pseudomallei also remain resistant.

Indications & Dosage:

Oral - Infections Caused by Beta-Lactamase producing strains of organisms
Upper and lower resp tract-streptococci,H.influenzae,moraxella.
Catarrhalis: One tablet every 8 hours.In severe infections 2 tablets every 8 hours.
Uncomplicated Gonorrhoea:
Amoxycillin 3g+clavulanate 250mg 2 doses at 4 or 6 hr interval
Skin and Soft Tissue infections- staph aureus,E.Coli,Klebsiella Spp – General Dosage.
Children under 40 kg general dosage for most infections:
20mg/kg/day of amoxicillin in 3 divided doses.
Otti Media, Sinusitis & Lower RTI: 40mg/kg/day of amoxicillin in 3 divided doses.

IV – All conditions listed above in severe infections: Amoxycillin sodium 1.0g clavulanate potassium 200 mg injections given every 6 or 8 hours.

Composition:

Each Capsule Contains

(a) Amoxycillin B.P. 250mg, Clavulanic B.P. 125mg.

(b) Amoxycillin B.P. 500mg, Clavulanic B.P. 125mg.

Safety Alert:

CL: Penicillin allergy.
SP: History of allergy especially tp cephalosporins, infectious mononucleosis, severe renal impairment, pregnancy.
INT POT-HAZ: None Reported Others – Absorption of oral contraceptives may be reduced if diarrhea occurs with oral use of this combination.
ADR POT-LT: Anaphylactic reaction with cardiovascular collapse especially with parenteral use.
INT FOOD: None on absorption.

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