Amoxicillin

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Amoxicillin
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alberto Plate [2]

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Overview

Amoxicillin is an antibiotic that is FDA approved for the treatment of infections of the ear, nose, throat, genitourinary tract and lower respiratory tract. Also for Gonorrhea and Helicobacter infections. Common adverse reactions include rash, diarrhea, nausea, headache and vulvovaginitis.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

‡ Dosing for infections caused by less susceptible organisms should follow the recommendations for severe infections.
§ The children’s dosage is intended for individuals whose weight is less than 40 kg. Children weighing 40 kg or more should be dosed according to the adult recommendations.
π Each strength of the suspension of amoxicillin is available as a chewable tablet for use by older children.

H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence:


The recommended adult oral dose is 1 gram amoxicillin, 500 mg clarithromycin, and 30 mg lansoprazole, all given twice daily (q12h) for 14 days.

Community Acquired Pneumonia

  • In patients wit comorbidities or use of antimicrobials within the previous 3 month
    • Dosage: 875mg PO q12h OR 500mg q8h

Acute Bacterial Rhinosinusitis

  • Mild/Moderate: 500mg q12h or 250mg q8h
  • Severe: 875mg q12h or 500mg q8h

Gonorrhea, Acute uncomplicated Anogenital and Urethral Infections due to Neisseria Gonorrhoeae

  • Dosage: 3g as single oral dose

Helicobacter Pylori Infection

Infection of Skin and/or Subcutaneous Tissue

  • Mild/moderate: 500mg q12h or 250mg q8h
  • Severe: 875mg q12h or 500mg q8h

Infectious Disease of Genitourinary System

  • Mild/Moderate: 500 mg q12h or 250mg q8h
  • Severe: 875mg q8h or 500mg q8h

Lower Respiratory Tract Infection

  • Dosage: 875 mg q12h or 500 mg q8h

Tonsillitis and/or Pharyngitis

  • Dosage: 775mg once daily taken within 1 hour of finishing a meal, for 10 days.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Bacterial Endocarditis Prophylaxis

  • Dosage: 2g PO q24h [1]

Chlamydial Infection

  • Pregnant women: 500mg q8h PO for 7 days. [2]

Lyme's Disease

Non–Guideline-Supported Use

Actinomycotic Infection

  • Dosage: 500mg q8h PO (in combination with cotrimoxazole (80mg/400mg) 2 tablets q12h for 2-5 months for home regimen) [4]

Acute Infective Exacerbation of Chronic Obstructive Pulmonary Disease

  • Dosage: 1g q12h PO. [5]

Cutaneous Anthrax

  • When first-line drugs are contraindicated in the patient
    • Dosage: 1g q8h PO [6]

Periodontal infection

  • Dosage: 500mg Amoxicillin q8h in combination with metronidazole 250-400mg q8h[7]

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Otitis Media with Effusion

  • Mild/Moderate: 25 mg/kg/day in divided doses q12h or 20 mg/kg/day in divided doses q8h
  • Severe: 45 mg/kg/day in divided doses q12h or 40 mg/kg/day in divided doses q8h

Acute Bacterial Rhinosinusitis

  • Mild/Moderate: 25 mg/kg/day in divided doses q12h or 20 mg/kg/day in divided doses q8h
  • Severe: 45 mg/kg/day in divided doses q12h or 40 mg/kg/day in divided doses q8h

Gonorrhea, Acute Uncomplicated Anogenital and Urethral Infections due to Neisseria Gonorrhoeae

  • Dosage: 50 mg/kg Amoxicillin combined with 25 mg/kg Probenecid (Only in pediatric population >2 years old).

Infection of skin and/or subcutaneous tissue

  • Mild/Moderate: 25mg/kg/day in divided doses q12h or 20mg/kg/day in divided doses q8h
  • Severe: 45mg/kg/day in divided doses q12h or 40mg/kg/day in divided doses q8h

Infectious Disease of Genitourinary System

  • Mild/Moderate: 25mg/kg/day in divided doses q12h or 20mg/kg/day in divided doses q8h
  • Severe: 45mg/kg/day in divided doses q12h or 40 mg/kg/day in divided doses q8h

Lower Respiratory Tract Infection

  • Dosage: 45mg/kg/day in divided doses q12h or 40mg/kg/day in divided doses q8h

Tonsillitis and/or Pharyngitis

  • Dosage: (>12 year old) 775mg once daily taken within 1 hour of finishing a meal, for 10 days.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Lyme's Disease

Streptococcal pharyngitis

  • Dosage: 50 mg/kg once daily (Max: 1 g/day) [8]

Non–Guideline-Supported Use

Periodontal infection

  • Dosage: 500mg Amoxicillin q8h in combination with metronidazole 250-400mg q8h[7]

Post Infective Arthritis

Preterm premature rupture of membranes

  • Dosage: Ampicillin 2 g IV every 6 hours with erythromycin 250 mg every 6 hours, for 48 hours followed by amoxicillin 250 mg orally every 8 hours and erythromycin base 333 mg every 8 hours for 5 days. [10]

Contraindications

A history of allergic reaction to any of the penicillins is a contraindication.

Warnings

Hypersensitivity

  • Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients on penicillin therapy. Although anaphylaxis is more frequent following parenteral therapy, it has occurred in patients on oral penicillins. These reactions are more likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens. There have been reports of individuals with a history of penicillin hypersensitivity who have experienced severe reactions when treated with cephalosporins. Before initiating therapy with amoxicillin, careful inquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens. If an allergic reaction occurs, amoxicillin should be discontinued and appropriate therapy instituted. Serious anaphylactic reactions require immediate emergency treatment with epinephrine. Oxygen, intravenous steroids, and airway management, including intubation, should also be administered as indicated.

Clostridium Difficile Associated Diarrhea

  • Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including amoxicillin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
  • C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use.
  • Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
  • If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.

Adverse Reactions

Clinical Trials Experience

Infections and Infestations

Gastrointestinal

Hypersensitivity Reactions

NOTE: These hypersensitivity reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids. Whenever such reactions occur, amoxicillin should be discontinued unless, in the opinion of the physician, the condition being treated is life-threatening and amenable only to amoxicillin therapy.

Liver

Renal

Hemic and Lymphatic Systems

NOTE: These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena.

Central Nervous System

Miscellaneous

Combination Therapy with Clarithromycin and Lansoprazole

In clinical trials using combination therapy with amoxicillin plus clarithromycin and lansoprazole, and amoxicillin plus lansoprazole, no adverse reactions peculiar to these drug combinations were observed. Adverse reactions that have occurred have been limited to those that had been previously reported with amoxicillin, clarithromycin, or lansoprazole.

Triple Therapy for H. pylori

Amoxicillin/Clarithromycin/Lansoprazole:The most frequently reported adverse events for patients who received triple therapy were diarrhea (7%), headache (6%), and taste perversion (5%). No treatment-emergent adverse events were observed at significantly higher rates with triple therapy than with any dual therapy regimen.

Dual Therapy for H. pylori with Amoxicillin/Lansoprazole

The most frequently reported adverse events for patients who received amoxicillin three times daily plus lansoprazole three times daily dual therapy were diarrhea (8%) and headache (7%). No treatment-emergent adverse events were observed at significantly higher rates with amoxicillin three times daily plus lansoprazole three times daily dual therapy than with lansoprazole alone.

Postmarketing Experience

There is limited information regarding Amoxicillin Postmarketing Experience in the drug label.

Drug Interactions

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): B

  • Reproduction studies have been performed in mice and rats at doses up to 10 times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to amoxicillin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.


Pregnancy Category (AUS): A There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Amoxicillin in women who are pregnant.

Labor and Delivery

  • Oral ampicillin-class antibiotics are poorly absorbed during labor. Studies in guinea pigs showed that intravenous administration of ampicillin slightly decreased the uterine tone and frequency of contractions but moderately increased the height and duration of contractions. However, it is not known whether use of amoxicillin in humans during labor or delivery has immediate or delayed adverse effects on the fetus, prolongs the duration of labor, or increases the likelihood that forceps delivery or other obstetrical intervention or resuscitation of the newborn will be necessary.

Nursing Mothers

  • Penicillins have been shown to be excreted in human milk. Amoxicillin use by nursing mothers may lead to sensitization of infants. Caution should be exercised when amoxicillin is administered to a nursing woman.

Pediatric Use

  • Because of incompletely developed renal function in neonates and young infants, the elimination of amoxicillin may be delayed. Dosing of amoxicillin should be modified in pediatric patients 12 weeks or younger (≤ 3 months)

Geriatic Use

  • An analysis of clinical studies of amoxicillin was conducted to determine whether subjects aged 65 and over respond differently from younger subjects. Of the 1,811 subjects treated with capsules of amoxicillin, 85% were < 60 years old, 15% were ≥ 61 years old and 7% were ≥ 71 years old. This analysis and other reported clinical experience have not identified differences in responses between the elderly and younger patients, but a greater sensitivity of some older individuals cannot be ruled out.
  • This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

Gender

There is no FDA guidance on the use of Amoxicillin with respect to specific gender populations.

Race

There is no FDA guidance on the use of Amoxicillin with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Amoxicillin in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Amoxicillin in patients with hepatic impairment.

Females of Reproductive Potential and Males

  • Amoxicillin and potassium clavulanate was negative in the mouse micronucleus test, and in the dominant lethal assay in mice. Potassium clavulanate alone was tested in the Ames bacterial mutation assay and in the mouse micronucleus test, and was negative in each of these assays. In a multi-generation reproduction study in rats, no impairment of fertility or other adverse reproductive effects were seen at doses up to 500 mg/kg (approximately 3 times the human dose in mg/m2).

Immunocompromised Patients

There is no FDA guidance one the use of Amoxicillin in patients who are immunocompromised.

Administration and Monitoring

Administration

  • oral

Monitoring

As with any potent drug, periodic assessment of renal, hepatic, and hematopoietic function should be made during prolonged therapy. All patients with gonorrhea should have a serologic test for syphilis at the time of diagnosis. Patients treated with amoxicillin should have a follow-up serologic test for syphilis after 3 months.

IV Compatibility

There is limited information regarding the compatibility of Amoxicillin and IV administrations.

Overdosage

  • In case of overdosage, discontinue medication, treat symptomatically, and institute supportive measures as required. If the overdosage is very recent and there is no contraindication, an attempt at emesis or other means of removal of drug from the stomach may be performed. A prospective study of 51 pediatric patients at a poison-control center suggested that overdosages of less than 250 mg/kg of amoxicillin are not associated with significant clinical symptoms and do not require gastric emptying.
  • Interstitial nephritis resulting in oliguric renal failure has been reported in a small number of patients after overdosage with amoxicillin.
  • Crystalluria, in some cases leading to renal failure, has also been reported after amoxicillin overdosage in adult and pediatric patients. In case of overdosage, adequate fluid intake and diuresis should be maintained to reduce the risk of amoxicillin crystalluria.

Renal impairment appears to be reversible with cessation of drug administration. High blood levels may occur more readily in patients with impaired renal function because of decreased renal clearance of amoxicillin. Amoxicillin may be removed from circulation by hemodialysis.

Pharmacology

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Amoxicillin-3D-balls.png
Amoxicillin
Systematic (IUPAC) name
(2S,5R,6R)-6-{[(2R)-2-amino-2-(4-hydroxyphenyl)-acetyl]amino}-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-24-carboxylic acid
Identifiers
CAS number 26787-78-0
ATC code J01CA04 Template:ATCvet
PubChem 33613
DrugBank DB01060
Chemical data
Formula C16H19N3O5S 
Mol. mass 365.4 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability 95% oral
Metabolism less than 30% biotransformed in liver
Half life 61.3 minutes
Excretion renal
Therapeutic considerations
Pregnancy cat.

A(AU) B(US)

Legal status

POM(UK) -only(US)

Routes Oral, intravenous

Mechanism of Action

  • Amoxicillin is similar to ampicillin in its bactericidal action against susceptible organisms during the stage of active multiplication. It acts through the inhibition of biosynthesis of cell wall mucopeptide.

Structure

  • Chemically it is (2S,5R,6R)-6-[(R)-(-)-2- amino-2-(p-hydroxyphenyl)acetamido]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0] heptane-2-carboxylic acid trihydrate. The amoxicillin molecular formula is C16H19N3O5S•3H2O, and the molecular weight is 419.45.
Amoxicilin Structure.png

Pharmacodynamics

There is limited information regarding Amoxicillin Pharmacodynamics in the drug label.

Pharmacokinetics

  • Amoxicillin is stable in the presence of gastric acid and is rapidly absorbed after oral administration. The effect of food on the absorption of amoxicillin from amoxicillin tablets and amoxicillin suspension has been partially investigated. The 400 mg and 875 mg formulations have been studied only when administered at the start of a light meal. However, food effect studies have not been performed with the 200 mg and 500 mg formulations. Amoxicillin diffuses readily into most body tissues and fluids, with the exception of brain and spinal fluid, except when meninges are inflamed. The half-life of amoxicillin is 61.3 minutes. Most of the amoxicillin is excreted unchanged in the urine; its excretion can be delayed by concurrent administration of probenecid. In blood serum, amoxicillin is approximately 20% protein-bound.
  • Orally administered doses of 250 mg and 500 mg amoxicillin capsules result in average peak blood levels 1 to 2 hours after administration in the range of 3.5 mcg/mL to 5 mcg/mL and 5.5 mcg/mL to 7.5 mcg/mL, respectively.
  • Mean amoxicillin pharmacokinetic parameters from an open, two-part, single-dose crossover bioequivalence study in 27 adults comparing 875 mg of amoxicillin with 875 mg of amoxicillin/ clavulanate potassium showed that the 875 g tablet of amoxicillin produces an AUC0-∞ of 35.4 ±8.1 mcg•hr/mL and a Cmax of 13.8 ±4.1 mcg/mL. Dosing was at the start of a light meal following an overnight fast.
  • Orally administered doses of amoxicillin suspension, 125 mg/5 mL and 250 mg/5 mL, result in average peak blood levels 1 to 2 hours after administration in the range of 1.5 mcg/mL to 3 mcg/mL and 3.5 mcg/mL to 5 mcg/mL, respectively.

Nonclinical Toxicology

There is limited information regarding Amoxicillin Nonclinical Toxicology in the drug label.

Clinical Studies

H. Pylori Eradication to Reduce the Risk of Duodenal UlcerRecurrence

  • Randomized, double-blind clinical studies performed in the United States in patients with H. pylori and duodenal ulcer disease (defined as an active ulcer or history of an ulcer within 1 year) evaluated the efficacy of lansoprazole in combination with amoxicillin capsules and clarithromycin tablets as triple 14 day therapy, or in combination with amoxicillin capsules as dual 14 day therapy, for the eradication of H. pylori. Based on the results of these studies, the safety and efficacy of 2 different eradication regimens were established:
  • Triple Therapy: Amoxicillin 1 gram twice daily/clarithromycin 500 mg twice daily/lansoprazole 30 mg twice daily.
  • Dual Therapy: Amoxicillin 1 gram three times daily/ lansoprazole 30 mg three times daily.

All treatments were for 14 days. H. pylori eradication was defined as 2 negative tests (culture and histology) at 4 to 6 weeks following the end of treatment.

Triple therapy was shown to be more effective than all possible dual therapy combinations. Dual therapy was shown to be more effective than both monotherapies. Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

H. pylori Eradication Rates – Triple Therapy (amoxicillin/clarithromycin/lansoprazole) Percent of Patients Cured [95% Confidence Interval] (Number of Patients)

Amoxicillin CS1.png

H. pylori Eradication Rates – Dual Therapy (amoxicillin/lansoprazole) Percent of Patients Cured [95% Confidence Interval] (Number of Patients)

Amoxicillin CS2.png

How Supplied

Amoxicillin Capsules, USP

  • Each capsule contains 250 mg or 500 mg amoxicillin as the trihydrate.
250 mg Capsule
  • 250 mg yellow opaque cap and yellow opaque body, size 2, printed “RX654” on both cap and body.
    • NDC 63304-654-20 bottles of 20
    • NDC 63304-654-30 bottles of 30
    • NDC 63304-654-01 bottles of 100
    • NDC 63304-654-05 bottles of 500
    • NDC 63304-654-77 Unit-dose 100s
500 mg Capsule
  • 500 mg maroon opaque cap and yellow opaque body, size 0-el, printed “RX655” on both cap and body.
    • NDC 63304-762-82 bottles of 12
    • NDC 63304-762-20 bottles of 20
    • NDC 63304-762-01 bottles of 100
    • NDC 63304-762-13 bottles of 120
    • NDC 63304-762-05 bottles of 500

Amoxicillin Tablets, USP

Each tablet contains 500 mg or 875 mg amoxicillin as the trihydrate.

500 mg Tablet
  • 500 mg pink colored, film coated, capsule shaped tablets; debossed with “RX762” on one side and plain on the other side.
    • NDC 63304-762-82 bottles of 12
    • NDC 63304-762-20 bottles of 20
    • NDC 63304-762-01 bottles of 100
    • NDC 63304-762-13 bottles of 120
    • NDC 63304-762-05 bottles of 500
875 mg Tablet
  • 875 mg pink colored, film coated, capsule shaped tablets; debossed with “RX763” on one side and scored on reverse side.
    • NDC 63304-763-82 bottles of 12
    • NDC 63304-763-20 bottles of 20
    • NDC 63304-763-01 bottles of 100
    • NDC 63304-763-13 bottles of 120
    • NDC 63304-763-05 bottles of 500

Amoxicillin Chewable Tablets, USP

Each chewable tablet contains 125 mg, 200 mg, 250 mg or 400 mg amoxicillin as the trihydrate.

125 mg Tablet
  • 125 mg pink colored, strawberry flavored, oval biconvex tablets, with mottled appearance; debossed with “RX514” on one side.
    • NDC 63304-514-01 bottles of 100
    • NDC 63304-514-05 bottles of 500
200 mg Tablet
  • 200 mg light pink colored, strawberry flavored, circular, flat faced, beveled edge tablets, with mottled appearance; debossed with “RX760” on one side.
    • NDC 63304-760-20 bottles of 20
    • NDC 63304-760-01 bottles of 100
    • NDC 63304-760-05 bottles of 500
250 mg Tablet
  • 250 mg pink colored, strawberry flavored, circular, flat faced, beveled edge tablets, with mottled appearance; debossed with “RX515” on one side.
    • NDC 63304-515-30 bottles of 30
    • NDC 63304-515-01 bottles of 100
    • NDC 63304-515-04 bottles of 250
400 mg Tablet
  • 400 mg light pink colored, strawberry flavored, circular, flat faced, beveled edge tablets, with mottled appearance; debossed with “RX716” on one side.
    • NDC 63304-761-20 bottles of 20
    • NDC 63304-761-01 bottles of 100
    • NDC 63304-761-05 bottles of 500

Amoxicillin For Oral Suspension USP is available in

  • The 200 mg per 5 mL oral suspension is off white to light orange granular powder forming a light orange to orange suspension on constitution with water. The resulting suspension has a characteristic fruity flavor and is available as follows:
    • NDC 63304-969-03 50 mL bottles
    • NDC 63304-969-01 75 mL bottles
    • NDC 63304-969-04 100 mL bottles

The 400 mg per 5 mL oral suspension is off white to light orange granular powder forming a light orange to orange suspension* on constitution with water. The resulting suspension has a characteristic fruity flavor and is available as follows:

    • NDC 63304-970-03 50 mL bottle
    • NDC 63304-970-01 75 mL bottle
    • NDC 63304-970-04 100 mL bottle

Storage

  • SHAKE ORAL SUSPENSION WELL BEFORE USING. Keep bottle tightly closed. Any unused portion of the reconstituted suspension must be discarded after 14 days. Refrigeration preferable, but not required.
  • Store amoxicillin capsules 250 mg and 500 mg, amoxicillin tablets 500 mg and 875 mg, amoxicillin chewable tablets 125 mg, 200 mg, 250 mg and 400 mg and amoxicillin unreconstituted powder 200 mg/5 mL and 400 mg/5 mL at controlled room temperature 15° – 30° C (59° – 86° F) (see USP).

Images

Drug Images

Package and Label Display Panel

Amoxicillin Appearance.png

Patient Counseling Information

There is limited information regarding Amoxicillin Patient Counseling Information in the drug label.

Precautions with Alcohol

Alcohol-Amoxicillin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

Look-Alike Drug Names

There is limited information regarding Amoxicillin Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M; et al. (2007). "Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group.". Circulation. 116 (15): 1736–54. PMID 17446442. doi:10.1161/CIRCULATIONAHA.106.183095. 
  2. "Centers for Disease Control and Prevention: Sexually transmitted diseases treatment guidelines, 2010" (PDF). 
  3. 3.0 3.1 Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS; et al. (2006). "The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America.". Clin Infect Dis. 43 (9): 1089–134. PMID 17029130. doi:10.1086/508667. 
  4. Ramam M, Garg T, D'Souza P, Verma KK, Khaitan BK, Singh MK; et al. (2000). "A two-step schedule for the treatment of actinomycotic mycetomas.". Acta Derm Venereol. 80 (5): 378–80. PMID 11200840. 
  5. Georgopoulos A, Borek M, Ridl W, Amoxycillin Bronchitis Study Group (2001). "Randomized, double-blind, double-dummy study comparing the efficacy and safety of amoxycillin 1 g bd with amoxycillin 500 mg tds in the treatment of acute exacerbations of chronic bronchitis.". J Antimicrob Chemother. 47 (1): 67–76. PMID 11152433. 
  6. Inglesby TV, O'Toole T, Henderson DA, Bartlett JG, Ascher MS, Eitzen E; et al. (2002). "Anthrax as a biological weapon, 2002: updated recommendations for management.". JAMA. 287 (17): 2236–52. PMID 11980524. 
  7. 7.0 7.1 Sgolastra F, Gatto R, Petrucci A, Monaco A (2012). "Effectiveness of systemic amoxicillin/metronidazole as adjunctive therapy to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta-analysis.". J Periodontol. 83 (10): 1257–69. PMID 22220767. doi:10.1902/jop.2012.110625. 
  8. "Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis" (PDF). 
  9. Astrauskiene D (2003). "Efficacy of empirically prescribed amoxicillin and amoxicillin + clavulanic acid in children's reactive arthritis: a randomised trial.". Clin Exp Rheumatol. 21 (4): 515–21. PMID 12942708. 
  10. "Antibiotic Therapy for Reduction of Infant Morbidity After Preterm Premature Rupture of the Membranes". 
















































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