阿莫西林

用途

• Gram-positive infections
• Gram-negative infections
• Susceptible UTI's
• Susceptible systemic infections (bacteremia/sepsis)
• Susceptible orthopedic infections
• Lyme disease
• Susceptible urinary tract infections
• Preventative therapy for repeated (>2 per 6 months) urinary tract Gram-positive bacterial infections
• Susceptible bacterial infections
• Susceptible bacterial infections (depot preparations)
• Susceptible bacterial infections
• Bacterial cystitis
• Susceptible infections

給藥方式

可能的副作用

• Gastrointestinal upset (anorexia, vomiting, diarrhea)
• Antibiotic-associated diarrhea and gut flora alteration
• Hypersensitivity reactions (rashes, fever, anaphylaxis)
• Eosinophilia, neutropenia, agranulocytosis, thrombocytopenia, leukopenia, anemias
• Lymphadenopathy
• Neurotoxicity (e.g., ataxia) at very high doses or prolonged use
• Elevated liver enzymes (rare)
• Tachypnea, dyspnea, edema, and tachycardia (reported in dogs)

注意事項與禁忌

• Patients with a history of hypersensitivity to penicillins
• Oral administration in hindgut fermenters (rabbits, guinea pigs, chinchillas, hamsters) due to risk of fatal clostridial enterotoxemia
• Oral administration in patients with septicemia, shock, or grave illness (due to delayed/diminished GI absorption)
• > **Species Warning**: Never administer amoxicillin (or other penicillins) orally to rabbits, guinea pigs, chinchillas, or hamsters, as it can cause severe, often fatal, clostridial enterotoxemia. * **Cross-Reactivity**: Use with caution in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., cephalosporins, carbapenems). * **Pregnancy**: Crosses the placenta. Categorized as FDA Category B (human) and Class A (veterinary - probably safe), but should be used only when potential benefits outweigh risks. * **Laboratory Tests**: May cause false-positive urine glucose determinations when using cupric sulfate solutions (e.g., Clinitest).

藥物相互作用

• Bacteriostatic antimicrobials (e.g., chloramphenicol, macrolides, tetracyclines, sulfonamides): Potential in vitro antagonism; concurrent use has historically been discouraged, though clinical significance is debated.
• Methotrexate: Amoxicillin may decrease the renal excretion of methotrexate, leading to increased levels and potential toxicity.
• Probenecid: Competitively blocks the tubular secretion of penicillins, increasing serum levels and prolonging serum half-life.
• Aminoglycosides: In vitro inactivation of aminoglycosides by beta-lactams; may falsely decrease aminoglycoside serum concentrations if samples are stored prior to analysis.
• Tetracycline: Potential antagonism of bactericidal activity (bacteriostatic vs bactericidal)
• Erythromycin: Potential antagonism of bactericidal activity
• Chloramphenicol: Potential antagonism of bactericidal activity
• Aminoglycosides (in vitro): Inactivation of aminoglycoside if mixed in the same syringe
• Aminoglycosides (in vivo): Synergistic antimicrobial effect when used concurrently

常見問題