Amoxicillin in the British National Formulary (BNF)

Amoxicillin in the British National Formulary (BNF)

The British National Formulary (BNF) is a comprehensive pharmaceutical reference guide widely used by healthcare professionals in the United Kingdom and beyond. It provides detailed information on the use, dosage, and administration of various medications, including amoxicillin. Here's an overview of how amoxicillin is presented in the BNF:

Classification:

The BNF classifies amoxicillin as a broad-spectrum penicillin antibiotic, effective against both gram-positive and gram-negative bacteria.

Indications:

According to the BNF, amoxicillin is indicated for various infections, including:

Respiratory tract infections

Urinary tract infections

Dental infections

Skin and soft tissue infections

Lyme disease

Helicobacter pylori eradication (as part of combination therapy)

Endocarditis prophylaxis (in certain high-risk patients)

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Dosage:

The BNF provides detailed dosage information for different age groups and conditions. For adults, typical oral doses range from 250mg to 1g every 8 hours, depending on the severity of the infection. Pediatric doses are usually calculated based on body weight.

Administration:

The BNF states that amoxicillin can be taken with or without food. It's typically administered orally, but the BNF also provides information on intravenous administration for severe infections.

Contraindications:

The BNF lists hypersensitivity to penicillins as the primary contraindication for amoxicillin use.

Cautions:

The BNF advises caution when prescribing amoxicillin to patients with:

Renal impairment

History of allergies

Lymphatic leukemia

Infectious mononucleosis

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Side Effects:

Common side effects listed in the BNF include:

Nausea and vomiting

Diarrhea

Rash

Superinfection (e.g., candidiasis)

The BNF also mentions less common but serious side effects such as anaphylaxis and antibiotic-associated colitis.

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Interactions:

The BNF highlights several important drug interactions, including:

Increased risk of rash when used with allopurinol

Potential reduction in the efficacy of oral contraceptives

Increased risk of bleeding with anticoagulants

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Pregnancy and Breastfeeding:

The BNF states that amoxicillin is generally considered safe for use during pregnancy and breastfeeding, but advises that it should be used only when clearly needed.

Special Considerations:

The BNF notes that amoxicillin may give a false-positive result in urine glucose tests and may affect the results of certain diagnostic tests.

Monitoring:

For patients on high doses or prolonged treatment, the BNF recommends monitoring liver function, especially in those with pre-existing liver dysfunction.

Formulations:

The BNF provides information on various formulations of amoxicillin, including capsules, oral suspensions, and injectable forms.

Brand Names:

While the BNF primarily uses generic names, it may also list common brand names under which amoxicillin is marketed in the UK.

Cost:

The BNF often includes information on the cost of different formulations and doses of amoxicillin, which can be useful for prescribers considering cost-effectiveness.

It's important to note that the information in the BNF is regularly updated to reflect the latest research and guidelines. Healthcare professionals should always consult the most recent edition of the BNF and consider individual patient factors when prescribing amoxicillin or any other medication.