Oral amoxicillin as prophylaxis for endocarditis: what is the optimal dose?

Abstract

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.

• Authors: A S Dajani, R E Bawdon, M C Berry
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 18 Issue 2 Pg. 157-60 (Feb 1994) ISSN: 1058-4838 [Print] United States
• PMID: 8161620 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Amoxicillin

Topics

• Administration, Oral
• Adult
• Amoxicillin (administration & dosage, adverse effects, blood)
• Digestive System (drug effects)
• Dose-Response Relationship, Drug
• Drug Tolerance
• Endocarditis, Bacterial (prevention & control)
• Female
• Humans
• Male