Amoxicillin (Amoxil®, Polymox®, Trimox®)

Section 1.1

Midwives may independently prescribe, order and administer this drug.

Penicillin antibiotics act as a broad spectrum bactericidal against many gram-positive and gram-negative microorganisms. This is achieved through the inhibition of biosynthesis of cell wall mucopeptide.

Indications and Clinical Use:

For treatment of uncomplicated asymptomatic or symptomatic urinary tract infections (UTIs) in pregnancy and the postpartum caused by Enterococcus faecalis, Escherichia coli, or Proteus mirabilis.

Contraindications:

Documented hypersensitivity or allergy to amoxicillin or to any other penicillin antibiotic.

Warnings and Precautions:

Reduces efficacy of oral contraceptives; adjust dose in renal impairment; may enhance chance of candidiasis. Prolonged use may result in fungal or bacterial superinfection, including C. difficile associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months post-antibiotic treatment.

Use with caution in asthmatic patients.

Breastfed infants may develop slightly looser stools than normal. Modification of bowel flora and allergic sensitization of the infant may occur.

Pregnancy:

Human Data Suggest Risk in 1st and 3rd Trimesters.

Lactation:

Category L1 – Compatible

Adverse Reactions:

Upset stomach, diarrhea, vomiting, vaginal infection and mild skin rash. The following should be reported to a medical practitioner immediately: severe skin rash, itching, hives, difficulty breathing or swallowing, wheezing, unusual bleeding or bruising, sore throat, painful mouth or throat sores, jaundice and diarrhea.

Dosage and Administration:

  • Asymptomatic bacteriuria (ASB):
    Amoxicillin (Amoxil®, Polymox®, Trimox®): 500 mg orally every 8 hours (tid) for 3 days
  • Acute cystitis:
    Amoxicillin (Amoxil®, Polymox®, Trimox®): 250-500 mg orally every 8 hours (tid) for 10 days

May be taken with food

Onset of Action:

Oral: Rapid; food does not interfere with absorption.

Half-life:

1-1.4 hours