Amoxicillin

Amoxicillin is an antibiotic used to treat many different types of bacterial infections in children. It does not help in viral infections such as a cold or flu. It’s often called “the pink stuff” or “the bubblegum-tasting one” by children. You might see a brand name such as Trimox, Moxatag, or Amoxil on the label. This common antibiotic comes as liquid, chewable tablets, regular tablets, and capsules. Any form can be given with or without food.

Liquid amoxicillin should be shaken before giving each dose. It’s fine to give the amoxicillin directly or to mix the medicine with another liquid if you’re fairly sure your child will drink it all. To get the correct dose, skip the silverware spoon and use a measuring spoon or dose-measuring device (ask your pharmacist for one if you don’t have one). Store it in the refrigerator between doses. It should not be allowed to freeze. Discard any unused amoxicillin 14 days after it was first prepared by the pharmacist. It may last only 7 days if stored at room temperature.

Whenever antibiotics are given, consider also giving your child probiotics (beneficial bacteria). Out of ten well-designed studies, nine showed significantly less diarrhea in the children receiving probiotics (the studies used between 5 and 40 billion cfu per day). Probiotics are available as supplements or in some foods and beverages (yogurt, kefir, juice). Whatever you choose, look for at least 5 billion colonies.

Amoxicillin is the recommended first choice antibiotic for most children with ear infections. When used to treat ear infections, the recommended dose is about 36 to 41 mg per day for each pound that the child weighs, up to a maximum of about 1500 to 1750 mg per day. This is much higher than the dose used for most other infections in children. The total daily dose is divided into two or three doses per day.

If you happen to miss a dose, you can go ahead and give it late – but try not to do two doses within about three hours of each other. If you happen to give too much at once (more than two doses), seek medical advice.

If your child is taking amoxicillin for an ear infection, you should expect improvement within 48 to 72 hours. If not, contact your doctor to discuss switching to a stronger antibiotic, such as amoxicillin-clavulanate or ceftriaxone.

Do Not use amoxicillin if your child is known to be allergic to this or to any of the penicillin-type antibiotics.

Depending on the type of allergy, other antibiotic options might include cefdinir, cefuroxime, azithromycin, or clarithromycin. Sometimes a non-itchy rash is a side effect of taking amoxicillin, and not an allergic reaction. If your child has had a rash with amoxicillin, discuss this possibility with your doctor.

Be sure the prescribing doctor knows if your child has any other medication allergies, or has mono, asthma, liver or kidney disease, or a bleeding problem. Be sure to report any other medicines your child might be taking. Get emergency care if your child is showing signs of a serious allergic reaction, such as difficulty breathing, spreading hives, or swelling of the lips, tongue, or throat. Black hairy tongue, a fairly common temporary side effect of amoxicillin, is not an allergic reaction.

Other side effects are possible with this or any medication. Be sure to report unexpected new symptoms to your healthcare provider. Whether they are caused by the antibiotic or by the illness getting worse, unexpected symptoms are important to report.

Johnston BC, Supina AL, Ospina M, Vohra S. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004827. DOI: 10.1002/14651858.CD004827.pub2.

AAP Clinical Practice Guideline. Diagnosis and management of acute otitis media. Pediatrics, May 2004, 113(5):1451-1465.