Amoxicillin for cystitis

No matter how wary we are of antibiotics, it is often only with their help that we can overcome inflammatory processes in the body caused by various infections. The pharmaceutical industry produces many antibacterial drugs, and amoxicillin is considered one of the most effective. Can it be used for cystitis and will it help overcome inflammation of the bladder mucosa?

Indications Amoxicillin for cystitis.

Amoxicillin is aimed at infections, the bacteria of which are destroyed under the influence of the active substance. The indications for its use are the following pathologies affecting:

• urinary and genital organs (urethritis, cystitis, pyelonephritis, prostatitis, gonorrhea, etc.);
• lower respiratory tract (bronchitis, pneumonia);
• upper (tonsillitis, pharyngitis, sinusitis, otitis);
• ducts that transport bile (cholangitis, cholecystitis);
• joints;
• bones;
• epidermis, soft tissues.

Amoxicillin is FDA-approved for the treatment of urinary tract infections, ear, nose, and throat infections, lower respiratory tract infections, Helicobacter pylori infections, pharyngitis, tonsillitis, and skin and skin structure infections. It is recommended as a first-line treatment by the Infectious Diseases Society of America (IDSA), for the treatment of acute bacterial rhinosinusitis, and as one treatment for community-acquired pneumonia.[ 1 ]

Release form

The drug is produced in:

• granules that are converted into a liquid consistency;
• tablets;
• capsules.

The last two types of medicine have a dosage of 250 and 500 mg of the active substance. To obtain 5 ml of suspension, 250 mg of amoxicillin and auxiliary components are used, including sucrose, fruit and berry flavors.

Depending on the manufacturer, the drug has other trade names, but one active substance - amoxicillin. Among them: amotit, amokson, amoksikar, gonoform, kuksacillin, ranoxil, hikoncil, flemoxin.

Pharmacodynamics

This antibacterial agent belongs to the semi-synthetic antibiotics of the penicillin class of a wide spectrum of action, when chemical methods are used to construct a drug molecule based on a bacterial strain. It covers both gram-positive and gram-negative aerobic microorganisms (Listeria monocytogenes and Enterococcus, Haemophilus influenzae, some Escherichia coli, Actinomyces, Clostridial, Salmonella, Shigella and Corynebacteria). It kills some enzymes present in bacterial cells, without which they die. [ 2 ]

Due to the presence of hydroxyls, the drug has high bioavailability when taken orally and is resistant to the action of gastric juice.

Pharmacokinetics

Amoxicillin is easily absorbed when taken orally, reaching maximum concentration in the blood after 1-2 hours. It is practically not converted in the liver. It is excreted from the body mainly with urine, partly through the liver.

Dosing and administration

How to take amoxicillin for cystitis?

Women are much more likely than men to suffer from urological pathologies, especially cystitis. This is explained by the anatomical structure of their urethra: it is shorter and wider than the male one, and is also located in close proximity to the vagina and anus, which increases the risk of infection.

Amoxicillin is used to treat women with acute and chronic inflammation of the bladder.

Currently, urinary tract infections (UTIs) such as cystitis are treated with either a short three-day course of antibiotics or a longer course (five days or more). Research has shown that three days of treatment is usually sufficient to relieve symptoms in women with uncomplicated cystitis. Long-term antibiotic use did not improve symptom relief and resulted in side effects such as gastrointestinal problems or rash. When deciding which antibiotics to take, women and men should consider what is more important to them: preventing the return of cystitis or avoiding side effects. Patients who want to be absolutely sure that the infection has cleared up may prefer to use antibiotics that are taken for five or more days. Patients who prefer to avoid side effects may choose a three-day treatment instead. [ 7 ]

The dosage and duration of the course of treatment is determined by the doctor individually (on average, it is 5-14 days). The instructions for solid forms of the drug recommend it according to the following scheme: children from 5 to 10 years old, 250 mg three times a day; older people and adults - 500 mg.

Application for children

Amoxicillin can be prescribed to children, but with reservations and a special dosage that takes into account their age. Thus, tablets can be taken from 6 years old, the suspension is suitable for babies from birth, and capsules are intended only from 5 years old due to their rapid absorption.

The suspension is prepared by adding purified water to a bottle with granulated powder up to the mark on it. Children under 2 years old (body weight does not exceed 10 kg) are given half a measuring spoon, 2-5 years (10-20 kg) - 0.5-1 l., 5-10 years - 1-2 l., adults two full 3 times a day.

Use Amoxicillin for cystitis. during pregnancy

The U.S. Food and Drug Administration (FDA) designates amoxicillin pregnancy category B (animal reproduction studies have not shown a risk to the fetus, and there are no adequate and well-controlled studies in pregnant women). Use of amoxicillin in early pregnancy may be associated with an increased risk of oral clefting.[ 3 ]

During pregnancy, it is best to avoid taking amoxicillin, as well as any other antibiotics, because it penetrates the placental barrier and can harm the fetus. If, however, it cannot be avoided in the event of a real threat to health, then the justification for this is the priority of the woman's life.

Limited information indicates that amoxicillin is excreted in breast milk at low levels that are not expected to cause adverse effects in breastfed infants. Rashes and disturbances in the infant's gastrointestinal flora, resulting in diarrhea or thrush, have occasionally been reported, but these effects have not been adequately evaluated. Amoxicillin is acceptable for nursing mothers.

Following a single 1 gram oral dose of amoxicillin in 6 women, peak amoxicillin levels in milk occurred 4 to 5 hours after dosing. Mean milk levels were 0.69 mg/L (range 0.46 to 0.88 mg/L) at 4 hours and 0.81 mg/L (range 0.39 to 1.3 mg/L) at 5 hours after dosing.[ 4 ] Using these data, an exclusively breastfed infant would be expected to receive a maximum daily dose of amoxicillin of approximately 0.1 mg/kg based on a 500 mg three times daily dose for the mother. This represents 0.25 to 0.5% of the usual pediatric amoxicillin dose.[ 5 ]

Contraindications

Amoxicillin is contraindicated in case of allergy to antibiotics (penicillins and cephalosporins), diseases such as lymphocytic leukemia and infectious mononucleosis. There are age restrictions, which have already been mentioned, as well as for pregnant and lactating women.

Side effects Amoxicillin for cystitis.

Side effects caused by taking the drug may include allergic reactions: skin rashes, urticaria, itching; nausea, diarrhea, colitis, increased liver function tests, reversible changes in blood count, headaches, sleep disorders. The suspension contains sucrose and may cause a jump in blood glucose.

Another important complication to be aware of is hypersensitivity reactions. Amoxicillin can cause type I, II, III, or IV reactions. It is important to differentiate between a type I and type IV hypersensitivity reaction, as one may be more dangerous than the other. A type I reaction is an IgE-mediated hypersensitivity in a sensitized patient that causes widespread histamine release, leading to a urticaria-like itchy rash or even more severe systemic symptoms such as anaphylaxis. A type IV hypersensitivity reaction is not mediated by histamine release, is more papular or morbilliform in nature, and is often not itchy. Experts suggest that almost all patients who inadvertently receive amoxicillin for infectious mononucleosis develop a maculopapular rash caused by a type IV-mediated hypersensitivity reaction.

How to cope with side effects? What to do if:

• feeling nauseous - stick to simple meals and avoid fatty or spicy foods. Take amoxicillin after meals.
• diarrhea - drink plenty of fluids to avoid dehydration. Signs of dehydration include little urination. Do not take any other medications to treat diarrhea without talking to your pharmacist or doctor. [ 6 ]

Overdose

Overdose causes symptoms typical of poisoning. To relieve them, it is advisable to wash out the stomach and take activated charcoal.

Interactions with other drugs

Concomitant administration of amoxicillin with antacids reduces its absorption, with allopurinol (anti-gout agent) increases the risk of allergic reactions, probenecid (same action) increases its concentration in the blood.

The drug is not prescribed together with tetracycline and chloramphenicol, antibiotics with a complex cyclic structure, since they reduce its effectiveness.

Amoxicillin can increase bleeding time when treated with anticoagulants, which slow blood clotting and prevent blood clots.

Storage conditions

The drug is stored at a temperature not exceeding +25ºС, in a dark place, out of reach of children.

Shelf life

Tablets and capsules are good for 4 years, granules - 3. The finished suspension should be used within 2 weeks.

Analogues

The following drugs are analogs of amoxicillin: amoxil DT, amofax, B-mox, graximol, osmapox, flemoxin solutab, ampiox, ampicillin.

Recent studies have shown that a three-day regimen of amoxicillin-clavulanate is not as effective as ciprofloxacin in treating acute uncomplicated cystitis even in women infected with susceptible strains. This difference may be due to the low ability of amoxicillin-clavulanate to kill vaginal E. coli, promoting early reinfection.[ 8 ]

Reviews

The drug is very safe, but it is always important to get a proper allergy history before prescribing the drug. [ 9 ], [ 10 ] The drug has mostly positive reviews. Its effectiveness in treating cystitis and other urological problems, and its affordable price are noted. Among the disadvantages are the occurrence of side effects, sometimes allergies, sometimes dysbacteriosis, but all antibiotics are guilty of this. To avoid negative effects on the digestive tract, it is recommended to take probiotics.