Usage
Amoxycillin + Cloxacillin + Lactobacillus is a combination medication used to treat various bacterial infections. It combines two antibiotics (Amoxycillin and Cloxacillin) with the probiotic Lactobacillus. This combination is effective against infections of the:
- Respiratory tract (e.g., pneumonia, bronchitis, tonsillitis, sinusitis)
- Skin and soft tissues (e.g., cellulitis, boils, abscesses)
- Urinary tract (e.g., cystitis, pyelonephritis)
- Ear, nose, and throat
- Bones and joints
- Blood
- Other infections in various organs.
Pharmacological Classification:
- Amoxycillin and Cloxacillin: Beta-lactam antibiotics (Penicillins)
- Lactobacillus: Probiotic
Mechanism of Action:
Amoxycillin and Cloxacillin inhibit bacterial cell wall synthesis by binding to and inactivating penicillin-binding proteins (PBPs). This weakens the cell wall, leading to bacterial lysis and death. Cloxacillin is penicillinase-resistant, making it effective against bacteria that produce this enzyme, which would otherwise inactivate Amoxycillin. Lactobacillus helps restore the balance of gut flora, which can be disrupted by antibiotic use, preventing antibiotic-associated diarrhea.
Alternate Names
There are no officially recognized alternate names for this specific combination drug. However, it is marketed under various brand names, which can vary regionally. Some examples include:
- Moxfit CX
- Oxfit CX
- Amoxyclox LB
- Kritmox-CL
How It Works
Pharmacodynamics: Amoxycillin and Cloxacillin exert bactericidal effects by disrupting bacterial cell wall synthesis. Lactobacillus helps maintain and restore the normal gut flora.
Pharmacokinetics:
- Absorption: Amoxycillin and Cloxacillin are well-absorbed orally. Food may slightly delay absorption, but overall bioavailability is not significantly affected. Lactobacillus colonizes the gut.
- Metabolism: Amoxycillin and Cloxacillin undergo minimal metabolism.
- Elimination: Primarily renal excretion for Amoxycillin and Cloxacillin.
Mode of Action: Amoxycillin and Cloxacillin inhibit transpeptidases and other enzymes involved in cell wall synthesis, preventing the cross-linking of peptidoglycans, thus weakening the cell wall.
Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: Amoxycillin and Cloxacillin inhibit penicillin-binding proteins (PBPs), enzymes essential for bacterial cell wall synthesis.
Elimination Pathways: Primarily renal excretion.
Dosage
Standard Dosage
Adults: 250mg/250mg (Amoxycillin/Cloxacillin) every 6 hours. Dosages up to 500mg/500mg may be used depending on the severity of the infection.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary based on renal function.
- Patients with Renal Impairment: Dose reduction is necessary depending on creatinine clearance.
- Patients with Hepatic Dysfunction: Caution is advised, and dosage adjustments may be required.
- Patients with Comorbid Conditions: Dosage adjustments may be necessary for conditions such as diabetes, gastrointestinal disease, and immunosuppression.
Clinical Use Cases
Dosage recommendations for these settings are similar to standard dosage, potentially adjusted based on infection severity and patient response. Consult local guidelines for specific scenarios.
- Intubation
- Surgical Procedures (prophylaxis)
- Mechanical Ventilation (for associated infections)
- Intensive Care Unit (ICU) Use
- Emergency Situations
Dosage Adjustments
Adjustments are based on renal function, hepatic function, patient age, and other relevant factors. Consult clinical guidelines and expert advice for specific recommendations.
Side Effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Stomach pain/bloating
- Skin rash or itching
Rare but Serious Side Effects:
- Clostridium difficile infection
- Allergic reactions (including anaphylaxis)
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
Long-Term Effects:
Long-term use can lead to antibiotic resistance and disruption of gut flora.
Contraindications
- Known hypersensitivity to penicillins or cephalosporins.
- History of cholestatic jaundice or hepatic dysfunction associated with penicillin use.
Drug Interactions
- Antibiotics: Tetracyclines, Macrolides, Chloramphenicol
- Anticoagulants: Warfarin
- Anti-gout Medications: Probenecid, Allopurinol
- Immunosuppressants: Methotrexate
- Oral Contraceptives: Efficacy may be reduced.
- Others: Allopurinol
Pregnancy and Breastfeeding
Generally considered safe during pregnancy and breastfeeding, but consult a doctor before use. Amoxicillin is excreted in breast milk in low concentrations.
Drug Profile Summary
- Mechanism of Action: Inhibits bacterial cell wall synthesis, restores gut flora.
- Side Effects: Nausea, vomiting, diarrhea, rash, allergic reactions.
- Contraindications: Penicillin/cephalosporin allergy, prior cholestatic jaundice/hepatic dysfunction with penicillins.
- Drug Interactions: Several, including some antibiotics, anticoagulants, and anti-gout medications.
- Pregnancy & Breastfeeding: Generally safe, but consult a doctor.
- Dosage: See detailed dosage section.
- Monitoring Parameters: Renal and hepatic function, signs of allergic reactions, resolution of infection.
Popular Combinations May be combined with other antibiotics or medications, depending on the specific infection.
Precautions
Assess renal and hepatic function, allergy history, and potential drug interactions. Monitor for adverse reactions. Advise on potential interactions with food (calcium-rich foods, grapefruit).
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Amoxycillin + Cloxacillin + Lactobacillus?
A: The typical adult dosage is 250mg/250mg (Amoxycillin/Cloxacillin) every 6 hours. Pediatric and adjusted dosages should be determined by a physician.
Q2: What are the common side effects?
A: Common side effects include nausea, vomiting, diarrhea, stomach pain, and rash.
Q3: What are the contraindications?
A: Contraindications include known allergy to penicillins or cephalosporins.
Q4: Can this medication be used in pregnancy?
A: Generally considered safe, but consult a doctor.
Q5: What are the potential drug interactions?
A: May interact with other antibiotics (tetracyclines), anticoagulants (warfarin), and others.
Q6: How does the Lactobacillus component work?
A: Lactobacillus helps prevent antibiotic-associated diarrhea by restoring the balance of gut flora.
Q7: What should patients do if they miss a dose?
A: Take the missed dose as soon as remembered, unless it’s close to the next dose. Do not double the dose.
Q8: What should patients do if they experience side effects?
A: Report any concerns to their physician, especially severe diarrhea or signs of allergic reaction.
Q9: What is the mechanism of action of this combination?
A: Amoxycillin and Cloxacillin inhibit bacterial cell wall synthesis, while Lactobacillus supports gut health.
Q10: Are there any dietary restrictions while taking this medication?
A: It’s generally recommended to avoid calcium-rich foods and grapefruit near the time of taking the medication, as these can affect absorption.
