|Reviewed by Brenda Hughes
(pharmacist), Dr Lesley Voss (SCH I.D), Eamon Duffy (pharmacist/I.D)
0 to 7
- Empirical therapy for infants with risk
factors for sepsis or suspected sepsis. Usually administered in
combination with gentamicin,
- Specific therapy for Streptococcus agalactiae (Group B
streptococcus), Listeria monocytogenes
- Hypersensitivity to penicillins/cephalosporins.
- Caution in preterm infants, especially extreme immaturity.
- Caution in infants with renal impairment – reduce dose
- Caution in infants with gastrointestinal disease.
Amoxicillin is a broad spectrum penicillin with
antibacterial activity against certain gram negative and gram positive
organisms. It is in activated by penicillinases including those produced
by Staphylococcus aureus, E.coli, Pseudomonas, Klebsiella, and Enterobacter.6
Widely distributed at varying concentrations in
human body tissues and fluids. Very little passes into the CSF unless the
meninges are inflamed. Low binding to human plasma protein.
Half-life (adults) of 1 to 1.5 hours, which would be extended in the neonate.
Excreted mainly unchanged by the kidneys.
Possible Adverse Effects11,12
- Venous irritation, soft tissue injury at site of IV injection.
- Crystalluria – may be associated with reduced urine output
- Gastrointestinal disturbance (diarrhoea
- Hypersensitivity reactions (including urticaria, fever, joint pains,
rash, angioedema, anaphylaxis, serum sickness-like reaction (discontinue
- CNS toxicity including convulsions (with high doses or in severe renal
- May give concurrently with aminoglycoside therapy for synergistic
- Administer amoxicillin separately from aminoglycosides as simultaneous
administration may cause inactivation.
- Maintain adequate fluid intake and urinary output during administration
of high doses, to avoid crystalluria.