Amoxicillin

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Benjamin Clanner-Engelshofen is a freelance writer in the medical department. He studied biochemistry and pharmacy in Munich and Cambridge / Boston (USA) and noticed early on that he particularly enjoyed the interface between medicine and science. That is why he went on to study human medicine.

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Amoxicillin is an antibiotic belonging to the aminopenicillin group. Compared to the classic penicillin G or penicillin V, these have an extended spectrum of activity in the area of ​​certain bacteria. Amoxicillin is well absorbed into the body when taken by mouth. Common side effects affect the gastrointestinal tract. Find out more about the effects, side effects and use of amoxicillin!

This is how amoxicillin works

Amoxicillin is an antibiotic from the aminopenicillin class and has a bactericidal effect:

As the bacteria grow and multiply, the cell wall is constantly dissolved in places and then re-linked and thus solidified. Amoxicillin inhibits a certain bacterial enzyme (transpeptidase) and thus the last step in bacterial cell wall synthesis. It binds to the active center of the enzyme and thereby irreversibly blocks it. As a result, the cell wall dissolves and cannot be reconnected - the bacterium dies.

Amoxicillin is well absorbed when taken orally and is gastric acid stable.

When is amoxicillin used?

Amoxicillin is used for infections with bacteria that are sensitive to the antibiotic. Among other things, it is used for:

• Urinary tract infections
• Upper respiratory tract infections (e.g. sinusitis, otitis media, bronchitis)
• Biliary tract infections
• Skin infections

This is how amoxicillin is used

The antibiotic is usually taken as a tablet. However, other forms of administration such as juices, powders for the preparation of drinking solutions and infusion solutions for intravenous use are also available.

Amoxicillin is usually taken three times a day (i.e. every eight hours), but sometimes only twice a day. The intake rhythm should be strictly adhered to in order to optimally hinder the bacteria in their growth.

If possible, the antibiotic should be taken at the beginning of a meal because it is then better tolerated. The exact dosage depends on the type and severity of the infection.

One way to improve the effectiveness of the drug is to administer clavulanic acid, sulbactam or tazobactam at the same time. These substances inhibit an enzyme in the bacteria (beta lactamase) that would otherwise break down the antibiotic. By combining, for example, amoxicillin with clavulanic acid, the spectrum of activity can be expanded.

To prevent the bacteria from becoming resistant to the antibiotic, patients should always strictly adhere to the amount, dose and duration of use prescribed by their doctor. Above all, the therapy should not be terminated prematurely on one's own initiative, even if the symptoms have already improved.

What are the side effects of amoxicillin?

As the most serious side effect, like other penicillins, amoxicillin can cause an allergic reaction (amoxicillin allergy). A cross allergy often occurs with penicillins. This means that if you have an allergic reaction to a certain penicillin antibiotic, you will very likely also do the same with other penicillin antibiotics.

As a typical and frequently occurring undesirable side effect, the antibiotic can lead to digestive problems (such as abdominal pain, flatulence, diarrhea, loss of appetite), as it disrupts the normal intestinal flora. As a result, fungi can spread more intensely in the intestine, as they are no longer kept in check by the now disturbed intestinal flora.

A typical but rare side effect of aminopenicillins is the appearance of a maculopapular rash (nodular, blotchy skin rash). Patients with mononucleosis (Pfeiffer's glandular fever) are particularly at risk in this regard.

Poisonous (toxic) side effects in the event of accidental overdosing must not be expected with amoxicillin, as it has a wide therapeutic range, i.e. it only becomes dangerous at extremely high doses.

In some cases of illness, the antibiotic is injected into the liquor space (cavity system in the brain and around the spinal cord, which is filled with cerebrospinal fluid = liquor). This so-called intrathecal application can lead to neurological problems.

What should be considered when taking amoxicillin?

Contraindications

Amixicillin must not be used if you are hypersensitive to the active ingredient or if you have a known allergy to penicillin.

Interactions

In contrast to other antibiotics (tetracyclines and fluoroquinolones), milk consumption is possible without any problems when taking amoxicillin.

Taking allopurinol (a gout medicine) at the same time may increase the risk of skin side effects.

Experts strongly recommend avoiding alcohol while using amoxicillin. Both antibiotics and alcohol have to be broken down by the liver, and this double burden on the organ can cause or intensify undesirable effects.

Age restriction

For severe infections, amoxicillin can be given regardless of age. The dosage is then chosen individually depending on body weight and age.

pregnancy and breast feeding period

There is no evidence of an increased risk of malformations due to amoxicillin. It is therefore one of the antibiotics of choice during pregnancy.

Amoxicillin is also one of the first choice antibiotics when breastfeeding because it hardly ever gets into breast milk. In individual cases, however, breast-fed children may have thinner stools.

How to get medication with amoxicillin

The antibiotic amoxicillin requires a prescription in Germany, Austria and Switzerland. You can get it on prescription in pharmacies.

How long has amoxicillin been known?

The actual urpenicillin, penicillin G, was discovered in 1928 by the Scottish bacteriologist Alexander Fleming. He found that one of his bacterial cultures - a Staphylococcus culture - was infected with mold. Wherever the fungus spread, Fleming could not see any bacterial growth. So this fungus must have developed a defense against these bacteria.

From then on, Fleming called this defense substance penicillin and the fungus Penicillium notatum. Amoxicillin is a derivative of penicillin. It came on the market in 1972, was approved in Switzerland in 1977 and in Germany in 1981.

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