Sihaiwang: amoxicillin belongs to penicillin antibiotics. Its mechanism of action is to combine with penicillin binding protein on bacterial cell membrane, so that the synthesis of mucin is blocked, cell wall is damaged, cell breaks and dies, which has no effect on the synthesized cell wall. It is a germicide in reproductive period, with strong activity and low toxicity. The following Yixian pharmacists introduced the antibacterial spectrum, clinical application, adverse reactions and precautions of amoxicillin:
Antibacterial spectrum:
Amoxicillin belongs to broad-spectrum penicillin. It is acid resistant and can be taken orally. Its antibacterial spectrum is wide. It has strong antibacterial and bactericidal effects on most pathogenic G + bacteria and G-bacteria (including cocci and bacilli). Among them, it has good antibacterial activity against Streptococcus such as Streptococcus pneumoniae, hemolytic streptococcus, Staphylococcus non penicillinase, Enterococcus faecalis and other aerobic Gram-positive cocci, and beta; lactamase and Helicobacter pylori non aerobic gram-negative bacteria such as Escherichia coli, Proteus mirabilis, Salmonella, Haemophilus influenzae and Neisseria gonorrhoeae.
Some Gram-negative bacteria such as Klebsiella pneumoniae, Acinetobacter, Proteus vulgaris and Legionella are resistant to amoxicillin, while amoxicillin is ineffective to Mycoplasma and Chlamydia without cell wall. When amoxicillin is often combined with & beta; - lactamase inhibitors such as clavulanic acid, the antibacterial effect is significantly enhanced, clavulanic acid can protect amoxicillin from B-lactamase hydrolysis. Amoxicillin potassium clavulanate has good antibacterial activity against Staphylococcus and Enterococcus. But it is resistant to methicillin resistant Staphylococcus (Masa).
Clinical application:
Amoxicillin is suitable for the following infections caused by sensitive bacteria (strains that do not produce & beta; - lactamase):
1. Upper respiratory tract infections such as otitis media, sinusitis, pharyngitis and tonsillitis caused by Streptococcus haemolyticus, Streptococcus pneumoniae, Staphylococcus or Haemophilus influenzae;
2. Urogenital tract infection caused by Escherichia coli, Proteus mirabilis or Enterococcus faecalis;
3. Skin and soft tissue infection caused by Streptococcus haemolyticus, Staphylococcus or Escherichia coli;
4. Acute bronchitis, pneumonia and other lower respiratory tract infections caused by Streptococcus haemolyticus, Streptococcus pneumoniae, Staphylococcus or Haemophilus influenzae;
5. Acute simple gonorrhea;
6. It can be used to treat typhoid, other Salmonella infections, typhoid carriers and leptospirosis; amoxicillin can also be used in combination with clarithromycin and lansoprazole to eradicate Helicobacter pylori in stomach and duodenum and reduce the recurrence rate of peptic ulcer.
According to the guidelines for clinical application of antibiotics, amoxicillin can be used for the following infectious diseases:
1. Acute bacterial pharyngitis and tonsillitis: group a hemolytic streptococcus is the main pathogen of infection, amoxicillin can be taken orally for 10 days.
2. Acute bacterial otitis media and sinusitis: amoxicillin can be taken orally for initial treatment. For example, amoxicillin / clavulanic acid can also be taken orally when Haemophilus influenzae and catamoraxella strains produce beta lactamase.
3. Mild chronic obstructive pulmonary disease: amoxicillin or amoxicillin / clavulanic acid can be selected as the empirical drug.
4. Bronchiectasis with infection: amoxicillin / clavulanic acid may be selected without the risk of Pseudomonas aeruginosa infection.
5. Community acquired pneumonia: amoxicillin or amoxicillin / clavulanic acid can be selected as the initial treatment.
6. Urinary tract infection: amoxicillin or amoxicillin / clavulanic acid is optional.
7. Bone and joint infection: amoxicillin or amoxicillin / clavulanic acid can be selected.
8. Oral and maxillofacial infections: amoxicillin or amoxicillin / clavulanic acid should be selected.
9. Helicobacter pylori eradication: triple therapy with proton pump inhibitors (such as omeprazole) and another antimicrobial (such as clarithromycin or metronidazole) for Helicobacter pylori eradication.
Major adverse reactions
1. Allergic reaction symptoms: drug fever, urticaria, skin rash and asthma may occur, rarely anaphylactic shock.
2. Digestive system symptoms: diarrhea, nausea, vomiting and other symptoms are common, and gastrointestinal reactions such as pseudomembranous colitis are occasionally seen.
3. Blood system symptoms: occasionally eosinophilia, leucopenia, thrombocytopenia, anemia, etc.
4. Occasionally, there are central nervous system symptoms such as excitement, anxiety, insomnia, dizziness and behavior abnormality.
5. Long term use of the drug can cause double infection caused by Candida or drug-resistant bacteria.
Medication precautions
1. Penicillin skin test must be carried out before amoxicillin is used.
2. Amoxicillin is a prescription drug. Patients should not buy their own medicine or take it for a long time.
3. Those who have a history of allergic diseases such as asthma and hay fever should use it with caution.
4. In case of anaphylactic shock, local rescue should be carried out to keep the airway unblocked, oxygen inhalation, adrenaline, glucocorticoid and other treatment measures.
5. Amoxicillin has a high requirement for storage environment. It should be kept in a cool, dark and dry place under the shade and sealed.
6. In case of serious adverse reactions of digestive system, such as diarrhea, vomiting, etc., the drug must be stopped immediately.
7. When amoxicillin is combined with the contraceptive, it can interfere with the circulation of intestine and liver of the contraceptive, thus reducing its efficacy.
8. Allopurine uric acid synthesis inhibitors (such as allopurinol) can increase the risk of skin adverse reactions of amoxicillin.