The Benefit and Pitfalls of Using Amoxicillin in the Treatment of Pneumonia - Essay Example

? The Benefit and Pitfalls of Using Amoxicillin in the Treatment of Pneumonia By of [Word Count] Introduction Pneumonia is a rather common infection of the lungs (Cunha, 2010). Usually, it is treated using antibiotics, which is followed well, results in full recovery. However, there are cases of pneumonia that are life-threatening, more so for patients with general poor health or elderly people (Cunha, 2010). In its basic definition, pneumonia is an inflammation of lung tissues, comparable to bronchitis in severity. In fact, in some instances, bronchitis and pneumonia occur together, a conditions referred to as called bronchopneumonia. Although home treatment is acceptable for mild pneumonia, it is advised that one seeks hospital treatment for severe cases. Whenever pneumonia is suspected, an antibiotic such as amoxicillin is often prescribed considering that bacterial infection is a major cause of pneumonia and antibiotics kill or destroy bacteria (Cunha, 2010). Amoxicillin is one of the most effective drugs against common causes of pneumonia. However, if proved to be less effective, contrary to expectations or allergy is noted, a change to another treatment is advised. In many cases, after using amoxicillin, symptoms are observed to improve after three days, which show that the treatment is working (Behera, 2010). This paper explores the uses, structure, benefits and the pitfalls of amoxicillin as a drug for treating a range of infections. In the process, how amoxicillin works to treat these infections will be discussed. Using Amoxicillin to Treat Pneumonia Amoxicillin is a drug that belongs to the penicillin family and is an improvement over the penicillin (Ravina, 2011). It was developed after penicillin was observed to have certain disadvantages (Ravina, 2011). The key use of amoxicillin, which is a prescription drug generally available to the public in different brand names, is in treating various forms of infections. Since it is used in treating a wide range of infections, it is necessary that one gathers enough information on the drug such as its structure, uses, benefits, shortcomings and brand names such as Amoxil, Dispermox and Trimox (Pichichero, 2005). Generally, amoxicillin, also referred to as amoxycillin and abbreviated as INN and BAN respectively or just amox, is moderate range ?-lactam bacteriolytic that treats infections that are due to the invasion of vulnerable pathogenic microorganisms such as pneumoniae. The drug first became available in 1972. There are several reasons amoxicillin is the favoured drug for treating diseases caused by such susceptible microorganisms. These reasons include the drug’s better absorption in oral administration. In fact, the drug does better in this regard compared to other ?-lactam antibiotics. It also finds a lot of uses in children suffering from pneumonia (Rudan et al., 2008). However, it must be recognized that the drug is susceptible to degradation by certain substances such bacteria that secrete ?-lactamase. In fact, this class of bacteria has been shown to be resistant to a wide range of other ?-lactam antibiotics including penicillin. Hence, some physicians prescribe it in combination with clavulanic acid, which is a ?-lactamase inhibitor. By combining it with these ?-lactamase inhibitors, physicians seek to ensure that the effectiveness of the drug is increased by its resistance to ?-lactamase being decreased (Pichichero, 2005). How Amoxicillin Kills Bacteria To best understand the advantages and disadvantages of using amoxicillin to treat pneumonia, it is imperative that one understands the manner in which the drug works against its target microorganisms. Generally, the drug targets the bacterial cell walls. That is, the drug restricts the capacity of the bacteria to shape cell walls. In other words, the importance of cell walls to bacterial life is targeted in this degradation process. In essence, the drug destroys the bonds that hold and compose the bacterial cell wall. Eventually, holes appear on the cell walls and the bacteria dies. The mechanism of action of amoxicillin is via the inhibition of the synthesis of bacterial cell walls. The drug blocks the cross-linking of the linear peptidoglycan polymer chains, which are major components of the cell walls of both Gram-positive and Gram-negative bacteria. The chains have two ionizable groups in the physiological range; the alpha-amino group in the amide carbonyl group and the carboxyl group (Whitney et al., 2003). The diagram below shows the two ionizable groups in the amoxicillin structure. Among the microorganisms susceptiable to this action by amoxicillin are Enterococcus, Streptococci, Haemophilus, Bacillus subtilis, Helicobacter and Moraxella whereas Klebsiella Citrobacter and Pseudomonas aeruginosa are generally resistant to amoxicillin. Medical Uses of Amoxicillin Amoxicillin finds usage in the treatment of a range of infections. These infections include urinary-tract infections, skin infections, and Salmonella, Lyme disease and Chlamydia infections. Others are acute otitis media, Streptococcal pharyngitis and pneumonia. Amoxicillin is also used to help prevent bacterial endocarditis, particularly for high-risk people such as those with dental problems. Streptococcus pneumoniae among other encapsulated bacterial infections such as sickle cell diseases are also prevented by the drug. The drug is also used to prevent anthrax. Amoxicillin is also highly recommended, as a first-choice treatment for bacterial sinusitis. Nonetheless, most sinusitis is due to viral infections hence amoxicillin is quite ineffective on such infections. Other areas in which amoxicillin is used are skin infections such as acne vulgaris. Benefits of Amoxicillin Based on penicillin, which was developed by scientists of great renown such as Alexander Fleming, Howard Florey and Ernest Chain, amoxicillin had improvements in areas of thorough absorption via the digestive system (Ravina, 2011). In addition, amoxicillin could deal with bacteria that penicillin could not deal destroy. In addition, there are certain adverse side effects of penicillin that are not observed in amoxicillin usage. For example, amoxicillin resists the side effects of stomach acid besides being effective on a wider range of bacteria than penicillin is (Cunha, 2010). Although amoxicillin does not kill bacteria directly, it is quite effective in inhibiting the reproduction of more bacteria by preventing bacteria from forming a protective cell wall (Ravina, 2011). Once these protective walls are absent the targeted bacteria cannot hold together and are exposed to the harsh environment in the cells. The other benefit of amoxicillin is that it can be used against a wide range of bacterial infections including N. gonorrhoea, Streptococci, Pneumococci and E. Coli, H. influenzae, and some types of Staphylococci. That the drug can treat infections caused by a wide range of bacteria has seen it being rather useful in different scenarios such as infected teeth, bite wounds, bladder infections, and upper respiratory and ear infections. The benefits of the drug are also seen in its variety of sizes and forms. That is, amoxicillin is available in the forms of capsules, chewable tablets, powdered tablets, tablets, which can all be mixed in suspension if needed. As for the capsules, amoxicillin is prescribed in 250 and 500 milligram dosages. For tablets, the drug is available in available in 500 and 875 milligram amounts whereas for the chewable tablets, the drug comes in 125, 200, 250 and 400 milligrams. The powder form of amoxicillin is obtained in various strengths while the suspension tablets are prescribed in 200 and 400 milligrams. Time and status consideration of consumption is the other benefit of the drug. That is, one can take the drug with meals or before meals, on an empty stomach because it rarely interacts adversely with food and it has mild side effects of nausea, insomnia and heartburn. The other advantage is that it can be used by expectant women who are not allergic to penicillin. Pitfalls of Amoxicillin Use One aspect of amoxycillin for which the drug is known is its adverse side effects, which are quite similar to those observed in the cases of other beta-lactam antibiotics. The general side effects of amoxicillin are rashes, drug-related colitis, nausea, vomiting and diarrhea. Besides these side effects, which are generally considered common, the drug has several rare adverse effects, which include confusion, insomnia, sensitivity to sound and light, mental changes and lightheadedness. The other is clouded thinking. For these rare adverse side effects, it is of the essence that immediate medical care is advised. Allergic reactions are the other disadvantages of amoxicillin usage. What is worse, these allergic reactions could be rather sudden and intense, implying that urgent medical care must be sought. The indications of allergic reactions include mild changes in mental status, skin rashes, itching, nausea and vomiting. However, any other signs and symptoms that raise suspicions should be seriously considered. Nevertheless, there are mild symptoms associated with allergy that may be observed throughout the treatment period. What is worth noting is that the allergic reactions could be deadly for some patients placed under amoxicillin dosage. Some patients could also develop mild hepatitis if placed under amoxicillin or a combination of amoxycillin and clavulanic (Cundiff & Joe, 2007). If children are given overdoses of amoxicillin, they could suffer lethargy or renal dysfunction and vomiting. The other pitfall of amoxicillin use in treating pneumonia is that it interacts with other classes of drugs including anticoagulants such as warfarin and pradaxa, allopurinol, birth control pills, some antibiotics and drugs for treating cancer. Others are uricosuric drugs, typhoid vaccine. The other noteworthy pitfall of amoxicillin is observed in nursing mothers in whom small amounts of amoxicillin could find their way into breast milk (Baselt, 2008). These traces of amoxicillin could result in diarrhea or allergic reactions in infants. However, the drug is generally considered safe during breastfeeding besides its uses in treating newborns’ infections. Conclusion Pneumonia is among the commonest infections of the lung for which patients use the antibiotic amoxicillin, developed by the improvement of penicillin. Amoxicillin interferes with the bacteria’s ability to form cell walls, which are quite vital cell components for bacterial survival. That is, cell walls keep unwanted substances from entering bacterial cells besides stopping cell contents from leaking. Amoxicillin breaks the bonds that hold bacterial cell walls together, allowing for holes to form on the cell walls and eventually killing the bacteria. Some bacteria are resistant to amoxicillin by acquiring the ability to produce defensive chemicals known as beta-lactamases, which interfere with structures of penicillin-type antibiotics, stopping them from working. The benefits of amoxicillin for which it is favoured by physicians are its various forms (capsules, tablets, powder and chewable tablets) and sizes (200mg, 500mg, 125mg and 250mg) and the range of infections it treats. However, it has pitfalls such as allergic reactions and resistance by some microorganisms. References Baselt, R. (2008) Disposition of toxic drugs and chemicals in man, eighth edition. Foster City, CA: Biomedical Publications. Behera, D. (2010) Textbook of pulmonary medicine, second edition. New Delhi: Jaypee Brothers Medical Publishers. Cundiff, J., and Joe, S. (2007) "Amoxicillin-Clavulanic Acid-Induced Hepatitis.” American Journal of Otolaryngology, 28(1): 30. Cunha, B. A. (2010) Pneumonia essentials, third edition. Sudbury, MA: Physicians' Press. Pichichero, M. E. (2005) "A Review of Evidence Supporting the American Academy of Pediatrics Recommendation for Prescribing Cephalosporin Antibiotics for Penicillin-Allergic Patients.” Pediatrics, 115(4): 1048–57. Ravina, E (2011) The evolution of drug discovery. Weinheim: Wiley-VCH. Rudan, I., Boschi-Pinto, C., Biloglav, Z., Mulholland, K., and Campbell, H. (2008). "Epidemiology and Etiology of Childhood Pneumonia.” Bulletin of the World Health Organization, 86(5): 408. Whitney, C. G., Farley, M. M., and Hadler, J. (2003) "Decline In Invasive Pneumococcal Disease after the Introduction of Protein-Polysaccharide Conjugate Vaccine.” New England Journal of Medicine, 348(18): 1737. Read More