ZIMOX ® - Amoxicillin

ZIMOX ® is a drug based on Amoxicillin

THERAPEUTIC GROUP: General antimicrobials for systemic use - broad-spectrum penicillins

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications ZIMOX ® Amoxicillin

ZIMOX ® is indicated for the treatment of bacterial infections caused by organisms sensitive to amoxicillin.

From the clinical point of view the efficacy of amoxicillin has been demonstrated in:

Acute and chronic respiratory infections;
Infections of the urogenital system;
Otorhinolaryngological and stomatological infections;
Enteric infections;
Surgical site infections;
Dermatological and soft tissue infections;
Eradications of Helicobacter Pylori.

Mechanism of action ZIMOX ® Amoxicillin

Amoxicillin, active ingredient of ZIMOX ®, is an aminopenicillin structurally similar to ampicillin from which however it differs due to the presence of a hydroxyl group on the side chain.

Its particular stability in an acid environment allows it to be taken orally with a significantly greater bioavailability than penicillins and ampicillin.

Once absorbed at the intestinal level, it is distributed both in the tissues and in the body's liquids, but with low concentrations at the level of the liquor, maintaining its therapeutic activity for about 8 hours.

In these districts the amoxicillin exerts its bactericidal action in a manner very similar to that of natural penicillins, inhibiting the transpeptidation reaction and thus preventing the formation of cross-links useful for stabilizing the bacterial wall.

This process results in greater bacterial sensitivity to osmotic gradients leading to the lysis of the bacterium.

Despite the presence of an amino group at the level of the beta-lactam ring, capable of giving greater stability to the antibiotic, amoxicillin is generally sensitive to the action of beta lactamase, capable of opening the beta lactam ring by altering the therapeutic activity.

Different studies have also shown how bacteria can resist the microbicidal action of amoxicillin reducing the permeability to antibiotics and at the same time structurally modifying the normal targets of antibiotic therapy.

Studies carried out and clinical efficacy

1. AMOXICILLIN IN THE TREATMENT OF ACUTE RHINOSINUSITIS

JAMA. 2012 Feb 15; 307 (7): 685-92.

Clinical study demonstrating that the administration of 1.5 g of amoxicillin per day is not effective in reducing the symptoms present during acute rhinosinusitis in the immediate period, while guaranteeing an excellent degree of success in about 10 days of therapy.

2 . TRIPLE THERAPY FOR THE ERADICATION OF HELICOBACTER PYLORI

S Afr Med J. 2012 May 8; 102 (6): 368-71.

Study evaluating the efficacy of amoxicillin in triple therapy in the eradication of Helicobacter Pylori. The study shows no additional benefit in prolonging therapy beyond seven days, instead of increasing the potential side effects.

3. THE AMOXICILLIN IN THE DENTISTRY CHIRURIGA

Acta Odontol Scand. 2012 Feb 3.

Interesting work to evaluate the possibility of using amoxicillin in the reduction of surgical site infections in dentistry. In these cases in fact the deposition of amoxicillin through electro-spray, could preserve the surgical site from the bacterial colonization resulting also little toxic.

Method of use and dosage

ZIMOX ®

500 mg capsules of amoxicillin;

Tablets of 1 g of amoxicillin;

Soluble and chewable tablets of 500 - 1000 mg of amoxicillin;

Oral drops containing 100 mg of amoxicillin per ml of solution;

250 mg amoxicillin oral suspension powder for 5 ml suspension.

Antibiotic therapy with amoxicillin varies both in terms of dosage and duration based on the physio-pathological characteristics of the patient, the severity of the clinical picture and the possible presence of conditions capable of compromising the efficacy and safety of the therapy .

Generally, the therapeutic range for adults ranges from one to three grams of amoxicillin per day, preferably taken in several administrations.

In therapy for the eradication of Helicobacter Pylori, amoxicillin is usually combined with clarithromycin and pantoprazole in a triple therapy that has generally proved to be more effective.

In any case, and especially for pediatric or elderly patients, medical supervision would be necessary and possibly a further adjustment of the doses used.

Warnings ZIMOX ® Amoxicillin

The use of ZIMOX ® should be preceded by a careful medical examination to assess the presence of conditions incompatible with the administration of the drug and the sensitivity of the pathogenic microorganism to amoxicillin.

An inadequate use of the drug could in fact contribute to the establishment of drug-resistant microbial strains, therefore insensitive to amoxicillin therapy.

The use of ZIMOX ® should be carried out with particular care in patients suffering from liver and kidney diseases, given the greater susceptibility to side effects of antibiotic therapy.

The entire treatment should be supervised by your doctor, who should periodically monitor, especially in the early stages of therapy, the patient's liver and kidney function.

ZIMOX ® in drops contains sucrose, therefore patients suffering from fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should opt for the capsule or tablet form.

PREGNANCY AND BREASTFEEDING

The absence of studies able to evaluate the safety profile of amoxicillin on the fetus suggests the use of the utmost caution in the use of ZIMOX ® during pregnancy and in the subsequent period of breastfeeding.

Should conditions require it, the use of this medicine should be under strict medical supervision.

Interactions

Although the pharmacologically relevant interactions are only rarely noteworthy, it would be advisable to avoid the simultaneous intake of amoxicillin and:

Allopurinol, given the increased risk of developing allergic reactions;
Probenecid, responsible for the increase in blood concentrations and the hepatic and renal side effects of amoxicillin;
Warfarin, due to the increased risk of bleeding;
Methotrexate, given the increase in blood concentrations of this active ingredient induced by amoxicillin, responsible for an increase in the toxicity of the drug;
Ethanol and amiloride able to alter its intestinal absorption profile.

Contraindications ZIMOX ® Amoxicillin

The use of ZIMOX ® is contraindicated in patients who are hypersensitive to penicillins and cephalosporins or to the relevant excipients and during infectious mononucleosis.

Undesirable effects - Side effects

Several clinical trials and careful post-marketing monitoring have shown that amoxicillin therapy can often be associated with the development of adverse reactions, sometimes clinically relevant.

Although the most worrying side effects are those related to the onset of hypersensitivity reactions to the drug such as rash, angioedema, bronchospasm, laryngospasm, hypotension and in more severe cases anaphylactic shock, vomiting, diarrhea, anorexia, pseudo colitis have occasionally been described membranous, epigastric pain, hypertransaminasemia, hyperbilirubinemia, headache and vertigo.