Adult

Amoxicillin

Warning

General information

A penicillin antibiotic. Do NOT use if patient is allergic to penicillin.

Formulary antimicrobial: Use in accordance with Trust guidelines  

AWaRe antibiotic classification: 'Access'. Use as per guidelines.

For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).

Standard dose

Oral amoxicillin

Intravenous amoxicillin

500mg - 1g TDS

1g TDS*

*2g 4-hourly can be used for listeria meningitis and infective endocarditis on the advice of Micro/ID.

Obesity

Dosing for penicillins should be at the upper end of recommended ranges, particularly for morbidly obese patient with severe infections, considering patient’s renal function.

Renal and hepatic impairment

Renal impairment

eGFR (mL/min/1.73m2)

amoxicillin dose 

10 or more

Dose as in normal renal function

Less than 10

250mg–1g every 8 hours. Maximum 6g per day in endocarditis

HD/HDF/High Flux/PD

Dose as in eGFR less than 10ml/min/1.73m2.

HD/HDF/High Flux: Dialysed; give after dialysis

 

Hepatic impairment

No dose adjustment required. Hepatic function to be monitored regularly.

References

  • Amoxicillin 500 mg Capsules BP [online]. Manufacturer - Sigma Pharmaceuticals PLC – last updated: 2023 June 30. Accessed via: www.emc.medicines.org.uk [Accessed 2023 Aug 24].
  • Amoxicillin 1g Powder for Solution for Injection [online]. Manufacturer - Bowmed Ibisqus Limited – last updated: 2023 July 24. Accessed via: www.emc.medicines.org.uk [Accessed 2023 Aug 24].
  • The Renal Drug Database. Amoxicillin - last updated: 2023 Mar 6. Accessed via: https://renaldrugdatabase.com [Accessed 2023 Aug 21].
  • Habib G, et al. 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC) endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). European heart journal. 2015 Nov 21;36(44):3075-128.
  • UK Medicines Information. How should antibiotics be doses in obesity – last updated 2017 Mar 1. Accessed via: https://www.gloshospitals.nhs.uk/media/documents/Obese_Dosing_2016_update.pdf [Accessed September 2023].

Editorial Information

Last reviewed: 01 Sept 2023

Next review date: 01 Sept 2026

Author(s): AMST.