Description
Amoxycillin is a semi-synthetic penicillin which exerts its bactericidal action by inhibition of cell wall synthesis. It acts against a broad-spectrum of gram-positive and gram-negative microorganisms.
Lactobacillus is an aerobic gram-positive, ubiquitous inhabitant of the human oral cavity, vagina and gastrointestinal tract. It inhibits the colonization of pathogenic bacteria upon the intestinal epithelium. The inhibitory process known as "competitive exclusion" can be expanded by the competition for the adherence sites of the intestinal mucosa between pathogens and lactobacilli and by the inhibitory substance.

Indications
Respiratory tract infections
Genito-urinary tract infections
Skin and soft tissue infection
Enteric infections
Helicobacter pylori infections
In acid-peptic disorders
Dental infections

Dosage and Administration
In all infections except gonorrhoea
Adults and children 20 kgs or more
250-500 mg thrice daily at equal intervals.
Gonorrhoea
Single dose of 3 gm

In impaired renal function
Dosage adjustments are required for patients with renal impairment or for patients undergoing haemodialysis.
A dose of 250-500 mg every 16-24 hours is suggested for adults with creatinine clearance less than 30 ml/minute.
A supplementary dose of 250 mg after every dialysis and maintenance dose of 250-500 mg every 16-24 hours is suggested for patients undergoing haemodialysis.
Contraindications
Hypersensitivity reactions to penicillins

Warnings and Precautions
DRUG INTERACTIONS
Allopurinol: A significant increase in skin rashes is observed when allopurinol and ampicillin are given concurrently. A similar interaction can occur with amoxycillin.
Bacteriostatic drugs: Bacteriostatic drugs like chloramphenicol, erythromycin and tetracyclines may reduce the bactericidal action of amoxycillin.
PREGNANCY
The drug can be used safely throughout pregnancy at the normal adult doses.
NURSING MOTHERS
Amoxycillin is secreted into breast milk in small amounts. The potential risk is for sensitisation and skin rash in the child.

Side Effects
As with penicillins, adverse reactions to amoxycillin are generally those related to allergic response. reactions. Nausea, vomiting and diarrhoea are less common with amoxycillin. Reversible hyperreactivity, agitation, anxiety, insomnia, confusion, behavioural changes and dizziness have been reported rarely.
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