(For veterinary information only)
The size of the tablet/medication is NOT an indication of a proper dose. Never administer any drug without your veterinarian's input. Serious side effects or death can occur if you use drugs on your pet without your veterinarian's advice.
It is our policy not to give dosing information over the Internet.
Available in oral suspension; 250 mg and 500 mg capsules; and 40 mg, 50 mg, 100 mg, 125mg, 150 mg, 200 mg, 250 mg, 400 mg, 500 mg, 875 mg tablets
But it quickly became obvious that this new wonder drug could bear improvement. For example, thanks to work by Alexander Fleming (1881-1955), Howard Florey (1898-1968), and Ernst Chain (1906-1979), penicillin was first produced on a large scale for human use in 1943. At this time, the development of a pill that could reliably kill bacteria was a remarkable development, and many lives were saved during World War II because this medication was available.
- Penicillin is not well absorbed from the intestinal tract, meaning that at least 70 percent of an oral dose is wasted.
- Penicillin is a short-acting medication, and half of the amount circulating is removed from the body every half hour.
- Not all bacteria have the type of cell wall that is susceptible to destruction by penicillin. (Bacteria are classified as gram-negative or gram-positive, depending on the cell wall characteristics. Penicillin is able to punch holes through the gram positive cell wall but is not very effective against the gram-negative cell wall.)
- Staphylococci (an important group of bacteria) have developed an enzyme to break the penicillin molecule apart and are thus rarely susceptible to penicillin.
Amoxicillin represents a synthetic improvement upon the original penicillin molecule. Amoxicillin is better able to resist damage from stomach acid, so less of an oral dose is wasted. While it is still susceptible to destruction by staphylococcal enzymes, it has a much broader spectrum against the gram-negative cell wall and is able to last a bit longer.
How this Medication is Used
Amoxicillin is regarded as having a fairly broad spectrum against many bacteria so it is used both on organisms known to be sensitive to it, and it is a good selection when the sensitivity of bacteria is unknown. It is especially helpful in anaerobic infections (those which grow without the benefit of oxygen). Typical uses might include:
It should be noted that staphylococcal infections are NOT sensitive to this medication with two exceptions:
- Staph infections in the bladder are frequently sensitive to amoxicillin simply because the kidney concentrates such a large amount of amoxicillin in the urine. The Staph protective enzymes are overwhelmed by the huge concentration of antibiotic and the Staph organism is killed. Methicillin-resistant Staphylococci bacteria have mutated, have less predictable sensitivity, and do not follow the above rules for Staph sensitivity. In event of this infection, a culture is needed to determine to which drug the infection will be sensitive.
- Staph infections are sensitive to amoxicillin if clavulanic acid is given concurrently to protect amoxicillin from the Staph enzymes. Amoxicillin/clavulanic acid combinations are marketed under the names Clavamox and Augmentin.
In these two situations, amoxicillin should prevail over a Staph infection; however, recent times have created yet another special situation.
Methicillin-resistant Staphylococcus aureus (also called MRSA) is a human bacterium that can be transmitted to animals, which can in turn, re-transfer the bacteria back to humans. Methicillin-resistant Staphylococcus pseudointermedius (often called MRSI) is a bacterium of pet species. These mutant forms of Staph make antibiotic selection more difficult and culture/sensitivity testing may be needed to select an effective anti-Staph antibiotic.
Interactions with Other Drugs
When the organism in a serious infection cannot be isolated, a common strategy is to attempt to cover for all possible bacteria. Amoxicillin is frequently used in combination with other antibiotics for this purpose.
Clavulanic acid may be added to amoxicillin to increase amoxicillin's spectrum against staphylococcal bacteria.
Amoxicillin is believed to synergize with members of the fluorquinolone class of antibiotics (enrofloxacin, orbifloxacin, etc.)
Some individuals experience nausea, diarrhea or appetite loss. These are generally mild, and giving the medication with food should reduce it.
Serious side effects are unusual but the following has been reported: fever, rashes, and bone marrow suppression.
Concerns and Cautions
The oral suspension should be refrigerated, though if it is mistakenly left out of the refrigerator, this is not a problem. The oral suspension should be discarded after 2 weeks.
If a dose is accidentally skipped, give the next dose when it is remembered and time the subsequent dose accordingly.
Amoxicillin may be given with or without food.
Amoxicillin will cross the placenta in a pregnant patient but is felt to be safe for use during pregnancy.
Amoxicillin is a time-dependent antibiotic, which means it must be given at specific intervals to maintain a therapeutic level. Amoxicillin is given 2-3 times daily, depending on the type of infection.