Oral Absorption of Amoxicillin in Ethiopian Children with Respiratory Symptoms and Different Nutritional Status

Severe acute malnutrition and infection

“…Amoxicillin reaches therapeutic plasma levels in acutely malnourished children when given orally, and is considered to be reasonably safe with few side-effects. 9 , 10 Therefore, pending further studies or significant changes in the availability of oral third-generation cephalosporins, current evidence suggests that amoxicillin 80–90 mg/kg/day in two divided doses for 7 days is the most appropriate treatment. While other dosages and regimens have been quoted previously, this is now the one with the strongest evidence base.…”

Antibiotics in severely malnourished children: systematic review of efficacy, safety and pharmacokinetics

“…21,[26][27][28][29] Characteristics of pharmacokinetic studies are detailed in Table 3, Table 4 and Table 5. [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] All included studies refer to children with SAM unless otherwise stated.…”

“…[30][31][32] The oral bioavailability of penicillin V was the same regardless of nutritional status, although it was significantly reduced when the drug was taken with food. 30 Time to maximum concentration (C max ) of amoxicillin was significantly longer in children with kwashiorkor 31 and time to C max of penicillin V was longer, though not significantly, in all malnourished groups.…”

“…[30][31][32] The oral bioavailability of penicillin V was the same regardless of nutritional status, although it was significantly reduced when the drug was taken with food. 30 Time to maximum concentration (C max ) of amoxicillin was significantly longer in children with kwashiorkor 31 and time to C max of penicillin V was longer, though not significantly, in all malnourished groups. 30 However, all malnourished subjects attained high enough serum levels for clinical effect to One child who was in shock had a trough level of 5.5 μg/ml; longer clearance was noted in children with hypothermia, high serum creatinine or large base excess.…”

“…the minimum inhibitory concentration [MIC] for common infecting organisms). [30][31][32] Although not reported, the volume of distribution (i.e. the distribution of a drug between plasma and the rest of the body) can be assumed from parenteral models given similar peak concentrations, as described later in the text.…”