Amoxicillin belongs to the group of aminopenicillins and is used as a broad spectrum antibiotic. The active ingredient has been approved since 1981 and has been available under various trade names since then. The drug works against both gram-negative and gram-positive bacteria.
What is amoxicillin?
Amoxicillin is a so-called β-lactam antibiotic from the penicillin class of active ingredients. A lactam ring occurs in its molecular structure, which mediates the antibiotic effectiveness of the active ingredient.
The drug has a wide range of uses against a wide variety of types of bacteria. Sometimes the combined use of amoxicillin and clavulanic acid can increase its effectiveness. Amoxicillin has a bacteriocidal effect, i.e. it kills bacteria, in contrast to bacteriostatic antibiotics, which have a growth-inhibiting effect.
The active substance class of penicillins only destroy bacteria, but not animal and plant cells. The reason is the completely different structure of the respective cell membranes. Like all penicillins, amoxicillin is relatively harmless to the human body. Amoxicillin is also relatively acid-resistant and can therefore easily be administered orally without losing its effectiveness.
Pharmacological effect
The effect of Amoxicillin is based on the interaction of the lactam ring with the bacterial cell membrane. Both gram-positive and gram-negative bacteria contain the so-called polysaccharide peptide murein in their cell membranes.
The lactam ring of the antibiotic forms peptide bonds with the murein and thus destroys the membranes of the bacteria. The membrane-destroying effect unfolds, among other things, during cell division. The bacteria die in the process. Some bacteria, such as b. The staphylococci produce the enzyme β-lactamase, which inactivates amoxicillin by destroying the ß-lactam ring. Therefore, the sole use of amoxicillin against staphylococci is ineffective.
However, through the combined administration of amoxicillin with clavulanic acid, its spectrum of action can also be extended to this type of bacteria. Clavulanic acid inhibits the action of the enzyme β-lactamase. When antibiotics are used, including amoxicillin, resistance slowly develops.
These resistances are caused by the emergence of insensitivity of the binding proteins to penicillin, by the strengthening of the bacterial cell membranes or by the increased production of the enzyme ß-lactamase. At least with this third type of resistance, the combined administration of amoxicillin with clavulanic acid has found a way to combat the bacterium.
Medical application & use
Amoxicillin As already mentioned, has a wide range of uses against various types of bacteria. In contrast to the classic penicillin, amoxicillin is also effective against gram-negative bacteria.
In contrast to gram-negative bacteria, gram-positive bacteria have a much thicker murein layer in the membrane. The determination of the Gram stain is often carried out in order to find the appropriate antibiotic for use. However, due to the broad spectrum effect of amoxicillin, this test is not necessary here. In addition to the classic penicillin use, amoxicillin can also be used against Escherichia coli, listeria, enterococci and various Proteus species.
This means that many infectious diseases of the upper respiratory tract, the ear (otitis media), the urinary tract and the gastrointestinal tract can be treated with amoxicillin. The combination of amoxicillin with clarythromycin (bacteriostatic antibiotic) can also treat infections with Helicobacter pylori in the stomach.
Among other things, this bacterium is responsible for gastric mucosal inflammation and gastric ulcers. People with heart disease are often treated with amoxicillin as a preventive measure before operations. During treatment, amoxicillin is mainly administered orally regardless of food intake, with the body absorbing 80 percent of the active ingredient. The kidneys excrete most of the active ingredient.
Risks & side effects
Basically is Amoxicillin well tolerated. It is less damaging to the intestinal flora than other antibiotics. The drug breaks down quickly.
However, as with all drugs, side effects are to be expected in some cases with the use of amoxicillin. Skin rashes, stomach upset, nausea, vomiting, gas, and diarrhea can occur.
Itching, fever, inflammation of the mucous membranes, dry mouth and impairment of the sense of taste are also observed. In rare cases, edema, anemia, liver disorders or even kidney inflammation occur. A penicillin allergy with anaphylactic shock can have particularly dramatic effects.
In this case, therapy with amoxicillin should be stopped immediately. Continuous use can lead to superinfection with resistant bacterial strains or yeasts.
