아목시실린
Amoxicillin
Amoxicillin trihydrate
다른 이름: Amoxil · Amoxi-Tabs · Amoxi-Drop · Amoxi-Mast · Trimox · Moxatag · Amoxibactin · Amoxycare · Amoxypen · Betamox · Bimoxyl · Clamoxyl · amoxycillin · p-hydroxyampicillin · BRL 2333
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Gram-positive infections | 10 mg/kg PO, IM, SC twice daily for at least 2 days after symptoms subside. | PO, IM, SC | q12h | At least 2 days after symptoms subside | 🌎 NA |
| Gram-negative infections | 20 mg/kg PO three times daily or IM, SC twice daily for at least 2 days after symptoms subside | PO, IM, SC | q8h (PO) or q12h (IM, SC) | At least 2 days after symptoms subside | 🌎 NA |
| Susceptible UTI's | 10-20 mg/kg PO q12h for 5-7 days. | PO | q12h | 5-7 days | 🌎 NA |
| Susceptible systemic infections (bacteremia/sepsis) | 22-30 mg/kg IV , IM, SC q8h for 7 days. | IV, IM, SC | q8h | 7 days | 🌎 NA |
| Susceptible orthopedic infections | 22-30 mg/kg IV , IM, SC, or PO q6-8h for 7-10 days. | IV, IM, SC, PO | q6-8h | 7-10 days | 🌎 NA |
| Lyme disease | 22 mg/kg PO q12h for 21-28 days | PO | q12h | 21-28 days | 🌎 NA |
| Susceptible urinary tract infections | 11 mg/kg PO q8h. | PO | q8h | — | 🌎 NA |
| Preventative therapy for repeated (>2 per 6 months) urinary tract Gram-positive bacterial infections | 20 mg/kg PO once daily before bedtime after the dog has urinated. | PO | q24h | — | 🌎 NA |
| Susceptible bacterial infections | 7 mg/kg | IM | q24h | — | 🌍 EU |
| Susceptible bacterial infections (depot preparations) | 15 mg/kg | IM | q48h | — | 🌍 EU |
| Susceptible bacterial infections | 10 mg/kg | PO | q8-12h | — | 🌍 EU |
| Bacterial cystitis | 11-15 mg/kg | PO | q8h | — | 🌍 EU |
- Preventative therapy for repeated (>2 per 6 months) urinary tract Gram-positive bacterial infections: Use only after effective treatment completed using full therapeutic doses.
- Susceptible bacterial infections (depot preparations): For depot preparations only
- Susceptible bacterial infections: Dose chosen will depend on site of infection, causal organism and severity of the disease.
- Bacterial cystitis: Evidence of a need for clavulanic acid is lacking even in infections with beta-lactamase producing bacteria.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Gram-positive infections | 10 mg/kg PO, IM, SC twice daily for at least 2 days after symptoms subside. | PO, IM, SC | q12h | At least 2 days after symptoms subside | 🌎 NA |
| Gram-negative infections | 20 mg/kg PO three times daily or IM, SC twice daily for at least 2 days after symptoms subside | PO, IM, SC | q8h (PO) or q12h (IM, SC) | At least 2 days after symptoms subside | 🌎 NA |
| Susceptible UTI's and soft tissue infections | 50 mg (total dose per cat) or 11-22 mg/kg PO once daily for 5-7 days. | PO | q24h | 5-7 days | 🌎 NA |
| Sepsis | 10-20 mg/kg IV , SC, or PO q12h for as long as necessary. | IV, SC, PO | q12h | As long as necessary | 🌎 NA |
| C. perfringens, bacterial overgrowth (GI) | 22 mg/kg PO once daily for 5 days | PO | q24h | 5 days | 🌎 NA |
| C. perfringens enterotoxicosis | 11-22 mg/kg PO two to three times daily for 7 days | PO | q8-12h | 7 days | 🌎 NA |
| H. pylori infections (triple therapy) | amoxicillin 20 mg/kg PO twice daily for 14 days; metronidazole 10-15 mg/kg PO twice daily; clarithromycin 7.5 mg/kg PO twice daily | PO | q12h | 14 days | 🌎 NA |
| Susceptible bacterial infections | 7 mg/kg | IM | q24h | — | 🌍 EU |
| Susceptible bacterial infections (depot preparations) | 15 mg/kg | IM | q48h | — | 🌍 EU |
| Susceptible bacterial infections | 10 mg/kg | PO | q8-12h | — | 🌍 EU |
| Bacterial cystitis | 11-15 mg/kg | PO | q8h | — | 🌍 EU |
- Sepsis: Generally treat for at least 2 days after all signs of infection are gone.
- H. pylori infections (triple therapy): Used in combination with metronidazole and clarithromycin.
- Susceptible bacterial infections (depot preparations): For depot preparations only
- Susceptible bacterial infections: Dose chosen will depend on site of infection, causal organism and severity of the disease.
- Bacterial cystitis: Evidence of a need for clavulanic acid is lacking even in infections with beta-lactamase producing bacteria.
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections (Hedgehogs) | 15 mg/kg IM or PO q12h | IM, PO | q12h | — | 🌎 NA |
- Susceptible infections (Hedgehogs): See contraindications regarding use in rabbits/rodents.
페렛
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Eliminating Helicobacter gastritis infections (triple therapy) | Metronidazole 22 mg/kg, amoxicillin 22 mg/kg and bismuth subsalicylate (original Pepto-Bismol ®) 17.6 mg/kg PO. Give each 3 times daily for 3-4 weeks. | PO | q8h | 3-4 weeks | 🌎 NA |
| Eliminating Helicobacter gastritis infections (triple therapy) | Metronidazole 20 mg/kg PO q12h, amoxicillin 20 mg/kg PO q12h and bismuth subsalicylate 17.5 mg/kg PO q8h. Give 21 days. | PO | q12h | 21 days | 🌎 NA |
| Susceptible infections | 10-35 mg/kg PO or SC twice daily | PO, SC | q12h | — | 🌎 NA |
- Eliminating Helicobacter gastritis infections (triple therapy): Sucralfate and famotidine are also used. Fluids and assisted feeding should be continued.
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections | 125 mg/kg q12h PO. Mix oral solution to double strength to a final concentration of 125 mg/mL. | PO | q12h | — | 🌎 NA |
| Susceptible infections | 100 mg/kg q8h, IM, SC, PO | IM, SC, PO | q8h | — | 🌎 NA |
| Susceptible infections (Ratites) | 15-22 mg/kg PO twice daily; in drinking water: 250 mg/gallon for 3-5 days | PO, drinking water | q12h / continuous | 3-5 days | 🌎 NA |
파충류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections (all species) | 22 mg/kg PO q12-24h | PO | q12-24h | — | 🌎 NA |
- Susceptible infections (all species): Not very useful unless used in combination with aminoglycosides
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Respiratory infections | 20-30 mg/kg PO q6h | PO | q6h | — | 🌎 NA |
| Susceptible infections (Foals - Amoxicillin Sodium) | 15-30 mg/kg IV or IM q6-8h | IV, IM | q6-8h | — | 🌎 NA |
| Susceptible infections (Foals - Amoxicillin trihydrate suspension) | 25-40 mg/kg PO q8h | PO | q8h | — | 🌎 NA |
| Susceptible infections (Foals - Amoxicillin/clavulanate) | 15-25 mg/kg IV q6-8h | IV | q6-8h | — | 🌎 NA |
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections | 6-10 mg/kg SC or IM q24h | SC, IM | q24h | — | 🌎 NA |
| Respiratory infections | 11 mg/kg IM or SC q12h | IM, SC | q12h | — | 🌎 NA |
| Susceptible infections (Calves - Amoxicillin trihydrate) | 7 mg/kg PO q8-12h | PO | q8-12h | — | 🌎 NA |
- Susceptible infections: Withdrawal time = 30 days
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
아목시실린은 수의학에서 다양한 세균 감염을 치료하는 데 널리 처방되는 광범위 아미노페니실린 항생제입니다.
주요 약리학적 특징은 다음과 같습니다:
- 항균 스펙트럼: 많은 그람 양성 호기성균, 일부 그람 음성 호기성균(예: 대장균, 클렙시엘라, 헤모필루스) 및 많은 절대 혐기성균(클로스트리디움 종 포함)에 효과적입니다.
- 베타락타마제 감수성: 암피실린과 마찬가지로 베타락타마제 생성 세균(예: 황색포도상구균)에 의해 불활성화됩니다. 이러한 내성을 극복하기 위해 종종 클라불란산과 병용됩니다.
- 임상적 유용성: 고양이의 농양, 감수성 있는 요로 감염(UTI) 및 연조직 감염에 대한 1차 경험적 치료제로 간주됩니다.
- 약동학적 장점: 암피실린과 비교하여 단위동물에서 경구 생체이용률이 현저히 우수하며, 동일 용량 투여 시 1.5~3배 더 높은 혈청 농도에 도달합니다.
작용 기전
Amoxicillin is a time-dependent, bactericidal antibiotic that disrupts bacterial cell wall synthesis.
- Mechanism: The beta-lactam ring mimics the D-alanyl-D-alanine terminal of the peptidoglycan precursor.
- Pathway: Amoxicillin binds to specific penicillin-binding proteins (PBPs) (such as transpeptidases, carboxypeptidases, and endopeptidases) located on the inner surface of the bacterial cell membrane → inhibits the cross-linking of mucopeptide (peptidoglycan) chains → compromises the structural integrity of the cell wall → creates an osmotically unstable spheroplast → results in cell lysis and death.
- Efficacy: It is most effective against actively dividing and growing bacteria.
안전성·주의사항
금기사항
- 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)
부작용
- 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)
주의
Species Warning: Never administer amoxicillin (or other penicillins) orally to rabbits, guinea pigs, chinchillas, or hamsters, as it can cause severe, often fatal, clostridial enterotoxemia.
- Cross-Reactivity: Use with caution in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., cephalosporins, carbapenems).
- Pregnancy: Crosses the placenta. Categorized as FDA Category B (human) and Class A (veterinary - probably safe), but should be used only when potential benefits outweigh risks.
- Laboratory Tests: May cause false-positive urine glucose determinations when using cupric sulfate solutions (e.g., Clinitest).
약물 상호작용
Potential in vitro antagonism; concurrent use has historically been discouraged, though clinical significance is debated.
Amoxicillin may decrease the renal excretion of methotrexate, leading to increased levels and potential toxicity.
Competitively blocks the tubular secretion of penicillins, increasing serum levels and prolonging serum half-life.
In vitro inactivation of aminoglycosides by beta-lactams; may falsely decrease aminoglycoside serum concentrations if samples are stored prior to analysis.
Potential antagonism of bactericidal activity (bacteriostatic vs bactericidal)
Potential antagonism of bactericidal activity
Potential antagonism of bactericidal activity
Inactivation of aminoglycoside if mixed in the same syringe
Synergistic antimicrobial effect when used concurrently
모니터링
- Clinical efficacy (resolution of infection signs)
- Adverse effects (GI upset, signs of hypersensitivity)
약동학
반감기
흡수
Relatively stable in gastric acid. About 74-92% absorbed orally in monogastric animals. Food decreases the rate but not the extent of absorption. Serum levels are generally 1.5-3 times greater than ampicillin after equivalent oral doses.
분포
Volume of distribution is ~0.2 L/kg in dogs. Widely distributed to tissues including liver, lungs, muscle, bile, and ascitic/pleural/synovial fluids. Crosses into CSF when meninges are inflamed (10-60% of serum levels). Crosses the placenta. Protein binding is ~13% in dogs.
대사
Some of the drug is metabolized by hydrolysis to inactive penicilloic acids.
배설
Eliminated primarily through renal mechanisms, principally by tubular secretion. Clearance is reportedly 1.9 mL/kg/min in dogs.
과다투여
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.
제품
제형
- Oral tablets
- Oral chewable tablets
- Oral capsules
- Powder for oral suspension
- Intramammary infusion
동물용의약품
- Amoxicillin Oral Tablets: 50 mg, 100 mg, 150 mg, 200 mg, & 400 mg (Amoxi-Tabs®)
- Amoxicillin Powder for Oral Suspension: 50 mg/mL after reconstitution (Amoxi-Drop®)
- Amoxicillin Intramammary Infusion: 62.5 mg/syringe (Amoxi-Mast®)
인용의약품
- Amoxicillin Oral Tablets (chewable): 125 mg, 200 mg, 250 mg, & 400 mg (Amoxil®)
- Amoxicillin Oral Tablets: 500 mg & 875 mg (Amoxil®)
- Amoxicillin Oral Capsules: 250 mg & 500 mg (Amoxil®)
- Amoxicillin Powder for Oral Suspension: 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL (Amoxil®, Trimox®)
- Amoxicillin Oral Extended-Release Tablets: 775 mg (Moxatag®)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Capsules, tablets, and powder for oral suspension should be stored at room temperature (15-30°C) in tight containers. After reconstitution, the oral suspension should preferably be refrigerated (though not absolutely necessary) and any unused product discarded after 14 days.
보호자 정보
- 투여 방법: 아목시실린은 음식과 함께 또는 빈속에 투여할 수 있습니다. 하지만 반려동물이 위장 장애(구토 또는 식욕 부진)를 겪는 경우, 음식과 함께 먹이면 도움이 될 수 있습니다.
- 보관 방법: 경구용 현탁액(물약)을 사용하는 경우 냉장 보관하는 것이 가장 좋지만, 실온 보관도 가능합니다. 조제 후 14일이 지난 남은 약은 반드시 폐기하십시오.
- 치료 완료: 반려동물이 완전히 나은 것처럼 보이더라도, 항상 수의사의 지시에 따라 처방된 약을 끝까지 먹이십시오. 일찍 중단하면 내성균 감염이 발생할 수 있습니다.
- 부작용: 가벼운 설사나 구토가 발생할 수 있습니다. 이러한 증상이 심해지거나 알레르기 반응의 징후(얼굴 부기, 두드러기 또는 호흡 곤란)가 관찰되면 즉시 수의사에게 연락하십시오.
- 동물종 경고: 토끼, 기니피그 또는 햄스터와 같은 소형 반려동물에게는 이 약을 절대 먹이지 마십시오. 이들에게는 치명적일 수 있습니다.
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