Indications

Fimoxyl (Amoxicillin) is a broad-spectrum penicillin antibiotic used to treat infections caused by susceptible organisms that do not produce beta-lactamase. These infections include:

• Ear, Nose, and Throat: Otitis media, sinusitis, tonsillitis, and pharyngitis.
• Lower Respiratory Tract: Pneumonia, acute and chronic bronchitis.
• Skin and Soft Tissue: Cellulitis, infected wounds, and abscesses.
• Genito-urinary Tract: Pyelonephritis, cystitis, and urethritis.
• Venereal Disease: Acute uncomplicated gonorrhea. It is also used for short-term therapy for dental abscesses and, as part of a triple therapy, to treat H. pylori infections and reduce the risk of duodenal ulcer recurrence.

Pharmacology

Amoxicillin is a broad-spectrum penicillin that works by inhibiting the biosynthesis of the bacterial cell wall. It is stable in the presence of gastric acid and is rapidly absorbed after oral administration, with peak plasma concentration reached within 1-2 hours. It is widely distributed throughout the body's tissues and fluids.

Dosage

• Adults: 250 mg three times daily, which can be increased to 500 mg three times daily for severe infections.
• Children (up to 10 years): 125 mg three times daily, which can be increased to 250 mg three times daily for severe infections.
• Specific Doses:
  • Severe Respiratory Infection: 3 gm every 12 hours.
  • Pneumonia: 500-1000 mg three times daily.
  • Dental Abscess/Urinary Tract Infection: 3 gm, repeated after 10-12 hours.
  • Gonorrhea: Single dose of 2-3 gm with 1 gm of Probenecid. Dose reduction may be necessary for patients with renal impairment.

Administration

The reconstituted suspension can be mixed with milk, fruit juice, or water and should be taken immediately.

Interaction

• Probenecid: Concurrent use may increase and prolong the blood levels of Fimoxyl.
• Oral Contraceptives: Fimoxyl may reduce the effectiveness of combined oral estrogen/progesterone contraceptives by affecting gut flora.

Contraindications

Amoxicillin is contraindicated in patients with a known hypersensitivity to penicillin.

Side Effects

Side effects are generally mild and temporary, and may include diarrhea, indigestion, or occasional rash. Pseudomembranous colitis has been reported rarely.

Pregnancy & Lactation

Fimoxyl is a US FDA pregnancy category B drug. It should be used during pregnancy only if clearly needed. It is excreted in human milk, so caution should be exercised when administering it to a lactating mother.

Precautions & Warnings

There is a risk of superinfections with other pathogens during therapy. If a superinfection occurs, Fimoxyl should be discontinued, and appropriate treatment should be started.

Therapeutic Class

Fimoxyl belongs to the class of broad-spectrum penicillins.

Reconstitution

• Intramuscular: Add 2.5 ml of water for injection to a 500 mg vial.
• Intravenous: Dissolve a 500 mg vial in 10 ml of water for injection.

Storage Conditions

Keep in a dry place away from light and heat. Keep out of the reach of children.