Amoxicillin
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DRUG-AMOXICILLIN |
|---|---|
| Тип | Препарат |
| Синоніми | AmoxilFlemoxinHiconcilOspamoxTrimoxАмоксицилін |
| Статус | переглянуто 2026-05-18 |
| Хвороби | DIS-GASTRIC |
| Джерела | SRC-NCCN-BCELL-2025 |
Дані про препарат
| Клас | Aminopenicillin (extended-spectrum beta-lactam antibiotic) |
|---|---|
| Механізм дії | Semi-synthetic aminopenicillin that binds to penicillin-binding proteins (PBPs) in actively dividing bacteria, inhibiting cross-linking of the peptidoglycan cell-wall layer and triggering autolysin-mediated bactericidal effect. Spectrum: broader than penicillin V/G — includes many Streptococcus spp., Enterococcus faecalis, Listeria monocytogenes, Helicobacter pylori, and some Gram-negatives (E. coli, Proteus mirabilis, Haemophilus influenzae, Salmonella, Shigella) where no β-lactamase expression. Susceptible to β-lactamase hydrolysis (hence Augmentin combination with clavulanic acid for many Gram-negative infections). |
| Типове дозування | H. pylori eradication (component of triple therapy, adult): 1 g PO BID × 14 days, taken with PPI (omeprazole 20 mg BID) + clarithromycin 500 mg BID. Adult CAP / sinusitis (high-dose): 1 g PO TID × 7-10 days. Adult UTI: 500 mg PO TID × 7 days. Pediatric: 25-50 mg/kg/day PO divided q8-12h; 90 mg/kg/day high-dose for AOM with drug-resistant S. pneumoniae risk. Renal adjustment: CrCl 10-30 → q12h dosing; CrCl <10 → q24h; HD → 250-500 mg q24h post-dialysis. Hepatic: no adjustment. Endocarditis prophylaxis: 2 g PO 30-60 min before procedure (adult), 50 mg/kg pediatric. |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | False |
| Остання перевірка для України | 2026-05-18 |
Нотатки
STUB — v0.2 prevention-workstream authoring; pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode. Standard β-lactam component of H. pylori triple therapy (clarithromycin + PPI + amoxicillin × 14d) used to prevent gastric MALT lymphoma progression and reduce gastric-adenocarcinoma risk. Penicillin allergy is the key contraindication — substitute metronidazole if true allergy, or refer for allergy evaluation as ~90% of self-reported penicillin allergy is not confirmed on testing. Active against H. pylori with virtually no resistance (unlike clarithromycin, where resistance is rising). Dose-limiting toxicity is rare; clavulanic acid combination (Augmentin) shifts the AE profile toward hepatotoxicity and diarrhea — not used in H. pylori. Ukraine: cheap, ubiquitous, out-of-pocket for H. pylori. Two-Co-Lead signoff queued for v0.2-A clinical review.
Де використовується
Access Pathways
AP-HP-ERADICATION-PHARMACY-OOP- H. pylori eradication (PPI + amox/clarithromycin / bismuth quadruple) — pharmacy out-of-p...
Regimens
REG-HP-PPI-CLAR-AMOX- PPI-clarithromycin-amoxicillin triple therapy — 14 days