Abstract

CLINICAL PHARMACOLOGY OF AMOXICILLIN IN INFANTS AND CHILDREN

Gian Maria Pacifici*

ABSTRACT

Amoxicillin is an aminopenicillin, expands the spectrum of activity of penicillin G, and is bactericidal against sensitive gram-positive and gram-negative bacteria. Amoxicillin is destroyed by β-lactamases and the formulation of amoxicillin with clavulanic acid, a β-lactamase inhibitor, expands the spectrum of activity of amoxicillin against Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Proteus, and Bacillus fragilis. Amoxicillin is stable in acid and is completely and rapidly absorbed after oral administration. The administration schedules of amoxicillin have been reported in infants and children. Amoxicillin is used to treat sinusitis, salmonellosis, oral infections, community-acquired pneumonia, acute exacerbations of bronchiectasis, acute cough, acute otitis media, Lyme disease, Lyme arthritis, anthrax, listeria meningitis, enterococcal endocarditis, eradication of Helicobacter pylori, prevention of pneumococcal infections, and prophylaxis and treatment of urinary-tract infections. Amoxicillin interacts with drugs. The prophylaxis, therapeutic use, treatment, and trials with amoxicillin have been reviewed in infants and children. The penetration of amoxicillin and clavulanic acid into the cerebrospinal fluid has been reviewed and the penetration-rate of amoxicillin and clavulanic acid into the cerebrospinal fluid increases with the extent of meningeal inflammation. Amoxicillin treats bacterial meningitis, is poorly transferred across the human placenta, and poorly migrates into the breast-milk. The aim of this study is to review amoxicillin dosing, efficacy and safely, pharmacokinetics, prophylaxis, therapeutic use, treatment, and trials in infants and children, and amoxicillin metabolism, interaction with drugs, penetration into the cerebrospinal fluid, treatment of bacterial meningitis, transfer across the human placenta, and migration into the breast-milk.

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