Active Ingredient: Amoxicillin
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Investigators propose to show in a clinical trial that the outcome of children diagnosed with WHO defined fast breathing pneumonia is similar regardless of whether they receive antibiotics or not.
This study will be conducted in five primary health care centers located in low income communities of Karachi, Pakistan, with extensive trial experience. The assignment of the antibiotic amoxicillin or placebo to a child will be done using a computer generated randomization list in a manner that at the end of the trial, there are equal numbers of children in both arms of the trial.
Based on the statistical calculations for sample size, investigators need to assign 1214 children to receive amoxicillin and the same number of children to receive placebo.
All children will receive the antibiotic or placebo under supervision of the primary health care physician in the morning. The Salvage regimen High-dose dual therapy: Amoxicillin 750 mg 4 times a day or 1 gm thrice daily in combination with a proton pump inhibitor 3 to 4 times daily for 14 days Off label use in Lyme disease: Patients with early and localized disease eg, erythema migrans: 500 mg thrice daily for 14 to 21 days Patients with disseminated disease carditis and neurologic involvement without meningitis: 500 mg thrice daily for 21 days.
Prosthetic joint infection: For chronic suppression of bacterial growth in patients who are not candidates for removal of the prosthesis with infected prosthetic joints caused by beta-hemolytic streptococci, penicillin-susceptible Enterococcus spp.
Amoxicillin dose for Group A Streptococcal pharyngitis: 500 mg twice daily or 1 g once daily for 10 days AHA Extended-release: 775 mg once daily for 10 days Amoxicillin dose in Urinary tract infection: Cystitis due to Enterococcus spp.
Asymptomatic group B Streptococcus bacteriuria in pregnancy: 500 mg thrice daily or 875 mg twice daily for 3 to 7 days. Amoxicillin dose for prophylaxis of bacterial endocarditis: Prophylaxis of endocarditis should be limited to high-risk patients and those with potential adverse outcomes including: Prosthetic heart valves Patients with previous IE Patients with unrepaired cyanotic congenital heart disease Those with repaired congenital heart disease during the first six months after the procedure or with prosthetic material Repaired congenital heart disease with residual defects Heart transplant recipients with cardiac valvulopathy.
Rare case reports of cleft lip and cleft palate have been observed.
Amoxicillin use in Breastfeeding Although amoxicillin is excreted in breast milk, it is generally considered acceptable. Allergic reactions, thrush, and diarrhea due to altered bowel flora in infants must be monitored.
Patients who were younger than 14 years, immunocompromised i.
Patients who agreed to participate were categorized according to the McIsaac Modified Centor System into scores 0, 2, 3 and 4. One point was assigned to each of the following symptoms: tonsillar exudates, tender anterior cervical lymphadenopathy or lymphadenitis, absence of cough, and history of fever oral temperature greater than 38.
A colony grown on blood agar plate and chocolate agar was taken, and streaked on the nutrient agar plate.Some countries are still using oral co-trimoxazole, despite a World Health Organization community level at the community level.
A bacitracin disc, and penicillin, ampicillin, amoxicillin, amoxicillin-clavulanate, cephradine, clarithromycin and erythromycin, were then placed on the plate and were incubated for 24 hours. Based on zones of inhibition, they were graded as sensitive, intermediate or resistant.
Testing methodology was same for all patients. Prescriptions were considered inappropriate if patients received inappropriate doses or duration of first- or second-line agents, or third- line agents or antibiotics that are not recommended for pharyngitis infection.
First-line antibiotics included penicillin oral penicillin V 500 mg every 8 hours for 10 days; benzyl penicillin 0.
Appropriate alternative second-line agents included cephalexin 500 mg every 12 hours for 10 days and other first-generation cephalosporins, cefaclor 500 mg every 8 hours orally for 10 days, a second-generation cephalosporin and erythromycin for penicillin-allergic patients 250 mg p.
Third-line agents were considered inappropriate, because they are too broad-spectrum, or do not have adequate activity. Broad-spectrum agents included amoxicillin-clavulanate 500—875 mg orally every 12 hours for 10 days, second-generation macrolides such as clarithromycin 250 mg orally every 12 hours for 5 days, azithromycin 500 mg orally on day 1; 250 mg on days 2—5 for 5 days and roxithromycin 150 mg orally every 12 hours or 300 mg once daily for 10 days, broader-spectrum second-generation cephalosporins like cefuroxime 250 mg or 500 mg every 12 hours for 5—10 days and third-generation cephalosporins like cefixime 400 mg orally daily for 5 days.
Use of erythromycin for non-penicillin allergic patients was also considered inappropriate. Finally, antibiotics not recommended for Gram-negative pathogens were also considered to be inappropriate or third-line agents; these included fluoroquinolones e.