FLUCAMOX CAPSULE 500MG

Indications

• Bacterial infections
• Urinary tract infections
• Sinusitis
• Uncomplicated community-acquired pneumonia
• Salmonellosis
• Oral infections
• Lyme disease (under expert supervision)
• Acute exacerbation of bronchiectasis
• Anthrax (treatment and post-exposure prophylaxis)

Dosage

Children: 1 month–11 years: 30 mg/kg 3 times a day for 21 days; children 1–4 years: 250 mg 3 times a day; children 5–11 years: 500 mg 3 times a day.

Adults: 500 mg 3 times a day; increased if necessary up to 1 g 3 times a day in severe infections.

Mechanism of action

Amoxicillin works by inhibiting bacterial cell wall synthesis, leading to cell lysis and death. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, interfering with the transpeptidation process necessary for cell wall integrity.

Pharmacodynamics

Amoxicillin exhibits bactericidal activity against susceptible bacteria. Its action is time-dependent, meaning that its effectiveness is related to the duration of time that the drug concentration remains above the minimum inhibitory concentration (MIC) for the target pathogen.

Pharmacokinetics

Amoxicillin is well absorbed from the gastrointestinal tract, with peak plasma concentrations achieved within 1-2 hours after oral administration. It is widely distributed in body tissues and fluids, and it is excreted primarily via the kidneys. The elimination half-life is approximately 1 hour, and renal impairment may necessitate dosage adjustments.

Adverse effects

• Skin rash
• Gastrointestinal disturbances (nausea, vomiting, diarrhea)
• Allergic reactions (including anaphylaxis)
• Superinfection (due to resistant organisms)

Interactions

• Allopurinol (increases risk of skin rash)

Precautions

• History of penicillin allergy
• Renal impairment (reduce dose)
• Use with caution in patients with mononucleosis

Pregnancy

Use only if clearly needed; no adequate studies in pregnant women.

Breast-feeding

Amoxicillin is excreted in breast milk; use with caution.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Phenoxymethylpenicillin 250mg/5ml oral solution
• Phenoxymethylpenicillin 250 mg tablets

Indications

• Bacterial infections
• Respiratory tract infections
• Skin infections
• Urinary tract infections
• Otitis media
• Sinusitis

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines based on age and weight.

Adults: Refer to the BNF for specific dosing recommendations based on the type and severity of infection.

Mechanism of action

Flucamox works by binding to penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding inhibits the transpeptidation enzyme, which is crucial for cross-linking peptidoglycan layers in bacterial cell walls, leading to cell lysis and death, particularly in actively dividing bacteria.

Pharmacodynamics

Flucamox exhibits time-dependent bactericidal activity, meaning its efficacy is related to the duration of time that the drug concentration remains above the minimum inhibitory concentration (MIC) for the target bacteria. It is generally effective against a range of infections, including respiratory tract infections, urinary tract infections, and skin infections caused by susceptible organisms.

Pharmacokinetics

Flucamox is well absorbed orally and reaches peak plasma concentrations within 1-2 hours. It has a volume of distribution indicating widespread distribution in body tissues. The drug is metabolized in the liver to a lesser extent and is primarily excreted unchanged in the urine. The half-life is approximately 1-2 hours, necessitating multiple doses throughout the day for optimal therapeutic effect.

Contra-indications

• Hypersensitivity to amoxicillin, flucloxacillin, or any of the excipients
• History of jaundice or hepatic impairment due to flucloxacillin
• Severe renal impairment

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Rash
• Anaphylaxis
• Hepatic dysfunction
• Clostridium difficile-associated diarrhea
• Renal impairment

Interactions

• Probenecid may increase levels of amoxicillin
• Anticoagulants may have enhanced effects when administered with amoxicillin
• Methotrexate clearance may be decreased
• Allopurinol may increase the risk of skin rashes when given with amoxicillin

Precautions

• Use with caution in patients with a history of allergic reactions to penicillins or cephalosporins
• Monitor for signs of hepatic and renal dysfunction
• Caution in patients with asthma
• Consider alternative therapy in severe infections due to potential for resistance

Pregnancy

Flucloxacillin is generally considered safe to use during pregnancy, but should be used only if clearly needed.

Breast-feeding

Flucloxacillin is excreted in breast milk, but is not expected to harm a nursing infant. Monitor for potential effects.

Storage

Store below 25°C. Protect from light. Discard any unused solution after 14 days.

Formulations

• Capsules
• Oral suspension
• Injection

Mechanism of action

Amoxicillin competitively inhibits penicillin-binding protein 1 and other high molecular weight penicillin binding proteins. Penicillin bind proteins are responsible for glycosyltransferase and transpeptidase reactions that lead to cross-linking of D-alanine and D-aspartic acid in bacterial cell walls. Without the action of penicillin binding proteins, bacteria upregulate autolytic enzymes and are unable to build and repair the cell wall, leading to bacteriocidal action. The penicillins and their metabolites are potent immunogens because of their ability to combine with proteins and act as haptens for acute antibody-mediated reactions. The most frequent (about 95 percent) or "major" determinant of penicillin allergy is the penicilloyl determinant produced by opening the beta-lactam ring of the penicillin. This allows linkage of the penicillin to protein at the amide group. "Minor" determinants (less frequent) are the other metabolites formed, including native penicillin and penicilloic acids. /Penicillins/ Amoxicillin is similar to penicillin in its bactericidal action against susceptible bacteria during the stage of active multiplication. It acts through the inhibition of cell wall biosynthesis that leads to the death of the bacteria.

Pharmacodynamics

Amoxicillin competitively inhibit penicillin binding proteins, leading to upregulation of autolytic enzymes and inhibition of cell wall synthesis. Amoxicillin has a long duration of action as it is usually given twice daily. Amoxicillin has a wide therapeutic range as mild overdoses are not associated with significant toxicity. Patients should be counselled regarding the risk of anaphylaxis, _Clostridium difficile_ infections, and bacterial resistance.