Infectious Disease Book

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AminopenicillinsAka: Ampicillin, Amoxicillin, Augmentin, Unasyn

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  1. See Also
    1. Penicillin
  2. Preparations: Amoxicillin and Ampicillin
    1. Ampicillin
      1. Child: 50-200 mg/kg/day IV divided qid
    2. Amoxicillin
      1. Maximum dose: Maximum dose: 3-4 grams/day
      2. Adult: 875 to 1000 mg orally twice daily
      3. Child
        1. Low dose: 45 mg/kg/day divided twice daily
        2. High dose: 90 mg/kg/day divided twice daily
  3. Preparations: Added Beta-lactamase resistance
    1. Ampicillin Sulbactam (Unasyn)
      1. Adult: 1.5-3 grams IV every 6 hours
    2. Amoxicillin Clavulanate (Augmentin)
      1. Adult: 875 mg PO bid
      2. Child: 45 mg/kg/day divided PO bid
  4. Mechanism
    1. Same as for Natural Penicillins
    2. Penetrates outer membrane of some Gram Negatives
    3. Clavulanic acid and sulbactam bind Beta-lactamases
  5. Pharmacokinetics
    1. Keep Augmentin suspension refrigerated
    2. Clavulanate suspension breaks down at room temperature
      1. Turns brown with breakdown
      2. Loses 90% of potency after 2 days at room temperature
  6. Pathophysiology: Bacterial Resistance Mechanisms Overcome
    1. Beta-lactamase Production
    2. Alteration of Penicillin binding protein
  7. Activity Spectrum
    1. General
      1. Gram Positive Cocci
      2. Gram Negative Rods
      3. Spirochetes (e.g. Treponema pallidum)
    2. Conditions
      1. Otitis Media
      2. Sinusitis
      3. CNS Infection
      4. Urinary Tract Infection
      5. Infectious Enteritis
      6. Borrelia Burgdorferi (Lyme Disease)
      7. Helicobacter Pylori
  8. Adverse effects
    1. Similar to Natural Penicillins
    2. Maculopapular rash
    3. Diarrhea (modifications can decrease stools to 12%)
      1. Dose exactly by kilogram for children
      2. Avoid food before dose
      3. Consider eating yogurt with each dose

Amoxicillin (C0002645)

Definition (MSH)A broad-spectrum semisynthetic antibiotic similar to AMPICILLIN except that its resistance to gastric acid permits higher serum levels with oral administration.
Definition (NCI)An antibiotic drug used to treat infection. It belongs to the family of drugs called penicillins or penicillin derivatives.
Definition (PDQ)A broad-spectrum, semisynthetic aminopenicillin antibiotic with bactericidal activity. Amoxicillin binds to and inactivates penicillin-binding protein (PBP) 1A located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42310&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42310&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C237" NCI Thesaurus)
Definition (NCI)A broad-spectrum, semisynthetic aminopenicillin antibiotic with bactericidal activity. Amoxicillin binds to and inactivates penicillin-binding protein (PBP) 1A located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishAMOX, Amoxicillin, AMOXICILLIN PREPARATION, Amoxicillin product, Amoxicilline, Amoxycillin, Amoxycillin product, Hydroxyampicillin
Spanishamoxicilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Ampicillin (C0002680)

Definition (MSH)Semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic.
Definition (CSP)semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic.
Definition (NCI)A broad-spectrum, semi-synthetic, beta-lactam penicillin antibiotic with bactericidal activity. Ampicillin binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis. Ampicillin is stable against hydrolysis by a variety of beta-lactamases, therefore, can be used in wide range of gram-positive and -negative infections.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishAminobenzyl Penicillin, Aminobenzylpenicillin, Ampicillin, AMPICILLIN PREPARATION
Spanishaminobenzilpenicilina, ampicilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Unasyn (C0147814)

ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishUnasyn
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Augmentin (C0591132)

ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishAugmentin
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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