Amoxicillin loading dose

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  1. nick_o XenForo Moderator

    Amoxicillin loading dose


    Objectives Inaccurate antibiotic dosing can lead to treatment failure, fuel antimicrobial resistance and increase side effects. The British National Formulary for Children (BNFC) guidance recommends oral antibiotic dosing according to age bands as a proxy for weight. Recommended doses of amoxicillin for children were increased in 2014 ‘after widespread concerns of under dosing’. However, the impact of dose changes on British children of different weights is unknown, particularly given the rising prevalence of childhood obesity in the UK. We aimed to estimate the accuracy of oral amoxicillin dosing in British children before and after the revised BNFC guidance in 2014. Interventions We calculated the doses each child would receive using the BNFC age band guidance, before and after the 2014 changes, against the ‘gold standard’ weight-based dose of amoxicillin, as per its summary of product characteristics. Primary outcome measure Assuming children of different weights were equally likely to receive antibiotics, we calculated the percentage of the children who would be at risk of misdosing by the BNFC age bands. Some clinicians select amoxicillin over penicillin VK to treat odontogenic infection because of a more convenient dosing regimen e.g., 2-3 doses daily for amoxicillin versus 4 doses daily for penicillin VK. Except for coverage of Haemophilus influenzae in acute sinus and otitis media infections, amoxicillin is not any more effective than penicillin VK for the treatment of odontogenic infections. It is less effective than penicillin VK against aerobic gram-positive cocci and similar in efficacy against anaerobes. Thus penicillin VK is the drug of choice for treating odontogenic infections. Contraindications: Hypersensitivity to amoxicillin, penicillin or any component of the formulation. Warnings/Precautions: Use with caution in patients with severe renal impairment (modify dosage); low incidence of cross-allergy with other beta-lactams and cephalosporins exists. The usual daily oral dose for treating odontogenic infections in children is: Children under 12 years: 20-40 mg/kg divided in 2-3 doses daily for 10 days.

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    Amoxicillin Loading dose of 1.0 g followed by a maintenance dose of 500 mg/t.i.d. for 3 days, followed by a patient evaluation to determine whether further antibiotic therapy or dosage adjustment is required. I always start antibiotics which I rarely needn with a “loading dose” i.e. double dose. This is in order to heighten the plasma levels with maximum efficiency. Sep 5, 2014. A quick explanation of Amoxicillin 500mg capsules, dosage and side effects. Read more.

    Β-lactamase−producing strains of Haemophilus influenzae and Moraxella catarrhalis Mild to moderate: 500/125 mg PO q12hr or 250/125 mg PO q8hr for 10 days Severe: 875/125 mg PO q12hr or 500/125 mg PO q8hr or 2000 mg (2 extended-release tabs) PO q12hr for 7-10 days Take with meals to avoid GI upset Take suspension at start of meal to enhance absorption Dysphagia: May substitute 250 mg/5 m L suspension for 500/125 mg tablet; may substitute 200 mg/5 m L or 400 mg/5 m L suspension for 875/125 mg tablet Because of the different amoxicillin-to-clavulanate ratios in the 250-mg tablet (amoxicillin 250 mg, clavulanate125 mg) and the 250-mg chewable tablet (amoxicillin 250 mg, clavulanate 62.5 mg), the 250-mg tablet should not be used if the pediatric patient weighs Hypersensitivity reactions Anaphylaxis Anemia Thrombocytopenia Leukopenia Agranulocytosis Hepatoxicity AST/ALT elevation Pseudomembranous colitis Serum sickness Abdominal discomfort Cholestatic jaundice Flatulence Allergy to cephalosporins, carbapenems Different tablets are not interchangeable, because ratios of amoxicillin to clavulanate are different Extended release tablets not for use in renal impairment (Cr Cl Amoxicillin binds to penicillin-binding proteins, thus inhibiting final transpeptidation step of peptidoglycan synthesis in bacterial cell walls; addition of clavulanate inhibits beta-lactamase-producing bacteria, allowing amoxicillin extended spectrum of action It is a semisynthetic antibiotic with a broad spectrum of bactericidal activity, covering both gram-negative and gram-positive microorganisms Not effective against Mycoplasma and Legionella spp Peak plasma time: 2 hr (amoxicillin); 1.1 hr (clavulanic acid) Peak concentration: 8-22 mcg/m L (amoxicillin); 0.8-2.6 mcg/m L (clavulanic acid) AUC: 40-80 mcg•hr/m L (amoxicillin); 2-6 mcg•hr/m L (clavulanic acid) The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Take without regard to meals Mixing oral suspension: Tap bottle until all powder flows freely; add approximately one third of the total amount of water for reconstitution and shake vigorously to wet powder; add remainder of water and shake vigorously again After reconstitution, place required amount of suspension directly on child’s tongue for swallowing; if taste is unacceptable, required amount of suspension can be added to formula, milk, fruit juice, water, ginger ale, or other cold drinks; preparation must be taken immediately Shake suspension well before using; any unused portion must be discarded after 14 days Mucocutaneous candidiasis Gastrointestinal (eg, black hairy tongue and hemorrhagic/pseudomembranous colitis, which may occur during or after treatment) Hypersensitivity reactions (eg, anaphylaxis, serum sickness–like reactions, erythematous maculopapular rashes, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, hypersensitivity vasculitis, urticaria) Moderate increase in AST and/or ALT; hepatic dysfunction (eg, cholestatic jaundice, hepatic cholestasis and acute cytolytic hepatitis have been reported) Renal (eg, crystalluria) Anemia (eg, hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, agranulocytosis) CNS reactions (eg, reversible hyperactivity, agitation, anxiety, insomnia, confusion, convulsions, behavioral changes, dizziness) Tooth discoloration (brown, yellow, or gray staining); may be reduced or eliminated with brushing or dental cleaning Anaphylaxis has been reported rarely but is more likely to occur following parenteral therapy with penicillins Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents; severity may range from mild diarrhea to fatal colitis; CDAD may occur over 2 months after discontinuation of therapy; if CDAD is suspected or confirmed, discontinue immediately and begin appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C difficile, and surgical evaluation Do not administer in patients with infectious mononucleosis because of risk of development of erythematous skin rash Do not administer to patients in the absence of a proven or suspected bacterial infection because of risk of development of drug-resistant bacteria Superinfections with bacterial or fungal pathogens may occur during therapy; if suspected, discontinue immediately and begin appropriate treatment Chewable tablets contain aspartame, which contains phenylalanine Use caution in patients with allergy to cephalosporins, carbapenems Endocarditis prophylaxis: use for only high-risk patients, as per recent AHA guidelines High doses may cause false urine glucose test by some methods Derivative of ampicillin and has similar antibacterial spectrum (certain gram-positive and gram-negative organisms); similar bactericidal action as penicillin; acts on susceptible bacteria during multiplication stage by inhibiting cell wall mucopeptide biosynthesis; superior bioavailability and stability to gastric acid and has broader spectrum of activity than penicillin; less active than penicillin against Streptococcus pneumococcus; penicillin-resistant strains also resistant to amoxicillin, but higher doses may be effective; more effective against gram-negative organisms (eg, N meningitidis, H influenzae) than penicillin The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

    Amoxicillin loading dose

    Amoxicillin Pediatric Dosing - Epocrates Online, Can I take a double dose of amoxicillin the first day? - Quora

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  5. Medscape - Indication-specific dosing for Augmentin, Augmentin XR amoxicillin/clavulanate, frequency-based adverse effects, comprehensive interactions.

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    Medscape - Infection-specific dosing for Amoxil, Moxatag amoxicillin, frequency-based adverse effects, comprehensive interactions, contraindications. Children 12 years 10-15 mg/kg/dose every 4-6 hours as needed maximum 90 mg/kg/24 hours,3. Usual oral dosage1,2 based on amoxicillin component. Although the absolute maximum Amoxicillin dose is 4000mg/day, we recommend the following for usual maximum dosing when targeting a high dose.

     
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