Oral Amoxicillin as Prophylaxis for Endocarditis: What Is the Optimal Dose?

We compared serum levels and tolerability of oral amoxicillin in 30 healthy adults who each received 2.0 g of amoxicillin and, 1 week later, 3.0 g of the same preparation. Serum levels of amoxicillin were determined at 1, 2, 4, and 6 hours following its ingestion. Mean serum levels of amoxicillin we...

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Bibliographic Details
Published in:Clinical infectious diseases 1994-02, Vol.18 (2), p.157-160
Main Authors: Dajani, Adnan S., Bawdon, Roger E., Berry, Michelle C.
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Amoxicillin - administration & dosage
Amoxicillin - adverse effects
Amoxicillin - blood
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Body weight
British culture
Capsules
Clinical Infectious Disease Articles
Dental treatments
Digestive System - drug effects
Dosage
Dose-Response Relationship, Drug
Drug Tolerance
Endocarditis
Endocarditis, Bacterial - prevention & control
Female
Food intake
Humans
Infectious diseases
Male
Medical sciences
Oral surgical procedures
Pharmacology. Drug treatments
Side effects
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Summary:We compared serum levels and tolerability of oral amoxicillin in 30 healthy adults who each received 2.0 g of amoxicillin and, 1 week later, 3.0 g of the same preparation. Serum levels of amoxicillin were determined at 1, 2, 4, and 6 hours following its ingestion. Mean serum levels of amoxicillin were significantly higher after 3.0-g doses than after 2.0-g doses. Levels in females were higher than in males; this was a reflection of differences in body weights. Food intake had no effect on serum levels. The 2.0-g doses resulted in adequate serum levels; 6 hours after dosing, levels were still substantially higher than the MICs for oral streptococci. Three individuals (10%) experienced mild gastrointestinal side effects after they received the 3.0-g doses; no side effects were noted after the 2.0-g doses. We propose that to prevent bacterial endocarditis in adults who are at risk, a single 2.0-g dose of oral amoxicillin may be adequate prophylaxis for dental, oral, or upper respiratory tract procedures.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/18.2.157