Drug Name Generic name: amoxicillin trihydrate (a mox i sill' in) Brand name: Amoxil, Amoxil Pediatric Drops,

ApoAmoxi (CAN), DisperMox, Novamoxin (CAN), NuAmoxi (CAN), Trimox Pregnancy Category B Drug class Antibiotic (penicillin ampicillin type)

Dosages ADULTS AND PEDIATRIC PATIENTS > 40 KG URIs, GU infections, skin and soft-tissue infections: 250500 mg PO q 8 hr or 875 mg PO bid. Postexposure anthrax prophylaxis: 500 mg PO tid. Lower respiratory infections: 500 mg PO q 8 hr or 875 mg PO bid. Uncomplicated gonococcal infections: 3 g amoxicillin with 1 g probenecid PO. C. trachomatis in pregnancy: 500 mg PO tid for 7 days or 875 mg PO bid. Prevention of SBE in dental, oral, or upper respiratory procedures: 2 g 1 hr before procedure. Prevention of SBE in GI or GU procedures: 2 g ampicillin plus 1.5 mg/kg gentamicin IM or IV 30 min before procedure, followed by 1 g amoxicillin; for lowrisk patients, 2 g 1 hr before procedure. H. pylori infections: 1 g bid with clarithromycin 500 mg bid and lansoprazole 30 mg bid for 14 days.

Therapeutic Actions Bactericidal: Inhibits synthesis of cell wall of sensitive organisms, causing cell death.

Indications Infections due to susceptible strains of Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Neisseria gonorrhoeae, Streptococcus pneumoniae, Enterococcus faecalis, streptococci, non penicillinaseproducing staphylococci Helicobacter pylori infection in combination with other agents Postexposure prophylaxis against Bacillus anthracis Unlabeled use: Chlamydia trachomatis in pregnancy

Adverse effects CNS: Lethargy, hallucinations, seizures GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black "hairy" tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembran ous colitis, nonspecific hepatitis GU: Nephritis Hematologic: Anemia, thrombocytopeni a, leukopenia, neutropenia, prolonged bleeding time Hypersensitivit y: Rash, fever, wheezing, anaphylaxis Other: Superinfections oral and rectal moniliasis, vaginitis

Contraindicati ons Contraindica ted with allergies to penicillins, cephalospori ns, or other allergens. Use cautiously with renal disorders, lactation.

Nursing considerations Assessment History: Allergies to penicillins, cephalosporins, or other allergens; renal disorders; lactation Physical: Culture infected area; skin color, lesion; R, adventitious sounds; bowel sounds; CBC, LFTs, renal function tests, serum electrolytes, Hct, urinalysis Interventions Culture infected area prior to treatment; reculture area if response is not as expected. Give in oral preparations only; amoxicillin is not affected by food. Continue therapy for at least 2 days after signs of infection have disappeared; continuation for 10 full days is recommended. Use corticosteroids, antihistamines for skin reactions. Teaching points Take this drug around-the-clock.

PEDIATRIC PATIENTS < 40 KG URIs, GU infections, skin, and soft-tissue infections: 2040 mg/kg/day PO in divided doses q 8 hr.

 Post-exposure anthrax prophylaxis: 80 mg/kg/day PO divided into 3 doses. Prevention of SBE in dental, oral, or upper respiratory procedures: 50 mg/kg 1 hr before procedure. Prevention of SBE in GI or GU procedures: 50 mg/kg ampicillin plus 2 mg/kg gentamicin IM or IV 30 min before procedure followed by 25 mg/kg amoxicillin. For moderate-risk patients, 50 mg/kg PO 1 hr before procedure. PEDIATRIC PATIENTS > 3 MO Mild to moderate URIs, GU infections, and skin infections: 20 mg/kg daily in divided doses q 8 hr or 25 mg/kg in divided doses q 12 hr. For lower respiratory infections, or severe URIs, GU, or skin infections: 40 mg/kg daily in divided doses q 8 hr or 45 mg/kg daily in divided doses q 12 hr. PEDIATRIC PATIENTS < 12 WK Up to 30 mg/kg daily in divided doses q 12 hr.

Take the full course of therapy; do not stop because you feel better. This antibiotic is specific for this problem and should not be used to selftreat other infections. You may experience these side effects: Nausea, vomiting, GI upset (eat frequent small meals); diarrhea; sore mouth (frequent mouth care may help). Report unusual bleeding or bruising, sore throat, fever, rash, hives, severe diarrhea, difficulty breathing.