아목시실린

동물 종별 용량

투여 경로

금기

• Patients with a history of hypersensitivity to penicillins
• Oral administration in hindgut fermenters (rabbits, guinea pigs, chinchillas, hamsters) due to risk of fatal clostridial enterotoxemia
• Oral administration in patients with septicemia, shock, or grave illness (due to delayed/diminished GI absorption)

이상반응

• Gastrointestinal upset (anorexia, vomiting, diarrhea)
• Antibiotic-associated diarrhea and gut flora alteration
• Hypersensitivity reactions (rashes, fever, anaphylaxis)
• Eosinophilia, neutropenia, agranulocytosis, thrombocytopenia, leukopenia, anemias
• Lymphadenopathy
• Neurotoxicity (e.g., ataxia) at very high doses or prolonged use
• Elevated liver enzymes (rare)
• Tachypnea, dyspnea, edema, and tachycardia (reported in dogs)

약물 상호작용

• Bacteriostatic antimicrobials (e.g., chloramphenicol, macrolides, tetracyclines, sulfonamides) · Potential in vitro antagonism; concurrent use has historically been discouraged, though clinical significance is debated.
• Methotrexate · Amoxicillin may decrease the renal excretion of methotrexate, leading to increased levels and potential toxicity.
• Probenecid · Competitively blocks the tubular secretion of penicillins, increasing serum levels and prolonging serum half-life.
• Aminoglycosides · In vitro inactivation of aminoglycosides by beta-lactams; may falsely decrease aminoglycoside serum concentrations if samples are stored prior to analysis.
• Tetracycline · Potential antagonism of bactericidal activity (bacteriostatic vs bactericidal) · moderate
• Erythromycin · Potential antagonism of bactericidal activity · moderate
• Chloramphenicol · Potential antagonism of bactericidal activity · moderate
• Aminoglycosides (in vitro) · Inactivation of aminoglycoside if mixed in the same syringe · major
• Aminoglycosides (in vivo) · Synergistic antimicrobial effect when used concurrently

모니터링

• Clinical efficacy (resolution of infection signs)
• Adverse effects (GI upset, signs of hypersensitivity)

과용량

Acute oral penicillin overdoses are unlikely to cause significant problems other than **gastrointestinal distress** (vomiting, diarrhea, anorexia). In humans, very high dosages of parenteral penicillins, especially in patients with compromised renal function, have induced **CNS effects** (e.g., seizures, ataxia). Treatment is generally supportive and symptomatic.