Usage
Amoxycillin + Lactobacillus + Serratiopeptidase is a combination medication primarily used for the treatment of various bacterial infections, particularly those involving inflammation. It combines an antibiotic, a probiotic, and an anti-inflammatory enzyme.
Pharmacological Classification:
- Amoxicillin: Beta-lactam antibiotic
- Lactobacillus: Probiotic
- Serratiopeptidase: Proteolytic enzyme (anti-inflammatory)
Mechanism of Action:
- Amoxicillin: Inhibits bacterial cell wall synthesis, leading to bacterial cell death.
- Lactobacillus: Replenishes beneficial gut flora, often disrupted by antibiotic use, reducing the risk of antibiotic-associated diarrhea.
- Serratiopeptidase: Breaks down proteins that contribute to inflammation and swelling, reducing pain and promoting healing.
Alternate Names
No widely recognized alternate names exist for this specific combination. Various brand names are used depending on the manufacturer. Some examples include Amoclas, Inloxy SLB.
How It Works
Pharmacodynamics:
- Amoxicillin: Bactericidal action through cell wall disruption.
- Lactobacillus: Improves gut microbial balance.
- Serratiopeptidase: Anti-inflammatory and analgesic effect.
Pharmacokinetics:
- Amoxicillin: Well-absorbed orally, metabolized in the liver, primarily excreted renally.
- Lactobacillus: Acts locally in the gut, colonization and multiplication.
- Serratiopeptidase: Absorbed orally, metabolized (specific details are limited).
Mode of Action:
- Amoxicillin: Inhibits transpeptidases and carboxypeptidases involved in bacterial cell wall synthesis.
- Lactobacillus: Competes with pathogenic bacteria, produces antimicrobial substances.
- Serratiopeptidase: Hydrolyzes bradykinin, histamine, and other inflammatory mediators.
Elimination Pathways:
- Amoxicillin: Primarily renal excretion.
- Lactobacillus: Eliminated through the gastrointestinal tract.
- Serratiopeptidase: Elimination pathway details are limited.
Dosage
Standard Dosage
Adults:
Dosages vary depending on the severity and type of infection. A common regimen is 250-500mg of Amoxicillin, combined with the manufacturer’s recommended dose of Lactobacillus and Serratiopeptidase, every 8 hours.
Children:
Dosage is weight-based and should be determined by a physician.
Special Cases:
- Elderly Patients: Dose adjustments based on renal function are often necessary.
- Patients with Renal Impairment: Dose reduction or extended intervals.
- Patients with Hepatic Dysfunction: Caution advised, potential adjustments needed.
- Patients with Comorbid Conditions: Careful consideration of drug interactions is needed.
Clinical Use Cases The data regarding this specific combination’s use in clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations is limited. Dosages would be determined on a case-by-case basis by the physician.
Dosage Adjustments
Adjustments are based on renal and hepatic function, concurrent medications, and individual patient health.
Side Effects
Common Side Effects
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Skin rash
- Flatulence
Rare but Serious Side Effects
- Clostridium difficile associated diarrhea (CDAD)
- Allergic reactions (anaphylaxis, angioedema)
- Stevens-Johnson Syndrome (SJS)
- Toxic epidermal necrolysis (TEN)
Long-Term Effects
Potential for antibiotic resistance and C. difficile infections with prolonged antibiotic use.
Adverse Drug Reactions (ADR)
Severe allergic reactions require immediate medical attention.
Contraindications
- Hypersensitivity to penicillins, cephalosporins, or any component.
- History of cholestatic jaundice/hepatic dysfunction associated with amoxicillin/cloxacillin.
Drug Interactions
- Allopurinol: Increased risk of rash
- Oral contraceptives: Reduced efficacy
- Anticoagulants (warfarin): Enhanced anticoagulant effect
- Probenecid: Increased amoxicillin/cloxacillin levels
- Methotrexate: Increased toxicity
- Tetracyclines: Decreased amoxicillin/cloxacillin effectiveness
- Alcohol: May increase side effects.
Pregnancy and Breastfeeding
The safety of this combination during pregnancy and breastfeeding is not well-established. Consult a physician before use. Amoxicillin and cloxacillin are generally considered safe during pregnancy, but data on serratiopeptidase and the combined formulation is limited. Both amoxicillin and cloxacillin are excreted in breastmilk; caution is advised.
Drug Profile Summary
- Mechanism of Action: Amoxicillin inhibits bacterial cell wall synthesis; Lactobacillus restores gut flora; Serratiopeptidase reduces inflammation.
- Side Effects: Nausea, vomiting, diarrhea, abdominal pain, skin rash, allergic reactions.
- Contraindications: Hypersensitivity to components, history of cholestatic jaundice/hepatic dysfunction with penicillins.
- Drug Interactions: See Drug Interactions section.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: Determined by a physician based on individual patient factors.
- Monitoring Parameters: Renal and hepatic function, signs of allergic reactions, superinfections (e.g., C. difficile).
Popular Combinations
Data on specific popular combinations is limited.
Precautions
- General Precautions: Assess for allergies, renal/hepatic function.
- Specific Populations: Consult a physician for pregnant/breastfeeding women, pediatric, and elderly patients.
- Lifestyle Considerations: Avoid alcohol.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Amoxycillin + Lactobacillus + Serratiopeptidase?
A: Dosage is determined by the physician based on patient age, weight, renal/hepatic function, infection severity, and specific product.
Q2: What infections are treated with this combination?
A: Respiratory tract infections, skin and soft tissue infections, urinary tract infections, among others.
Q3: What are the common side effects?
A: Nausea, vomiting, diarrhea, abdominal pain, skin rash are common side effects.
Q4: What are the serious side effects?
A: C. difficile infection, allergic reactions (anaphylaxis, angioedema), and severe skin reactions (SJS/TEN).
Q5: Can this medication be used during pregnancy?
A: Consult a physician; safety not fully established. Limited data suggests amoxicillin and cloxacillin are generally safe, but information regarding combined formulation and serratiopeptidase is lacking.
Q6: Can this be used during breastfeeding?
A: Consult a physician. Amoxicillin and cloxacillin are excreted in breastmilk. Caution is advised.
Q7: Are there any drug interactions I should be aware of?
A: Yes, several. See the Drug Interactions section for a full list.
Q8: What should I do if a patient experiences an allergic reaction?
A: Discontinue the medication immediately and provide appropriate medical support. Epinephrine may be required for anaphylaxis.
Q9: Does this combination offer any advantages over amoxicillin alone?
A: The addition of lactobacillus aims to reduce antibiotic-associated diarrhea. Serratiopeptidase is intended to decrease inflammation and pain. However, robust clinical data demonstrating superior efficacy compared to amoxicillin alone for all infections is currently limited.
Q10: How should I monitor patients on this medication?
A: Monitor for signs of allergic reactions, superinfections (e.g. C. difficile), and therapeutic response. Renal and hepatic function should be monitored, especially in patients with pre-existing conditions.
