Amoxiclav for angina: instructions for use

Among the infectious diseases of the respiratory system, angina occupies a special position, because who would have thought that the inflammatory process in the pharynx region could knock down not only the child, but also the adult. In addition, this pathology, which usually proceeds against a background of very high temperatures, can cause many complications to other vital organs. Do not treat such a disease is more expensive. But to cope with the infection definitively and irrevocably without antibiotic therapy is indispensable. And although many antibiotics are effective against the most popular pathogens, the drug "Amoxiclav" in angina doctors appoint more often than other medications.

It would seem that there are many antimicrobial agents that are perhaps even safer than penicillins, which cause severe reactions of intolerance. Why do doctors tend specifically to the drug penicillin series, and how this drug differs from other popular penicillins.

Angina and effective antibiotics

Acquaintance with tonsillitis in most of us begins in childhood, when for a few days because of the high temperature, we must observe the hated bed rest regime, constantly gargle, suffer with food intake, when, due to pain in the throat, there is not a piece there , ingest mouth-watering syrups and tasteless pills. And these most insipid tablets were most often antibiotics.

Later, in adulthood, angina became the cause of hospital, especially in the autumn-winter period. And again, the bed, hot tea, rinses, compresses, inhalations, antipyretics and all the same antibiotics. But do they really have such a need, if angina occurs against the background of hypothermia and the use of cold drinks?

At first glance it seems that such a disease can be cured without the help of strong drugs. Enough heat on the throat area, tea with raspberries, salt rinses. And in some cases this method works. Yes, only such treatment is not always effective. But why the same disease has to be treated by different methods?

The reason is that the causative agents of the disease can be both bacteria and viruses. And hypothermia of the legs, throat, or the entire body is only a provocative factor for the activation of pathogens, which use the fact that a small malfunction has occurred in the work of the immune system.

In viral pathologies, there is no need to use potent agents. Doctors will prescribe antipyretic drugs and stimulants of immunity. The body itself can overcome the viral infection with the help of antibodies produced by it.

With bacterial infections, only an organism that has high immunity can cope, but in this case a person would not get sick at all. And if there are symptoms of angina, it means that such a struggle is beyond the strength of the body and he needs help from the outside.

But who can deal with bacteria better than antimicrobial drugs called antibiotics? That's why doctors have to prescribe antibiotic-effective antibiotics, which have a wide range of actions, which help to start the fight against pathogens even before their appearance is determined. In the vast majority of cases, the first prescribed antibiotic is sufficient to kill the infection.

Based on the spectrum of pathogens of angina, doctors determined that the antibiotics of the penicillin and cephalosporin series are quite capable of coping with any of them. If a person has an individual intolerance to these antibacterial agents, they resort to the help of macrolides, which are somewhat weaker in that they have not bactericidal but bacteriostatic action. But even this action would be enough, if the bacteria were not such "opportunists".

Yes, they can be called that way, after all, adapting to unfavorable conditions, they struggle for survival through a variety of mutations that make whole subgroups (strains) of pathogenic microorganisms resistant to antibiotics. So it happened with penicillins, which are considered quite safe for our body drugs, if not for the relatively frequent severe manifestations of intolerance. Some strains of bacteria have learned to produce an enzyme penicillinase (aka beta-lactamase), which deactivates the antibiotic. Thus, previously effective in angina penicillin, ampicillin, amoxicillin became simply useless.

But science does not stand still, every year more and more new drugs are being developed to combat bacterial infection. Just why develop a new one, if you can improve the old, but effective. So the usual penicillin drugs, most effective against the main pathogens of angina (hemolytic and golden staphylococcus, streptococcus, pneumococcus and other pathogens), came protected penicillins.

These drugs are nothing more than a combination of "old" proven semi-synthetic penicillins (most often amoxicillin) and specific components (eg, clavuonic acid) that make penicillins resistant to bacterial enzymes. It was on the basis of these two components (amoxicillin and clavuonic acid) that Amoxiclav was developed, which is quite actively used in angina, because it is effective even against those strains of bacteria that did not respond to the usual penicillins, the same amoxicillin.

[1], [2], [3], [4], [5], [6]

Indications of the amoxiclav in case of angina

So, we figured out that "Amoxiclav" is a vivid representative of protected penicillins. The spectrum of action of these drugs is truly unique, since there are very few microorganisms resistant to them, and even then they are unlikely to provoke the development of angina.

Thanks to a wide range of actions, penicillins resistant to beta-lactamase, and in particular Amoxiclav, are successfully used in the treatment of various infectious and inflammatory pathologies of ENT organs, respiratory and genitourinary systems, infectious lesions of the skin, subcutaneous tissue, muscles, tendons, cartilage and bones . When it comes to inflammatory diseases of the ENT organs, one can not fail to mention the effectiveness of "Amoxiclave" in the treatment of various forms of angina.

Yes, angina is not only viral or bacterial, it can still leak in various forms: catarrhal, lacunar, follicular or purulent. It must be said that in case of viral sore throat, "Amoxiclav", like other antibacterial drugs, will prove ineffective even because it is simply impossible to defeat viruses with weapons against bacteria. After all, these are completely different forms of life. In addition, viruses are considered non-cellular structures that parasitize within the host cell. So in this case, destroy the antibiotic?

Moreover, such an incorrect treatment can only exacerbate the disease if its pathogen is a virus. Helping the body to fight with a bacterial infection, antibiotics, however, do not know how to act strictly selectively. Killing pathogenic bacteria, in parallel they conduct a "sweep" of the body and a useful microflora, which provides us with natural immunity. And viruses at this time in conditions of reduced immunity begin to multiply more actively, aggravating the patient's condition and complicating the course of the disease.

But with bacterial pathologies with antibiotics, few will compare. "Amoxiclav" in angina in most cases becomes the main drug that helps and reduce temperature (and it keeps with inflammation of the throat very tightly), and the symptoms of the disease eliminate.

Catarrhal angina is one of the most mild forms of the disease that occurs against a background of reduced immunity. It can be caused by both viruses and bacteria that have settled in the pharynx and upper respiratory tract. Moreover, in most cases, these bacteria are a conditionally pathogenic microflora, which actively multiplies only when the defenses of the organism decrease.

Fighting opportunistic microflora is meaningful only when it begins excessive activity. And this is exactly the case. Therefore, "Amoxiclav" doctors can prescribe even with catarrhal angina, despite the fact that it is an easy form of the disease.

The antibiotic in this case helps quickly to remove unpleasant symptoms of the disease and does not allow the infection to go deep into the body. Provoking there new inflammatory processes. And this is quite possible, considering that the same bacterium can provoke diseases of completely different, practically unrelated organs (in fact, everything is interconnected in our organism, it is a multicomponent integrated system).

The decision on whether to take antibiotics in catarrhal angina is taken by the doctor, based on the symptoms of the disease and the patient's condition.

Lacunar angina is also a common form of throat disease. The process can be localized both on the surface of the tonsils (then the throat in the upper sky, the tongue and tonsils seems rich pink or red), and deeper in the throat, when even the back wall of the pharynx reddens. The cause of the disease can be both already existing in the body bacteria, and those that penetrated into it from the outside.

In principle, for the delay of bacterial infection, we have adenoids, which also inflame with angina. But inflamed adenoids tend to expand and they are often removed even in younger children. Worst of all, if in childhood, along with adenoids, the child was also removed tonsils. In this case, bacteria quickly spread through the respiratory tract, reaching the lungs and causing a dangerous complication in the form of pneumonia (pneumonia).

Without antibiotics, the treatment of lacunar angina will be ineffective, the ved even after the disappearance of the symptoms of the underlying disease, the bacterial infection will not disappear, but only lurks for a time under the pressure of protective cells produced by the immune system. And it's only worth the immunity to decrease at least a little bit, the bacteria again rush into the battle, provoking various pathologies already inside the body, including repeated episodes of angina, fraught with rheumatic complications.

Assigning "Amoxiclav" in lacunar angina doctors try not only to cure the disease more quickly, but also to prevent possible dangerous complications. Treatment with antibiotics in this case begins with the first days of the disease, supplementing it with the intake of antihistamines and immunostimulants in the form of vitamin complexes.

Purulent form of sore throat is not an isolated disease, but a complication of catarrhal or lacunar pathology, if they are not treated or inadequately treated. In principle, this development of events is often observed when catarrhal tonsillitis due to a mild course is attempted to treat without antibiotics. The most frequent causative agent of the disease is Staphylococcus aureus, which simply waits for the right time to begin to multiply.

The transition to a purulent form can indicate a strong increase in temperature, great difficulties with swallowing and eating food, the appearance of whitish pustules on the surface of bright red tonsils. In most cases, the disease proceeds with an increase in the lymph nodes at the bottom of the lower jaw, which in itself is already a danger, because with the flow of lymph infection can spread throughout the body much faster and further than through the respiratory tract.

With purulent angina, penicillins and cephaloporins are considered particularly effective. However, in cephalosporins, the majority of drugs effective against Staphylococcus aureus and other representatives of pathogenic microflora are for injection, which requires certain skills or visits to a health facility. It is easier in purulent angina to use oral preparations such as "Amoxiclav", especially if the pathology is not treated in a hospital.

By the way, such treatment solves simultaneously and a problem of the increased lymphonoduses.

One of the varieties of purulent pathology is follicular angina, in which there is an increase and suppuration of the follicles of the tonsils. Purulent follicles look like round pustules filled with a white or turbid yellow liquid. The pustules subsequently open themselves on their own, forming a whitish coating on the tonsils.

The causative agent of the disease in this case usually become streptococci and pneumococci, although it is impossible to exclude the contribution to the purulent process of other bacterial factors. Actively multiplying and allocating the products of life, bacteria become a source of toxic substances that cause poisoning of the body, and then symptoms of intoxication are associated with intoxication (headaches, weakness, nausea, disruption of internal organs, etc.).

Antibiotics, and in particular "Amoxiclav" in follicular angina, help actively fight infection, which leads to a decrease in its "livestock", and hence the concentration of toxic substances in the body gradually decreases, preventing a negative impact on human organs and systems.

As you can see, the antimicrobial drug "Amoxiclav" is not for nothing so loved by doctors, because it helps with any forms of bacterial sore throat. And its effect is visible even where other penicillins do not show good efficacy.

[7], [8], [9]

Release form

"Amoxiclav" is considered a combined drug, because it contains two complementary active substances. It is clear that the main effect (antibacterial) provides yet an antibiotic amoxicillin, but without the help of clavuonic acid, it could not overcome an infection that is capable of producing protective enzymes.

Excipients depend on the form of release of the drug, but there are quite a few of them. There are several varieties of tablets in the name "Amoxiclav":

• Amoxiclav 375 mg (250/125 mg - where the first figure denotes the dosage of amoxicillin, the second - the content of a tablet of clavuonic acid)
• Amoxiclav 2X 625 mg (or 500/125 mg)
• Amoxiclav 2X 1000 mg (or 825/125 mg)
• Tablets dispersible Amoxiclav Quiktab 625 mg (or 500/125 mg)
• Tablets dispersible Amoxiclav Quiktab 1000 mg (or 875/125 mg)

As you can see, "Amoxiclav" in tablets, which can be used for angina in hospital and at home, can differ in the dosage of amoxicillin (and the composition of excipients), while the content of clavuonic acid in them remains constant. It should be said that "Amoxiclav" 250/125 mg and 500/125 mg, are interchangeable. Those. Instead of a tablet containing 500 mg of amoxicillin, you can take 2 tablets of 250 mg, and it does not matter that the content of clavuonic acid in this case will be 2 times greater. For the body, this is not dangerous, the main thing is that the daily dose of clavuonic acid does not exceed 600 mg.

Tablets "Amoxiclav 2X" with increased dosage have a protective coating. They include flavors with a taste of tropical fruits and citrus fruits.

"Amoksiklav Quiktab" - these are not ordinary tablets, which need to be swallowed whole and washed down with water. This is a resorption tablet with a tropical flavor. They dissolve in the oral cavity, and therefore suitable for those patients who have difficulty in swallowing tablets.

In addition to the tablets "Amoxiclav" with angina, a suspension is used for internal use, which is treated for children older than 2 months and adults. It is produced in the form of a crystalline powder with a slightly yellowish tinge in a 100 ml glass vial. To prepare the suspension, the vial is shaken, opened, water is added to it to a special mark, closed and shaken well. For accurate dosing, a pipette with a piston is added to the preparation, the fission rate of which is 0.1 ml.

The suspension can have 2 dosages: 156.25 mg / 5 ml and 312.5 mg / 5 ml (Amoxiclav forte). In the first case, it can be understood that 5 ml of the suspension contains 125 mg of amoxicillin and 31, 25 mg of clavuonic acid, in the second case, a ratio of 250 to 62.5 mg.

There is a preparation "Amoxiclav" and such form of release, as a powder for intravenous infusions in 2 dosages: 600 (500/100) and 1000 (800/200) mg. The powder is used to prepare an infusion solution. It is a solution that is injected into the body through the system. In this case, water for injection is used as the solvent.

[10], [11], [12], [13]

Pharmacodynamics

If you carefully look at the composition of the drug "Amoxiclave" says its very name, which consists of two parts. The first part is the abbreviation for "amoxicillin", the second part - 4 letters of the word "clavuon". Now the strange name of the drug does not seem so. But the strength of the drug is not in the name, but in the action.

Amoxicillin is an antibiotic with a wide spectrum of antimicrobial activity. This is one of the most commonly used semi-synthetic penicillins, which have a pronounced bactericidal effect. Its activity extends to many types of streptococcal, staphylococcal and enterococcal infections, including pneumococci. The drug can be successfully used to combat pathologies caused by Escherichia coli, proteus, clostridia, Klebsiella, Helicobacter pylori and many other pathogenic bacteria.

Alas, amoxicillin can not cope with bacteria that produce a special enzyme against penicillins, which destroys the antimicrobial agents of the penicillin as well as the cephalosporin series. To help him comes clavuonic acid, which forms stable compounds with beta-lactamase bacteria, which can not harm the antibacterial component of the drug. Particularly worthy of note are such compounds with plasmid beta-lactamases, with which cross-linked antibiotic resistance is associated.

[14], [15], [16]

Pharmacokinetics

The drug shows good activity also due to the fact that it penetrates well and quickly into the blood with various methods of administration. The possibility of oral administration of the drug is due to the fact that both components of the drug dissolve well in water at various pH values in the stomach and in the body. They are not destroyed in the acidic environment of the gastrointestinal tract, which is typical for many natural penicillins and antibiotics of the cephalosporin series. It is possible to take the drug both at the beginning of the meal, and during meals, which practically does not affect its absorption and effectiveness.

The maximum content of active substance in the blood plasma and body fluids is reached after an hour after taking the medication. The components of the drug are able to accumulate in the lesions. With angina such is the mucosa of the upper respiratory tract, where the active struggle of the preparation "Amoxiclav" with bacterial infection takes place. The presence of antibiotic in the blood, as well as other fluids and body tissues prevents generalization of the infection.

With the excretion of amoxicillin, the kidneys are taken from the body. In this case, it is displayed unchanged. Unlike an antibiotic, clavuonic acid is metabolized in the liver. Its metabolites are found in the exhaled air, feces and urine.

[17], [18], [19], [20]

Dosing and administration

Since angina is considered a pathology of many faces and can occur in different forms, the universal prescriptions of the antibiotic "Amoxiclav" can not be spoken. Something depends on the form of angina. So, with catarrhal angina "Amoxiclav" and other effective antibiotics are not always required. In the mild form of the disease, doctors are limited to the appointment of abundant drink, antiseptics and thermal procedures (at low temperatures).

"Amoxiclav" in catarrhal angina to an adult patient or child can be prescribed in the presence of such menacing symptoms as:

• a high body temperature that lasts at least 3 days (meaning a temperature of 38 degrees, lower temperatures indicate that the body is struggling with the disease on its own and quite successfully),
• the appearance on the tonsils of a light raid, which indicates the transition of the disease to a more severe form, and any complications are associated with the attachment of a bacterial infection, even if initially this was not discussed,
• an increase in the submaxillary lymph nodes, which indicates an inflammatory factor and is fraught with the spread of infection throughout the body.

 But with lacunar, follicular and purulent form of angina without antibiotics can not do, because dangerous symptoms are usually already at the very beginning of the disease. And the preparation "Amoxiclav" in angina is preferred by many experienced doctors, especially if amoxicillin is prescribed for the first time in connection with infectious pathologies. It should be understood that with subsequent appointments, doctors will prefer drugs with other active substances to avoid the development of bacteria in the addiction to the drug.

The dosage regimen of an antibiotic based on amoxicillin and clavuonic acid depends not only on the form of the angina and the patient's well-being, but also on the age, and in some cases also on the weight of the patient.

Consider the method of application and dose of the drug, which are recommended in the instructions for use of the drug.

Tablets. As for the usual "Amoxiclav" tablets, it is recommended to take them during meals (preferably at the very beginning of the meal). Tablets do not need to be ground, they are swallowed whole and washed down with water.

Tablets "Amoxiclav" 375 mg are intended for the treatment of adults and children. Children are recommended to give the tablet no earlier than 6 years.

To small patients before 12-year-old age or before achievement of weight in 40 kg the dosage is calculated as 40 mg per 1 kg of the child's weight. It is recommended to give the medicine in the received dosage to the child 3 times a day.

Patients whose weight exceeds 40 kg, the drug in a mild form of pathology is prescribed in a dosage of 375 mg. Take the drug in this dosage you need every 8 hours, i.e. 2-3 times a day.

For patients with moderate angina, the preferred dosage is 625 mg, so you need to buy the appropriate drug and take it 1 tablet every 12 hours. Appropriate for treatment and preparation 250/125 mg, but you will need to take it 3 times a day for 1 tablet with an eight-hour interval between doses.

In severe form of the disease prescribed drugs 625 or 1000 mg. The first will have to take 1 tablet three times, the second - twice a day.

Tablets "Amoxiclav Quiktab", as well as "Amoxiclav" with increased dosage, are also intended for adult patients. They are accepted only by those patients whose weight is above 40 kg.

The dosage regimen of soluble tablets is identical to the dosages and the frequency of administration of conventional tablets of 625 mg and 1000 mg, respectively. But the method of application is somewhat different. Tablets can be resorbed, chewed or dissolved in water (half cup), after which the resulting suspension is drunk.

Suspension for oral administration. "Amoxiclav" in angina in children under 6 years of age is prescribed primarily as a peroral suspension, which contains small concentrations of active substances. The effective dosage of the drug in the form of a suspension is calculated according to the weight of the child.

Newborns up to 2 months of age, the suspension can be prescribed in a daily dosage of not more than 30 mg per kilogram of the weight of the baby. For children about 2 months to 2 years, the daily dose can be increased to 40 mg per 1 kg of body weight.

For children older than 2 years, whose body weight does not exceed 40 kg, the daily dose, depending on the severity of the pathology, can vary from 20 to 60 mg per kilogram of the child's weight. In this case, the proportion of clavulanic acid for each kilogram of the child's weight will not exceed 15 mg. At a weight of 40 kg this will be 600 mg, which is considered the daily maximum for adults.

The calculated dose, depending on the doctor's appointment, will need to be divided into 2 or 3 doses. Intervals between receptions (8 or 20 hours) should be observed as accurately as possible.

Suspension can be treated and adults, but given the low dosage of the drug, it is advisable to use it only with a mild course of sore throat. The adult dosage of powder for the suspension is 500 mg three times a day, i. E. Only 1500 mg.

When we talked about the dosage, the suspension was not about the finished product, but about the amount of ampicillin in the amount of powder that is needed to make this dose. But each time to prepare a single dose alone is not necessary. The powder is mixed with water immediately in a vial, pouring the liquid in 2 doses and constantly shaking the tube to make the compositions evenly mixed. As a result, 100 ml of the finished drug (suspension) will be obtained.

In the package with the drug should be a special dosage syringe or measuring spoon, a volume of 5 ml. Based on the dosage indicated on the package, 5 ml of the suspension will contain 125 or 250 mg of amoxicillin.

Usually, patients do not need to calculate how much they will need to drink medicine in terms of ampicillin. The doctor prescribes the drug, indicating clearly the number of spoons or the volume of the suspension that you need to drink for 1 reception. In mild cases, the child is usually given 5 ml of a ready-made suspension containing 125 mg of amoxicillin and 31.25 mg of clavuanate. If the disease occurs in a more severe form, the doctor may prescribe a drug with a higher dosage containing 250 mg of amoxicillin in the same 5 ml of the suspension.

Take the suspension, like tablets, during a meal, at the very beginning, ie immediately before eating.

Powder for injection. Intravenous administration of the drug is carried out using a syringe or system. Medicinal solution for them is prepared from powder and water for injections (for drippers, the finished formulation is additionally mixed with saline solution). Injections and droppers can be prescribed only in hospital conditions with severe form of sore throat or when oral medication is not possible. The pediatric dose is calculated as 30 mg per kilogram of the patient's weight, and the frequency of administration depending on the patient's condition can vary from 2 to 4 times a day. Adults are prescribed 1200 mg three times a day.

A dropper is placed for 30-40 minutes. At the same time, a freshly prepared injection or infusion solution must be used within 20 minutes, after which it becomes unusable and must be disposed of.

When asked how many days to drink "Amoxiclav" in angina, only the attending physician can answer. Usually the course of treatment lasts no more than 2 weeks. With a mild course of angina, the symptoms can go away in 3-5 days, but the antibiotic will take at least 7 days. The disappearance of the symptoms of the disease does not mean the complete destruction of the microbes. It speaks only of a decrease in the activity of bacterial infection.

Overdose. The maximum daily dose of amoxicillin for an adult is 6000 mg, for a child - 2400 mg. Excess of these doses in comparison with the recommendations for dosing of the drug is unlikely. But if very high doses were inadvertently taken, or when long-term use of the drug in large doses, symptoms such as dizziness, insomnia, nervous excitement, stomach problems, less often convulsive syndrome, effective hemodialysis and symptomatic therapy.

If a large dose of the drug has been taken orally, you should immediately wash the stomach and drink enterosorbents.

Many have become accustomed to believe that such potent medicines as antibiotics can not be administered to children and pregnant women. Penicillins are called upon to destroy this not entirely true belief. After all, a child with permanently unformed immunity can not effectively resist infection, and therefore, antibiotics can not be avoided. At the same time, "Amoxiclav" in angina in children is prescribed by doctors at least as often as in adults, because this antibiotic brings much more benefit than possible harm. It does not have a negative impact on the development of the child and on the formation of various organs and systems. In addition, the preparation has a special form of release in the form of a suspension, which is intended for infants starting from 2 months, but can be used according to strict indications even from the first days of the child's life.

For more details on the advisability of prescribing antibiotics for angina in a child, read here.

[31], [32], [33], [34], [35]

Use of the amoxiclav in case of angina during pregnancy

As for expectant mothers, safety studies of the drug on pregnant women, of course, were not carried out, but animal experiments did not show a teratogenic effect of the drug on the fetus. Does not cause the drug and premature delivery. For this reason, the use of the drug during pregnancy can be considered quite acceptable if there is a risk for the life of the future mother and her baby.

In any case, the decision on the possibility of treatment with the drug "Amoxiclav" is taken by an experienced doctor. As with other potent agents, "Amoxiclav" in angina and other diseases is better not to take in the first 3 months of pregnancy, when the vital organs of a child are formed.

Some part of the antibiotic enters the breast milk. And, despite the fact that antibiotics itself is considered quite safe for newborns, breastfeeding against the background of drug treatment can lead to a disorder of the stool in the child and the appearance of fungal lesions of mucous membranes. Yes, antibiotics have such a feature that by killing a harmful and useful microflora, they give the soil for growth and reproduction of fungi. Proceeding from the foregoing, we conclude that breastfeeding for the duration of antibiotic treatment is best interrupted, if possible.

Contraindications

As already mentioned, penicillins are widespread not only due to good efficacy against various bacterial infections, but also due to the relative safety of this type of drugs, which makes it possible to prescribe them in childhood and the elderly, as well as in delicate periods associated with pregnancy and breastfeeding.

However, like other penicillins, taking Amoxiclav with angina can provoke the development of severe allergic reactions, which in the absence of effective emergency care can lead to the death of the patient. And there is a considerable percentage of people with congenital intolerance to penicillins, which makes it impossible to treat angina in such people with the help of "Amoxiclave" and other preparations of penicillin and a similar cephalosporin series. In principle, any hypersensitivity reactions to beta-lactam antibiotics are a contraindication to the use of the drug "Amoxiclav".

But hypersensitivity to penicillins is not the only contraindication to the use of this drug. The whole point is that the blood, containing particles of medicinal substances, is filtered with the help of the liver. Amoxicillin does not have a noticeable negative effect on the liver, but clavuonic acid with its metabolites can cause some irregularities in the body. For this reason, the medication is not prescribed to patients who have previously had episodes of jaundice and other symptoms indicating a malfunction in the liver.

Do not prescribe the drug and with such infectious pathologies as mononucleosis and lymphocytic leukemia or suspected of them. The matter is that in overwhelming majority of cases the above-mentioned diseases are caused by the Epstein-Barr virus, i.e. This is not a bacterial infection, which means there is no need for antibiotics.

[21], [22], [23]

Side effects of the amoxiclav in case of angina

Probably before you start taking Amoxiclav, a person will want to know what he can face with the medication and what unpleasant symptoms he may have. This is quite logical, because who is aware, he is armed.

Let's start with the smallest patients. Children often quite often get diarrhea when taking the medicine, Often parents also note symptoms such as nausea and vomiting. Similar symptoms are possible for babies who are breastfeeding if their mothers take "Amoxiclav" in connection with an infectious disease, for example, with angina.

In adult patients, diarrhea is also considered one of the most frequent side effects. Slightly less complaints are received about fungal pathologies of the skin and mucous membranes, nausea, vomiting, heaviness in the epigastrium, associated with digestive disorders, headaches and dizziness, elevation of the level of liver enzymes.

Very rare symptoms include convulsive syndrome, which can be observed in patients with severe kidney pathology, as well as in those who take the drug in high doses. Also, complaints about the development of antibiotic-associated colitis (inflammation of the intestine) are rarely received.

Changes in the composition and quality of blood are rare and are considered reversible after discontinuation of the drug.

Quincke's edema and anaphylactic reactions are possible in patients with hypersensitivity to beta-lactam antibiotics.

To rare symptoms in the treatment with the drug "Amoxiclav" also include hepatitis (inflammation of the liver) and cholestatic jaundice (congestion in the gallbladder causes a discoloration of the skin and eye proteins). This symptom is more characteristic of the male sex and people of advanced age.

Bactericidal antibiotics can cause dysbiosis and development against its background of superinfections associated with excessive growth of bacteria insensitive to a particular preparation. For "Amoxiclave" such a consequence is uncommon, such a state arises only in individual cases.

[24], [25], [26], [27], [28], [29], [30]

Interactions with other drugs

When prescribing any medication as part of complex therapy, the doctor must take into account the interactions of the prescribed drug with other drugs and solvents (in the case of powders for the preparation of solutions and solutions that need to be diluted further). The same is recommended for patients who prescribe medicines themselves or do not bother to inform the doctor about the medications they take.

As for the drug "Amoxiclav", often used in angina, it should not be taken simultaneously in probenecid, allopurinol, methotrexate, estrogen-containing drugs, oral contraceptives, bacteriostatic drugs. Caution should be observed when assigning "Amoxiclav" in parallel with acenocoumarol and warfarin.

Powder for the preparation of intravenous solution can be combined with water for injection, Ringer's solution, saline solution. In a glucose solution, it forms unstable compounds, so it is better to limit the above solvents.

[36], [37], [38], [39], [40], [41]

Storage conditions

You can store any form of antibiotic at room temperature. 

A ready suspension for oral administration is recommended to be stored in the vial in which it was sold by placing it in a cold place with a temperature not exceeding 8 degrees. Use this suspension for a week.

Prepared suspensions and intravenous solutions should not be frozen. The injection solution should be administered to the patient within 20 minutes after preparation.

Any form of the preparation and in particular a ready-made suspension for oral administration that has a pleasant taste and smell should be stored in a place where access to children is limited. It is impossible to exclude the possibility that the baby will want to speed up his recovery with an additional dose of the medicine, especially if it is as delicious and sweet as a suspension or smells like citrus, like tablets with a high dosage.

[42], [43], [44], [45], [46]

Shelf life

Shelf life in their native packaging is 2 years.

[47], [48], [49], [50], [51], [52]

Reviews and Analogues

Doctors knowingly so often turn to the help of the drug "Amoxiclav" in angina, because this drug shows good and fast results in the treatment of this pathology. In most cases, stabilization of the patients' condition or complete disappearance of the symptoms of the disease occurs already on the 3-5th day of antibiotic therapy. The temperature drops to normal values, which could not be brought down by any antipyretic agents and alternative recipes.

But even after the disappearance of symptoms, doctors insist on continuing treatment with "Amoxiclav" for at least 2-3 days. Only then will a stable, reliable result be achieved.

About self-prescribing antibiotics, it was said enough already that people would understand that this can not be done. Nevertheless, self-treatment continues to flourish and negative reviews of the drug confirm this.

Yes, there are cases of stability of the pathogen to "Amoxiclav" (new resistant strains and atypical pathogens can not be ignored) and inefficiency of treatment due to individual characteristics of the organism. But the wrong diagnosis is basically the prerogative of the patients themselves.

For example, in the absence of necessary knowledge and experience, purulent tonsillitis can be confused with fungal, herpetic or other viral pathology of the throat, in which antibiotics are not only ineffective, but sometimes dangerous. An uncontrolled intake of antibiotics can also harm the chronic course of tonsillitis when it comes to the allergic reaction to irritants rather than the bacterial infection.

With regard to the safety of the use of the drug "Amoxiclav", containing clavuonic acid, which in large doses has a bad effect on the liver, everything is adjusted by reducing the dose or switching to other treatment options. So, if you suspect a typical pathogen sensitive to penicillins, doctors prefer to treat with analogues of "Amoxiclav", also effective in angina. Such analogues include Ampicillin, Amoxicillin, Flemoxin Solutab.

With intolerance to penicillins and cephalosporins, doctors resort to the help of macrolides. The most popular drugs with angina are. "Azithromycin" and its analogue "Sumamed", which can be considered a universal medicine for many infectious diseases. Despite the fact that macrolides have only bacteriostatic effect, but in azithromycin (the active substance of both drugs) it is expressed so much that it is quite enough to treat any form of sore throat.

If, nevertheless, the doctor stopped on the drug Amoxiclav, but he was not in the drugstore, you can safely take an antibiotic with the name "Augmentin", which is a complete analogue of the drug described by us.