Amoxicillin Research Paper

Amoxicillin is an antibiotic in the penicillin class that destroys bacteria. The mechanism of action of amoxicillin involves inhibition of bacterial cell wall synthesis. Therefore, it is valuable in destroying actively growing and cell wall synthesizing bacteria. Lysis of bacteria causes a lack of bacterial cell wall leading to death. Amoxicillin is used to treat several forms of infections of the nose, ear, skin, urinary tract, or throat and other infections caused by bacteria, such as bronchitis, pneumonia, and tonsillitis. R.T. was prescribed amoxicillin to treat acute otitis media, infection of the right ear. Amoxicillin 750 mg/15 mL by oral suspension every 12 hours for 10 day. This dose is appropriate for the treatment of acute otitis
media in the pediatric patient (Lexi-Comp, 2016). History of allergies to amoxicillin or other penicillin antibiotics, including ampicillin (Omnipen, Principen), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), and penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids), contradicts the use of amoxicillin. Allergies to cephalosporins such as Ceftin, Cefzil, Keflex, and Omnicef may lead to cross-sensitivities. R.T. does not have a history of allergies to penicillin or cephalosporin antibiotics; therefore, it is presumed safe to move forward with the treatment choice of amoxicillin (Lexi-Comp, 2016). Patients with a history of allergy, asthma, hay fever, and urticaria are most likely to acquire hypersensitivity reaction. Hypersensitivity reactions are seen in at least 10% of patients including anaphylaxis, angioedema, dyspnea, edema, eosinophilia, erythema multiforme, erythematous maculopapular rash, fever, hypotension, serum sickness-like reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, and urticaria. Erythematous maculopapular rashes commonly occur in patients with infectious mononucleosis who take amoxicillin, such as R.T (Lexi-Comp, 2016). Side effects of amoxicillin may effect the gastrointestinal, renal, and nervous system.
Gastrointestinal side effects may include abdominal pain, black hairy tongue, colitis, diarrhea, generalized abdominal cramps, hemorrhagic colitis, nausea, pseudomembranous colitis (Clostridium difficile associated diarrhea), and vomiting. Renal side effects may include acute interstitial nephritis and crystalluria, which is frequently associated with eosinophilia, fever, and rash. Nervous system side effects are rare but may include agitation, anxiety, behavioral changes, confusion, convulsions, dizziness, headache, insomnia, reversible hyperactivity, and somnolence. Hematologic side effects related to penicillins may include agranulocytosis, anemia, eosinophilia, granulocytopenia, hemolytic anemia, leukopenia, and thrombocytopenia. Hematologic effects are typically reversible and are thought to be due to hypersensitivity reactions. Immunologic side effects may include mucocutaneous candidiasis and vulvovaginal mycotic infection. Moderate elevations of liver enzymes, AST (SGOT) and/or ALT (SGPT) may be elevated. Other hepatic effects may include acute cytolytic hepatitis, cholestatic jaundice, and hepatic cholestasis. Respiratory side effects may include cough and rhinorrhea. Rare side effects may include tooth discoloration, mainly in pediatric patients. Discoloration may be eliminated or reduced in most cases by brushing or dental cleaning (Lexi-Comp,
2016). R.T. is not currently taking any other medications so he is not at risk for any drug interactions at this moment. However, this patient is also expected to have mononucleosis, which has known interactions when taking amoxicillin. Interactions to be considered include pruritic erythematous maculopapular skin rash that generally occurs in patients with mononucleosis 5 to 10 days after amoxicillin treatment is started. The rash is typically self-limiting and resolves within days of stopping the treatment. Skin rash under during this occurrence does not essentially suggest a life-long reaction to these agents or other penicillin agents. Lab tests to monitor during amoxicillin thearapy include complete blood count with differential to monitor blood counts, and liver function tests to evaluate liver function (Lexi-Comp, 2016).