Amoxicillin for Armageddon

Last week we covered penicillin.  This week's focus is another member of the penicillin family, amoxicillin.  It's a newer version of ampicillin that is effective against Gram-positive and Gram-negative bacteria, making it an intermediate-spectrum antibiotic.  It is very well absorbed, much better than penicillin, and well-tolerated with fewer side effects.

Amoxicillin is another relatively inexpensive antibiotic.  If you can't get it through your family physician, overseas pharmacies are an option (or they were).  Barring that, the veterinary equivalent can be purchased at some feed and ranch stores, often under the names Fish-Mox (250 mg) and Fish-Mox Forte (500 mg). 

When treating various bacterial infections with amoxicillin, physicians will prescribe along the lines of the following:

• upper respiratory infections:
• bacterial bronchitis, 500 mg, 3 times per day, at least 5 days, or until no fever for 2-3 days
• bacterial pneumonia, 500 mg-1000 mg, 3 times per day, at least 5 days, or until no fever for 2-3 days
• sinusitis, 250-500 mg, 3 times per day, 5-7 days
• strep throat, 1000 mg, once per day, or 500 mg twice per day, for 10 days
• ear infection
• adults, 500 mg, 3 times per day, 5-7 days
• children 25-90 mg/kg/day, in two divided doses, for 7-10 days  (there's a pretty wide range among doctors in what they recommend for children)
• skin:
• cutaneous anthrax, 1000 mg, 3 times per day, 60 days
• cellulitis, 250-500 mg, 3 times per day, 7-10 days
• mastitis, 500 mg, 3 times per day, 10-14 days
• dog bites, 500 mg, 3 times day (2nd line), 3-5 days prophylaxis or 7-10 days treatment
• digestive
• Helicoacter pylori, 1000 mg, twice per day, 7-10 days
• urogenital
• gonorrhea, 3 grams, in a single dose
• chlamydia, 500 mg, 3 times per day, 7 days
• bladder or kidney infections, including cystitis, 500 mg, 2-3 times per day, 7 days
• for cystitis, it's safe to stop taking the antibiotics two days after symptoms are gone.
• Lyme disease, 500 mg, 3 times per day, 14-28 days
• other bacterial tick-borne diseases, 500 mg, 3 times per day, 14 days
• typhoid fever,  for patients 12 years of age and older, 75-100 mg/kg per day for 14 days
• dental abscess

Amoxicillin may be taken with or without food.  Common side effects include upset stomach, diarrhea, headache, and dizziness.  As amoxicillin is in the penicillin family, it is not administered to individuals allergic to penicillin.  Amoxicillin is safe for use during pregnancy and breastfeeding but is excreted into breast milk.  Infants of nursing mothers may develop thrush as a result.

Alternatives for those allergic to penicillin-family antibiotics include the following:

• azithromycin
• ciprofloxacin
• clindamycin
• doxycycline 
• erythromycin
• metronidazole
• minocycline
• sulfa drugs
• tetracycline 

Links to related posts:
Allergic to Penicillin?  What Are the Options? 
Usnea
Doxycycline
Penicillin
Antibiotic Chart to Guide Acquisition
Expired Medications
Ear Infections 

For further reading:  

Armageddon Medicine 
Alton's Antibiotics, p 150 
Survival and Austere Medicine, 3rd Edition, p 210

 25 february 2020