Category Archives: Uncategorized

Strategi Taruhan Dan Cepat Kaya Dalam Poker Online

heheDengan taruhan olahraga online, dunia peluang sudah dibuka, tanpa ada batasan, dimana tiap pemakai bisa membuahkan uang dalam jumlahnya besar di dalam rumah perjudian online, bila mereka mujur serta perasaan tidak menyedihkan mereka.

Kadang, Anda harus ambil efek untuk menang. Ini ialah pepatah yang pemula tidak turuti, mereka perkiraan score mulai dengan sedikit uang, serta hampir tetap bertaruh aman. Dengan langkah ini, keuntungan makin bertambah dengan cara perlahan-lahan di account Anda. Penjudi yang eksper mempunyai senjata rahasia : pengalaman mereka serta mereka pilih untuk menganekaragamkan taruhan mereka.

Pada tahun 2008, angka untuk taruhan online melesat di penjuru dunia serta studi yang dilaksanakan oleh organisasi Strategy Analytics memprediksi pasar judi internet membuahkan 11. 000 juta dolar tahun itu.

Statistik kuantitatif tidak ada saat mengacu pada kehilangan uang dalam taruhan online. Untuk pemain baru, dianjurkan tidak untuk membuat taruhan beresiko, mengurus jumlahnya uang di tiap taruhan ; dengan langkah ini Anda memenangi jumlahnya kecil dan juga kehilangan jumlahnya kecil. Dianjurkan untuk menganggap untuk hoby dimana Anda memenangi uang serta bukan untuk sumber penghasilan. JANGAN lupa jika selanjutnya taruhan ialah permainan kesempatan.

Banyak yang yakin jika peruntungan bukan kuncinya serta jika beberapa faktor lain harus diperhitungkan. Contohnya, di Inggris, sejumlah besar taruhan yang dibikin di Internet terkait dengan sepak bola. Mempunyai pengetahuan mengenai olahraga atau tahu keadaan semasing pemain, seberapa banyak kartu yang sudah mereka mengumpulkan atau bila mereka memakai pemain pengganti … akan menolong untuk bikin ketetapan yang lebih tepat.

Kita harus juga mempertimbangkan rumah perjudian tempat kita menginvestasikan uang kita. William Hill, Landbrokes, serta Bwin ialah tiga perusahaan penting yang menguasai pasar taruhan online.

William Hill Inggris mempunyai rekam jejak yang hebat. Dibangun pada tahun 1936, rumah ini dipandang seperti salah satunya rumah judi paling tua di Eropa.

Landbroker, Inggris, dibangun di akhir 1980-an. Situs situs untuk rumah judi ini ada dalam jumlahnya bahasa yang tidak terbatas sebab hadirnya di beberapa negara di dunia.

Perusahaan lain dengan rekam jejak baik ialah Bwin, sponsor Real Madrid serta Milan AC. Tidak sama yang lain, ini ialah perusahaan Austria yang lahir pada tahun 1999. Semenjak itu jadi mode peranan serta adalah salah satunya rumah judi pertama yang sangat mungkin taruhan langsung, yang bermakna jika kemungkinan untuk meramalkan hasil yang tidak sama untuk acara olahraga sedang Acara sedang berjalan.

Free Poker Games And Strategy On Poker Online

hehePlaying free poker matches on the internet is a superb way to learn how to play Butyou will often be faced with playing people that you haven’t ever played on most games. Here are my suggestions about what to elevate your chances of winning!

I suggest watching afew sahabatqq complimentary poker matches hands, watch to find out who’s loose, and who’s tight. Unlike players that are loose, it’s important to realize that an increase will generally not leave those players give up there cards. If you should be a player that is strong, this makes it challenging since the range of players which go in the pot, increase your odds of losing a whole lot of chips, even on the other hand, if you are a poor player, the more in the better.

When playing with a tight set of players, you should loosen up your play, play with more pots, and make use of a poin bet, unless your kompetitor has a very strong handtight players can fold more often then not. Play more control, and bluff longer to maximize your stack size.

The opposite is true when playing a table, play your cards, and also utilize odds that will assist you to winagainst loose players bluffing more often and not will get you in some masalah fast!

You ought to learn to correct, and play different depending on the calibre of players your up against ; that is particularly true in tournament play where you can encounter both fashions on precisely the same table. Consistently make emotional catatan, and when you’re not able, place careful awareness of what’s happening at the dining table. It’s important to know the ability level at the dining table, tighten against great players, and loosen up when you are feeling
You are the skilled player at the table.

Amoksisilin di masyarakat

Cara pemberian obat[sunting | sunting sumber]

Amoksisilin yang ada di pasar umumnya berupa kristal trihidrat, untuk penggunaan oral tersedia dalam bentuk kapsul, tablet kunyah dan dapat terdispersi, sirup dan suspensi untuk pasien pediatri, dan berupa garam natrium untuk pemberian intravena. Amoksisilin paling sering diberikan secara oral. Obat bentuk cair digunakan untuk pasien yang kesulitan untuk menelan tablet atau kapsul.

Penelitian dengan tikus menunjukkan amoksisilin dalam bentuk mikropartikel dapat diberikan secara intraperitoneal.[28]

Penamaan[sunting | sunting sumber]

Amoksisilin merupakan salah satu penisilin semisintetis yang ditemukan oleh ilmuwan Beecham. Paten amoksisilin telah berakhir, dengan demikian sediaan amoksisilin dan co-amoxiclav dijual dengan berbagai nama dagang dan/atau memiliki beberapa sinonim di seluruh dunia, seperti:

  • Actimoxi[29]
  • Alphamox
  • Almox
  • Amimox
  • AMOXIZIF
  • Amocla
  • AMK
  • Amoksiklav
  • Amorion
  • Amoxibactin (animal use)
  • Amoxibos
  • Amoxiclav
  • Amoxidal
  • Amoxil
  • Amoxin[30]
  • Amoxibiotic[31]
  • Amoxicilina
  • Amoxidal
  • Amoxoral (animal use)
  • Apo-Amoxy
  • Arsogil[32]
  • Augmentin
  • Bactox
  • Bioxidona[33]
  • Cilamox
  • Clamoxyl
  • Clavamox
  • Clonamox
  • Curam
  • Dedoxil
  • Dispermox
  • Duomox
  • Defender[34]
  • E-Mox[35]
  • Enhancin
  • Ezymox[36]
  • Gimalxina
  • Geramox
  • Hiconcil
  • Himox
  • Isimoxin[37]
  • Klavax
  • Klavocin
  • Klavox
  • Lamoxy
  • Largopen
  • MOX
  • Moxatag
  • Moxiclav Duo[38]
  • Moxikem
  • Moxilen
  • Moxypen
  • Moxyvit
  • Nobactam
  • Novamoxin
  • Optamox
  • Ospamox
  • Pamoxicillin
  • Panklav
  • Pinamox
  • Penamox
  • Polymox
  • Senox[39]
  • Sinacilin
  • Skymox[40]
  • Spektramox
  • Starmox[41]
  • Trimox
  • Tolodina[42]
  • Tormoxin
  • Tyclav[43]
  • Unimox
  • Vidamox
  • Wedemox
  • Wymox
  • Yucla
  • remox
  • Zerrsox
  • Zimox
  • Zoxicillin[44]

Nama tanpa rujukan yang spesifik dirujuk dari situs drugs.com.[45]

Referensi[sunting | sunting sumber]

  1. ^ a b c d e f g h “Amoxicillin”The American Society of Health-System Pharmacists. Diakses tanggal 1 August 2015.
  2. ^ Gillies, M; Ranakusuma, A; Hoffmann, T; Thorning, S; McGuire, T; Glasziou, P; Del Mar, C (17 November 2014). “Common harms from amoxicillin: a systematic review and meta-analysis of randomized placebo-controlled trials for any indication”. CMAJ : Canadian Medical Association [Journal de l’Association medicale canadienne]187: E21–31. doi:10.1503/cmaj.140848PMID 25404399.
  3. ^ Roy, Jiben (2012). An introduction to pharmaceutical sciences production, chemistry, techniques and technology. Cambridge: Woodhead Pub. hlm. 239. ISBN 9781908818041.
  4. ^ “19th WHO Model List of Essential Medicines” (PDF). World Health Organization. April 2015. Diakses tanggal 14 December 2015.
  5. ^ Kelly, Deirdre (2008). Diseases of the liver and biliary system in children (edisi ke-3). Chichester, UK: Wiley-Blackwell. hlm. 217. ISBN 9781444300543.
  6. ^ “Amoxicillin”International Drug Price Indicator Guide. Diakses tanggal 1 August 2015.
  7. ^ American Academy of Allergy, Asthma, and Immunology. “Five Things Physicians and Patients Should Question” (PDF). Choosing Wisely: an initiative of the ABIM FoundationAmerican Academy of Allergy, Asthma, and Immunology. Diakses tanggal August 14, 2012.
  8. ^ Ahovuo-Saloranta, A.; Rautakorpi, U. M.; Borisenko, O. V.; Liira, H.; Williams Jr, J. W.; Mäkelä, M. (2014).
  9. ^ “Pneumonia – National Library of Medicine – PubMed Health”.
  10. ^ “Revised WHO Classification and Treatment of Pneumonia in Children at Health Facilities – NCBI Bookshelf”.
  11. ^ “Adolescent Acne: Management”.
  12. ^ “Amoxicillin and Acne Vulgaris”. scienceofacne.com. 2012-09-05. Diakses tanggal 2012-08-17.
  13. ^ “Guideline: Managing Possible Serious Bacterial Infection in Young Infants When Referral Is Not Feasible – NCBI Bookshelf”.
  14. ^ “CG64 Prophylaxis against infective endocarditis: Full guidance”(PDF). NICE. Diakses tanggal 8 June 2011.
  15. ^ Thornhill, MH; Dayer, MJ; Forde, JM; Corey, GR; Chu, VH; Couper, DJ; Lockhart, PB (2011-05-03). “Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study”BMJ (Clinical research ed.)342: d2392. doi:10.1136/bmj.d2392PMC 3086390alt=Dapat diakses gratisPMID 21540258.
  16. ^ “Amoxicillin Susceptibility and Resistance Data” (PDF). Diakses tanggal 20 July 2013.
  17. ^ “Amoxicillin spectrum of bacterial susceptibility and Resistance”(PDF). Diakses tanggal 8 April 2012.
  18. ^ Cundiff j, Joe S.; Joe, S (2007). “Amoxicillin-clavulanic acid-induced hepatitis”. Am. J. Otolaryngol28 (1): 28–30. doi:10.1016/j.amjoto.2006.06.007PMID 17162128.
  19. ^ R. Baselt (2008). Disposition of Toxic Drugs and Chemicals in Man(edisi ke-8th). Foster City, CA: Biomedical Publications. hlm. 81–83.
  20. ^ Pichichero ME (April 2005). “A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients”Pediatrics115 (4): 1048–57. doi:10.1542/peds.2004-1276PMID 15805383.
  21. ^ Schmitt, Barton D. (2005). Your child’s health: the parents’ one-stop reference guide to symptoms, emergencies, common illnesses, behavior problems, healthy development (edisi ke-2nd). New York: Bantam Books. ISBN 0-553-38369-8.
  22. ^ Kagan, B (1977). “Ampicillin rash”Western Journal of Medicine126 (4): 333–335. PMC 1237570alt=Dapat diakses gratisPMID 855325.
  23. ^ British National Formulary 57 March 2009
  24. ^ Alcamo, I. Edward (2003), Microbes and Society: An Introduction to Microbiology, Jones & Bartlett Learning, hlm. 198, ISBN 9780763714307.
  25. ^ Geddes, AM; et al. (Dec 2007). “Introduction: historical perspective and development of amoxicillin/clavulanate”. Int J Antimicrob Agents30(Suppl 2): S109–12. doi:10.1016/j.ijantimicag.2007.07.015PMID 17900874.
  26. ^ a b Raviña, E (2014). The Evolution of Drug Discovery. Weinheim: Wiley-VCH. hlm. 262. ISBN 9783527326693.
  27. ^ Bruggink, A (2001). Synthesis of β-lactam antibiotics. Springer. hlm. 17. ISBN 0-7923-7060-0.
  28. ^ Farazuddin, Mohammad; Chauhan, Arun; Khan, Raza M.M.; Owais, Mohammad (2011). “Amoxicillin-bearing microparticles: potential in the treatment of Listeria monocytogenes infection in Swiss albino mice”Bioscience Reports31 (4): 265–72. doi:10.1042/BSR20100027PMID 20687896.
  29. ^ Catalog.md: Actimoxi Linked 2013-12-09
  30. ^ Amoxin Linked 2014-07-23
  31. ^ Catalog.md: Amoxibiotic Linked 2013-12-09
  32. ^ Aversi (Georgia): Arsogil Linked 2013-12-09
  33. ^ Catalog.md: Bioxidona Linked 2013-12-09
  34. ^ DrugsUpdate India: Defender from Sac Pharma Linked 2013-12-09
  35. ^ Eipico (Egypt): E-Mox Linked 2013-12-09
  36. ^ DrugsUpdate India: Ezymox from Sac Pharma Linked 2013-12-09
  37. ^ Catalog.md: Isimoxin Linked 2013-12-09
  38. ^ “Moxiclav Duo 500/125”.
  39. ^ BioPortal: Senox Linked 2013-12-09
  40. ^ PalMediNet: Skymox Linked 2013-12-09
  41. ^ Sarthak Biotech India: Starmox Linked 2013-12-09
  42. ^ Catalog.md: Tolodina Linked 2013-12-09
  43. ^ Beximco Pharma, Bangladesh: Tyclav Linked 2013-12-09
  44. ^ PakMediNet (Pakistan): Zoxicillin Linked 2013-12-09
  45. ^ Drugs.com: Amoxicillin Linked 2013-12-09

Amoksisilin

Amoksisilin merupakan antibiotik yang digunakan dalam pengobatan berbagai infeksi bakteri.[1] Obat ini merupakan lini pertama untuk pengobatan infeksi telinga tengah. Obat ini juga dapat digunakan untuk mengobati faringitis streptokokuspneumoniainfeksi kulit, dan infeksi saluran kemih. Obat ini diberikan secara per oral.[1]

Efek samping yang umum terjadi antara lain mual dan ruam.[1] Amoksisilin juga dapat meningkatkan risiko infeksi jamur. Ketika digunakan bersamaan dengan Asam klavulanat akan memiliki efek samping diare.[2] Amoksisilin tidak boleh digunakan kepada orang yang alergi terhadap penisilin. Amoksisilin dapat digunakan pada pasien dengan masalah ginjal, hanya saja dosisnya perlu diturunkan. Amoksisilin dapat digunakan kehamilan dan menyusui.[1]

Amoksisilin mulai dipasarkan pada tahun 1972.[3] Obat ini termasuk dalam Daftar Obat Esensial Organisasi Kesehatan Dunia, obat yang perlu ada dalam sistem kesehatan mendasar.[4] Obat ini merupakan salah satu antibiotik yang paling sering diresepkan pada anak-anak.[5] Amoksisilin tersedia dalam bentuk obat generik.[1] Amoksisilin dijual di negara berkembang dengan harga antara 0,02 dan 0,05 USD per tablet.[6] Di Amerika Serikat, pengobatan selama sepuluh hari dengan Amoksisilin membutuhkan biaya sekitar 16 USD.[1]

Penggunaan medis[sunting | sunting sumber]

Amoksisilin BP

Amoksisilin digunakan dalam pengobatan berbagai infeksi, seperti radang telinga tengah akutfaringitis streptokokuspneumoniainfeksi kulitinfeksi saluran kemih, infeksi Salmonellapenyakit Lyme, dan infeksi chlamydia.[1]

Infeksi saluran pernapasan[sunting | sunting sumber]

Amoksisilin dan amoksisilin-klavulanat telah direkomendasikan sebagai obat pilihan untuk sinusitis yang disebabkan oleh bakteri, tetapi sinusitis lebih banyak disebabkan oleh virus, sehingga amoksisilin dan amoksisilin-klavulanat tidak efektif,[7] dan manfaat kecil yang didapat pada terapi dengan amoksisilin mungkin tidak sebanding dengan efek obat tidak diinginkan yang banyak.[8] Amoksisilin direkomendasikan sebagai pengobatan lini pertama untuk pneumonia pada orang dewasa oleh National Institute for Health and Care Excellence, dalam bentuk tunggal (untuk pneumonia ringan sampai sedang) atau dalam bentuk kombinasi dengan makrolida.[9] Organisasi Kesehatan Dunia (WHO) merekomendasikan amoksisilin sebagai pengobatan lini pertama untuk radang paru-paru yang tidak terlalu parah.[10]

Infeksi kulit[sunting | sunting sumber]

Amoksisilin cukup sering digunakan untuk pengobatan infeksi kulit, seperti jerawat.[11] Obat ini cukup efektif untuk mengobati jerawat ketika tidak mempan diberikan antibiotik lainnya seperti doksisiklin dan minosiklin.[12]

Infeksi pada bayi dengan keterbatasan tertentu[sunting | sunting sumber]

Amoksisilin direkomendasikan oleh Organisasi Kesehatan Dunia untuk pengobatan pneumonia pada bayi ketika orang tua tidak mampu atau tidak mau membawa bayi ke rawat inap. Amoksisilin dengan kombinasi gentamisin direkomendasikan untuk pengobatan infeksi parah pada bayi ketika tidak mampu untuk dirawat inap.[13]

Pencegahan endokarditis yang disebabkan bakteri[sunting | sunting sumber]

Amoksisilin juga digunakan untuk mencegah endokarditis yang disebabkan bakteri pada pasien perawatan gigi dengan risiko tinggi, digunakan untuk mencegah Streptococcus pneumoniae dan bakteri lainnya pada pasien yang telah menjalani pengangkatan limpa, seperti pasien dengan anemia sel sabit, dan digunakan untuk pencegahan dan pengobatan antraks.[1] Kementerian Kesehatan Britania Raya merekomendasikan penggunaan amoksisilin untuk terapi profilaksis endokarditis yang menulat.[14] Rekomendasi ini tidak terlihat telah menurunkan tingkat infeksi untuk endokarditis yang menular.[15]

Pengobatan kombinasi[sunting | sunting sumber]

Amoksisilin rentan terhadap degradasi oleh β-laktamase yang diproduksi bakteri resisten terhadap antibiotik spektrum sempit golongan β-laktam, seperti penisilin. Karena hal tersebut, amoksisilin dikombinasikan dengan asam klavulanat, inhibitor β-laktamase. Kombinasi ini sering disebut dengan co-amoxiclav.[16]

Spektrum aktivitas[sunting | sunting sumber]

Amoksisilin merupakan antibiotik spektrum menengah, bakteriolitik, antibiotik β-laktam golongan aminopenisilin yang digunakan untuk mengobati infeksi dari bakteri Gram-positif dan Gram-negatif. Amoksisilin menjadi pilihan obat dalam golongan tersebut karena dapat diabsorbsi dengan baik melalui pemberian peroral jika dibandingkan dengan antiobiotik β-laktam lainnya. Pada umumnya, StreptococcusBacillus subtilisEnterococcusHaemophilusHelicobacter, dan Moraxella rentan terhadap amoksisilin, sementara CitrobacterKlebsiella dan Pseudomonas aeruginosa resisten terhadap amoksisilin.[17] Beberapa E. coli dan sebagian besar galur Staphylococcus aureus telah menunjukkan resistensi terhadap amokisilin.

Society and culture

Modes of delivery[edit]

Pharmaceutical manufacturers make amoxicillin in trihydrate form, for oral use available as capsules, regular, chewable and dispersible tablets, syrup and pediatric suspension for oral use, and as the sodium salt for intravenous administration. Amoxicillin is most commonly taken orally. The liquid forms are helpful where the patient might find it difficult to take tablets or capsules.

An extended-release is available.[45] The intravenous form of amoxicillin is not sold in the United States.[46] When an intravenous aminopenicillin is required in the United States, ampicillin is typically used. When there is an adequate response to ampicillin, the course of antibiotic therapy may often be completed with oral amoxicillin.[47]

Research with mice indicated successful delivery using intraperitoneally injected amoxicillin-bearing microparticles.[48]

Names[edit]

“Amoxicillin” is the International Nonproprietary Name (INN), British Approved Name (BAN), and United States Adopted Name (USAN), while “amoxycillin” is the Australian Approved Name (AAN).

Amoxicillin is one of the semisynthetic penicillins discovered by Beecham scientists. The patent for amoxicillin has expired, thus amoxicillin and co-amoxiclav preparations are marketed under various trade names across the world.[1]

Other animals[edit]

Amoxicillin is also sometimes used as an antibiotic for animals. The use of amoxicillin for animals intended for human consumption (chickenscattle, and swine for example) has been approved.[49]

References[edit]

  1. Jump up to:a b “International brand names for amoxicillin”www.drugs.com. Drugs.com. Archived from the original on 29 May 2016. Retrieved 15 November 2016.
  2. ^ “Amoxicillin”www.chemsrc.com.
  3. Jump up to:a b c d e f g h i j k l “Amoxicillin”The American Society of Health-System PharmacistsArchived from the original on 5 September 2015. Retrieved 1 August 2015.
  4. ^ “Amoxicillin Sodium for Injection”EMC. 10 February 2016. Archived from the original on 27 October 2016. Retrieved 26 October2016.
  5. ^ Gillies, M; Ranakusuma, A; Hoffmann, T; Thorning, S; McGuire, T; Glasziou, P; Del Mar, C (17 November 2014). “Common harms from amoxicillin: a systematic review and meta-analysis of randomized placebo-controlled trials for any indication”CMAJ : Canadian Medical Association Journal187 (1): E21–31. doi:10.1503/cmaj.140848PMC 4284189PMID 25404399.
  6. ^ Fischer, Janos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 490. ISBN 9783527607495Archived from the original on 2017-09-08.
  7. ^ Roy, Jiben (2012). An introduction to pharmaceutical sciences production, chemistry, techniques and technology. Cambridge: Woodhead Pub. p. 239. ISBN 9781908818041Archived from the original on 2017-09-08.
  8. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  9. ^ Kelly, Deirdre (2008). Diseases of the liver and biliary system in children (3 ed.). Chichester, UK: Wiley-Blackwell. p. 217. ISBN 9781444300543Archived from the original on 2017-09-08.
  10. ^ “Amoxicillin”International Drug Price Indicator Guide. Retrieved 1 August 2015.
  11. ^ “The Top 300 of 2019”clincalc.com. Retrieved 26 February 2019.
  12. Jump up to:a b c d e f g h “Amoxicillin” (PDF). Davis. 2017. Archived (PDF)from the original on September 8, 2017. Retrieved March 22, 2017.
  13. ^ Venekamp, Roderick P.; Sanders, Sharon L.; Glasziou, Paul P.; Del Mar, Chris B.; Rovers, Maroeska M. (2015-06-23). “Antibiotics for acute otitis media in children” (PDF)The Cochrane Database of Systematic Reviews (6): CD000219. doi:10.1002/14651858.CD000219.pub4ISSN 1469-493XPMC 7043305PMID 26099233.
  14. ^ Thanaviratananich S, Laopaiboon M, Vatanasapt P (December 2013). “Once or twice daily versus three times daily amoxicillin with or without clavulanate for the treatment of acute otitis media”. Cochrane Database Syst Rev (12): CD004975. doi:10.1002/14651858.CD004975.pub3PMID 24338106.
  15. ^ American Academy of Allergy, Asthma, and Immunology. “Five Things Physicians and Patients Should Question” (PDF)Choosing Wisely: An Initiative of the ABIM FoundationAmerican Academy of Allergy, Asthma, and ImmunologyArchived (PDF) from the original on November 3, 2012. Retrieved August 14, 2012.
  16. ^ Ahovuo-Saloranta, A.; Rautakorpi, U. M.; Borisenko, O. V.; Liira, H.; Williams Jr, J. W.; Mäkelä, M. (2014). Ahovuo-Saloranta, Anneli (ed.). “Antibiotics for acute maxillary sinusitis”. The Cochrane Library (2): CD000243. doi:10.1002/14651858.CD000243.pub3PMID 24515610. (Retracted, seedoi:10.1002/14651858.cd000243.pub4. If this is an intentional citation to a retracted paper, please replace {{Retracted}} with{{Retracted|intentional=yes}}.)
  17. ^ Pneumonia – National Library of Medicine – PubMed Health. National Institute for Health and Care Excellence: Clinical Guidelines. National Institute for Health and Care Excellence (UK). 2014. Archived from the original on 2017-09-08.
  18. ^ Revised WHO Classification and Treatment of Pneumonia in Children at Health Facilities – NCBI Bookshelf. WHO Guidelines Approved by the Guidelines Review Committee. World Health Organization. 2014. ISBN 9789241507813Archived from the original on 2017-09-08.
  19. ^ Chey WD, Leontiadis GI, Howden CW, Moss SF (February 2017). “ACG Clinical Guideline: Treatment of Helicobacter pylori Infection”. Am. J. Gastroenterol112 (2): 212–239. doi:10.1038/ajg.2016.563PMID 28071659.
  20. ^ Torbahn G, Hofmann H, Rücker G, Bischoff K, Freitag MH, Dersch R, Fingerle V, Motschall E, Meerpohl JJ, Schmucker C (November 2018). “Efficacy and Safety of Antibiotic Therapy in Early Cutaneous Lyme Borreliosis: A Network Meta-analysis”JAMA Dermatol154 (11): 1292–1303. doi:10.1001/jamadermatol.2018.3186PMC 6248135PMID 30285069.
  21. ^ “Adolescent Acne: Management”Archived from the original on 2010-12-22.
  22. ^ “Amoxicillin and Acne Vulgaris”. scienceofacne.com. 2012-09-05. Archived from the original on 2012-07-21. Retrieved 2012-08-17.
  23. ^ Guideline: Managing Possible Serious Bacterial Infection in Young Infants When Referral Is Not Feasible – NCBI Bookshelf. WHO Guidelines Approved by the Guidelines Review Committee. World Health Organization. 2015. ISBN 9789241509268Archived from the original on 2017-09-08.
  24. ^ “CG64 Prophylaxis against infective endocarditis: Full guidance”(PDF)NICE. Archived from the original (PDF) on 12 November 2011. Retrieved 8 June 2011.
  25. ^ Thornhill, MH; Dayer, MJ; Forde, JM; Corey, GR; Chu, VH; Couper, DJ; Lockhart, PB (2011-05-03). “Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study”BMJ (Clinical Research Ed.)342: d2392. doi:10.1136/bmj.d2392PMC 3086390PMID 21540258.
  26. ^ “Amoxicillin Susceptibility and Resistance Data” (PDF). Retrieved 20 July 2013.
  27. ^ “Amoxicillin spectrum of bacterial susceptibility and Resistance”(PDF). Retrieved 8 April 2012.
  28. ^ Cundiff j, Joe S.; Joe, S (2007). “Amoxicillin-clavulanic acid-induced hepatitis”. Am. J. Otolaryngol28 (1): 28–30. doi:10.1016/j.amjoto.2006.06.007PMID 17162128.
  29. ^ R. Baselt (2008). Disposition of Toxic Drugs and Chemicals in Man(8th ed.). Foster City, CA: Biomedical Publications. pp. 81–83.
  30. ^ Gillies M, Ranakusuma A, Hoffmann T, Thorning S, McGuire T, Glasziou P, Del Mar C (January 2015). “Common harms from amoxicillin: a systematic review and meta-analysis of randomized placebo-controlled trials for any indication”CMAJ187 (1): E21–31. doi:10.1503/cmaj.140848PMC 4284189PMID 25404399.
  31. ^ “Role of delayed cellular hypersensitivity and adhesion molecules in amoxicillin-induced morbilliform rashes”. Cat.inist.fr. Archived from the original on 2011-12-29. Retrieved 2010-11-13.
  32. ^ Pichichero ME (April 2005). “A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients”Pediatrics115 (4): 1048–57. doi:10.1542/peds.2004-1276PMID 15805383Archived from the original on 2008-12-18.
  33. ^ Schmitt, Barton D. (2005). Your child’s health: the parents’ one-stop reference guide to symptoms, emergencies, common illnesses, behavior problems, healthy development (2nd ed.). New York: Bantam Books. ISBN 978-0-553-38369-0.
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  37. ^ Handsfield HH, Clark H, Wallace JF, Holmes KK, Turck M (February 1973). “Amoxicillin, a new penicillin antibiotic”Antimicrob. Agents Chemother3 (2): 262–5. doi:10.1128/AAC.3.2.262PMC 444397PMID 4208282.
  38. ^ Alcamo, I. Edward (2003), Microbes and Society: An Introduction to Microbiology, Jones & Bartlett Learning, p. 198, ISBN 9780763714307.
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  43. Jump up to:a b Raviña, E (2014). The Evolution of Drug Discovery. Weinheim: Wiley-VCH. p. 262. ISBN 9783527326693.
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  46. ^ Marek, Cindy L.; Timmons, Sherry R. (2018). Nowak, Arthur (ed.). Antimicrobials in Pediatric DentistrySaundersISBN 978-0323608268. Retrieved 2019-07-24.
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Adverse effects

Adverse effects are similar to those for other β-lactam antibiotics, including nausea, vomiting, rashes, and antibiotic-associated colitis. Loose bowel movements (diarrhea) may also occur. Rarer adverse effects include mental changes, lightheadedness, insomnia, confusion, anxiety, sensitivity to lights and sounds, and unclear thinking. Immediate medical care is required upon the first signs of these adverse effects.[citation needed]

The onset of an allergic reaction to amoxicillin can be very sudden and intense; emergency medical attention must be sought as quickly as possible. The initial phase of such a reaction often starts with a change in mental state, skin rash with intense itching (often beginning in fingertips and around groin area and rapidly spreading), and sensations of fever, nausea, and vomiting. Any other symptoms that seem even remotely suspicious must be taken very seriously. However, more mild allergy symptoms, such as a rash, can occur at any time during treatment, even up to a week after treatment has ceased. For some people allergic to amoxicillin, the adverse effects can be fatal due to anaphylaxis.

Use of the amoxicillin/clavulanic acid combination for more than one week has caused mild hepatitis in some patients. Young children having ingested acute overdoses of amoxicillin manifested lethargy, vomiting, and renal dysfunction.[28][29]

There is poor reporting of adverse effects of amoxicillin from clinical trials. For this reason, the severity and frequency of adverse effects from amoxicillin is probably higher than reported from clinical trials.[30]

Nonallergic rash[edit]

Between 3 and 10% of children taking amoxicillin (or ampicillin) show a late-developing (>72 hours after beginning medication and having never taken penicillin-like medication previously) rash, which is sometimes referred to as the “amoxicillin rash”. The rash can also occur in adults.

The rash is described as maculopapular or morbilliform (measles-like; therefore, in medical literature, it is called “amoxicillin-induced morbilliform rash”.[31]). It starts on the trunk and can spread from there. This rash is unlikely to be a true allergic reaction and is not a contraindication for future amoxicillin usage, nor should the current regimen necessarily be stopped. However, this common amoxicillin rash and a dangerous allergic reaction cannot easily be distinguished by inexperienced persons, so a healthcare professional is often required to distinguish between the two.[32][33]

A nonallergic amoxicillin rash may also be an indicator of infectious mononucleosis. Some studies indicate about 80-90% of patients with acute Epstein Barr virus infection treated with amoxicillin or ampicillin develop such a rash.[34]

Interactions[edit]

Amoxicillin may interact with these drugs:

Pharmacology[edit]

Amoxicillin (α-amino-p-hydroxybenzyl penicillin) is a semisynthetic derivative of penicillin with a structure similar to ampicillin but with better absorption when taken by mouth, thus yielding higher concentrations in blood and in urine.[37] Amoxicillin diffuses easily into tissues and body fluids. Penetration into the central nervous system increases in meningitis. It will cross the placenta and is excreted into breastmilk in small quantities. It is excreted into the urine and metabolized by the liver. It has an onset of 30 minutes and a half-life of 3.7 hours in newborns and 1.4 hours in adults.[12]

Amoxicillin attaches to the cell wall of susceptible bacteria and results in their death. It also is a bactericidal compound. It is effective against streptococci, pneumococci, enterococci, Haemophilus influenzaeEscherichia coliProteus mirabilisNeisseria meningitidisNeisseria gonorrhoeaeShigellaChlamydia trachomatisSalmonellaBorrelia burgdorferi, and Helicobacter pylori.[12] As a derivative of ampicillin, amoxicillin is a member of the penicillin family and, like penicillins, is a β-lactam antibiotic.[38] It inhibits cross-linkage between the linear peptidoglycan polymer chains that make up a major component of the bacterial cell wall. It has two ionizable groups in the physiological range (the amino group in alpha-position to the amide carbonyl group and the carboxyl group).[39]

History[edit]

Amoxicillin was one of several semisynthetic derivatives of 6-aminopenicillanic acid (6-APA) developed at Beecham, England in the 1960s.[40][41] It became available in 1972 and was the second aminopenicillin to reach the market (after ampicillin in 1961).[42][43][44] Co-amoxiclav became available in 1981.[43]

Amoxicillin

Amoxicillin is an antibiotic used to treat a number of bacterial infections.[3] These include middle ear infection, strep throat, pneumonia, skin infections, and urinary tract infections among others.[3] It is taken by mouth, or less commonly by injection.[3][4]

Common adverse effects include nausea and rash.[3] It may also increase the risk of yeast infections and, when used in combination with clavulanic acid, diarrhea.[5] It should not be used in those who are allergic to penicillin.[3] While usable in those with kidney problems, the dose may need to be decreased.[3] Its use in pregnancy and breastfeeding does not appear to be harmful.[3] Amoxicillin is in the beta-lactam family of antibiotics.[3]

Amoxicillin was discovered in 1958 and came into medical use in 1972.[6][7] It is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system.[8] It is one of the most commonly prescribed antibiotics in children.[9] Amoxicillin is available as a generic medication.[3] It has a wholesale cost in the developing world of between US$0.02 and $0.05 per pill.[10] In the United States, ten days of treatment costs about US$16 ($0.40 per pill).[3] In 2016, it was the 28th most prescribed medication in the United States, with more than 28 million prescriptions.[11]

Contents
1 Medical uses
1.1 Acute otitis media
1.2 Respiratory infections
1.3 H. pylori
1.4 Lyme borreliosis
1.5 Skin infections
1.6 Infections in infants in resource-limited settings
1.7 Prevention of bacterial endocarditis
1.8 Combination treatment
1.9 Spectrum of activity
2 Adverse effects
2.1 Nonallergic rash
3 Interactions
4 Pharmacology
5 History
6 Society and culture
6.1 Modes of delivery
6.2 Names
7 Other animals
8 References
9 Further reading
10 External links
Medical uses

Amoxicillin BP
Amoxicillin is used in the treatment of a number of infections, including acute otitis media, streptococcal pharyngitis, pneumonia, skin infections, urinary tract infections, Salmonella infections, Lyme disease, and chlamydia infections.[3][12]

Acute otitis media
Children with acute otitis media who are younger than 6 months of age are generally treated with amoxicillin or other antibiotic. Although most children with acute otitis media who are older than two years old do not benefit from treatment with amoxicillin or other antibiotic, such treatment may be helpful in children younger than two years old with acute otitis media that is bilateral or accompanied by ear drainage.[13] In the past, amoxicillin was dosed three times daily when used to treat acute otitis media, which resulted in missed doses in routine ambulatory practice. There is now evidence that two times daily dosing or once daily dosing has similar effectiveness.[14]

Respiratory infections
Amoxicillin and amoxicillin-clavulanate have been recommended by guidelines as the drug of choice for bacterial sinusitis and other respiratory infections.[12] Most sinusitis infections are caused by viruses, for which amoxicillin and amoxicillin-clavulanate are ineffective,[15] and the small benefit gained by amoxicillin may be overridden by the adverse effects.[16] Amoxicillin is recommended as the preferred first-line treatment for community-acquired pneumonia in adults by the National Institute for Health and Care Excellence, either alone (mild to moderate severity disease) or in combination with a macrolide.[17] The World Health Organization (WHO) recommends amoxicillin as first-line treatment for pneumonia that is not “severe”.[18] Amoxicillin is used in post-exposure inhalation of anthrax to prevent disease progression and for prophylaxis.[12