Antibiotics are strong medicines that can kill bacteria. For ear infections, doctors often prescribe oral antibiotics that you swallow in pill or liquid form.
However, eardrops can sometimes be safer and more effective than oral medicines. Here’s why:
- Oral antibiotics have risks.
- Oral antibiotics have more side effects.
- Who should use antibiotic eardrops?
- What about over-the-counter eardrops?
- Antibiotics can lead to more costs.
- Who should take oral antibiotics for ear infections?
- Oral antibiotics help treat Swimmer’s Ear when:
- What is amoxicillin?
- How to take amoxicillin
- Precautions – before starting amoxicillin
- Possible side effects
- Learn more
- Dosage information for amoxicillin
- Important Information
- Before taking this medicine
- How should I take amoxicillin?
- What happens if I miss a dose?
- What happens if I overdose?
- What should I avoid while taking amoxicillin?
- Amoxicillin side effects
- What other drugs will affect amoxicillin?
- Further information
- More about amoxicillin
Oral antibiotics have risks.
- Oral antibiotics are more likely to cause resistant bacteria outside the ear. When that happens, these medicines will not work as well in the future. Illnesses will be harder to cure and more costly to treat.
- Antibiotic eardrops kill the bacteria faster and more completely than oral antibiotics. Drops don’t go into the bloodstream, so more medicine reaches the infection.
Oral antibiotics have more side effects.
Oral antibiotics can cause more side effects than antibiotic eardrops. Side effects include diarrhea, nausea and vomiting, stomach pain, rash, headache, and dangerous allergic reactions.
Who should use antibiotic eardrops?
Antibiotic eardrops can be more effective and safer for:
- People with Swimmer’s Ear, an infection caused by water in the ear.
- Children who have tubes in their ears. The tubes prevent most infections behind the eardrum—an area known as the middle ear. If there is an infection, antibiotic eardrops can be given right through the tube.
What about over-the-counter eardrops?
Over-the-counter eardrops can often be effective for Swimmer’s Ear.
People who have a hole or tube in the eardrum should check with their doctor before using any kind of eardrops. The drops may cause pain, infection, or even damage hearing. For bacterial infections, the only eardrops they should use are the antibiotics ofloxacin (Floxin Otic and generic) or the more pricey combination drug ciprofloxacin-dexamethasone (Ciprodex).
Antibiotics can lead to more costs.
Most oral antibiotics don’t cost much. But if they don’t work well, you may need extra doctor visits, a hospital stay, and costly drugs. You may also miss work. Treatment of a severe infection that is antibiotic-resistant can cost more than $25,000.
Who should take oral antibiotics for ear infections?
- Children without ear tubes should take oral antibiotics for middle-ear infections, especially when they have severe ear pain or high fever.
- Children with ear tubes should take oral antibiotics if:
- They are very ill.
- They have another reason to be on an antibiotic.
- The infection doesn’t go away with eardrops.
Oral antibiotics help treat Swimmer’s Ear when:
- Infection spreads beyond the ear.
- The person has other conditions, such as diabetes, that increase the risk of complications.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
© 2017 Consumer Reports. Developed in cooperation with the American Academy of Otolaryngology-Head And Neck Surgery.
You are free to share this article under the Attribution 4.0 International license.
University University of Pittsburgh
When treating children between 9 and 23 months old with antibiotics for ear infections, a shortened course has worse clinical outcomes without reducing the risk of antibiotic resistance or adverse events.
The results of the trial appear today in the New England Journal of Medicine with an accompanying commentary.
Acute otitis media is a bacterial infection of the middle ear behind the ear drum that causes it to become painfully inflamed. Three out of four children experience this infection within their first year and it is the most common reason why children are prescribed an antibiotic.
8 ways to keep kids off unnecessary antibiotics
“Given significant concerns regarding overuse of antibiotics and increased antibiotic resistance, we conducted this trial to see if reducing the duration of antibiotic treatment would be equally effective along with decreased antibiotic resistance and fewer adverse reactions,” says Alejandro Hoberman, chief of the Division of General Academic Pediatrics at Children’s Hospital of Pittsburgh at the University of Pittsburgh Medical Center, and professor of pediatric research at the University of Pittsburgh School of Medicine.
In the current trial, 520 children with acute otitis media were randomly assigned to either a standard 10-day regimen of the antibiotic amoxicillin-clavulanate or a shortened 5-day treatment followed by five days of placebo. Neither the study participants nor the physicians knew which group the participant was assigned to.
Children were followed starting in October through the rest of the annual respiratory-infection season, and had a final visit during the following September.
They found that the risk of treatment failure in the 5-day group (34 percent) was more than twice as much the risk in the 10-day group (16 percent). The results were significant when considering the trial design which was set up to find out whether the 5-day treatment would be as good as the 10-day regimen, Hoberman says. Instead, the results clearly showed that not only was their initial assumption proven wrong, but the 10-day treatment was far more effective.
When they tested the presence of antibiotic-resistant bacteria through nasopharyngeal (back of the nose) swabs, there was no decrease in the 5-day group as might have been expected with a shorter duration of antibiotics. Also, reduced-duration antibiotics did not decrease the risk of frequent adverse events like diarrhea or diaper rash.
Many people with an ‘allergy’ could take penicillin
When testing the risk of a recurrent infection, they found that it was higher when children were exposed to three or more children for 10 or more hours per week, such as in a daycare setting, or if the initial infection occurred in both ears as opposed to just one ear.
Importantly, the study also shows for the first time that almost one in two children in whom residual fluid was observed in the middle ear after treatment had a recurring infection, a significantly higher percentage when compared to children without any residual fluid in the middle ear.
The marked superiority of the 10-day regimen over the 5-day regimen led the independent safety monitoring board overseeing the trial to conclude it prematurely as the primary end point was achieved.
“The results of this study clearly show that for treating ear infections in children between 9 and 23 months of age, a 5-day course of antibiotic offers no benefit in terms of adverse events or antibiotic resistance. Though we should be rightly concerned about the emergence of resistance overall for this condition, the benefits of the 10-day regimen greatly outweigh the risks,” says Hoberman.
A contract from the National Institute of Allergy and Infectious Diseases and University of Pittsburgh Clinical and Translational Science Awards from the National Center for Research Resources, now at the National Center for Advancing Translational Sciences, National Institutes of Health, supported the work.
Source: University of Pittsburgh
Easy-to-read medicine information about amoxicillin – what is it, how to take it safely and possible side effects.
|Type of medicine||Also called|
What is amoxicillin?
Amoxicillin is an antibiotic used to treat different infections caused by bacteria, such as chest infections, dental infections and infections of the throat, ear and sinus. It works by killing or stopping the growth of bacteria (bugs) and gets rid of the infection. Amoxicillin is sometimes used to get rid of Helicobacter pylori, an infection often found in people with stomach ulcers. It is not effective against infections caused by viruses. Amoxicillin belongs to a group of antibiotics called penicillins. In New Zealand amoxicillin is available as capsules and liquid and can be given as an injection in the hospital.
- The dose of amoxicillin will be different for different people depending on the type of infection and your age.
- Adults: the usual dose in adults is 250 or 500 milligrams 3 times a day.
- Children: the dose for children will depend on their body weight. It is usually given 3 times a day.
- Your doctor will advise you how long to take amoxicillin for (usually 3 to 7 days).
- Always take your amoxicillin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.
How to take amoxicillin
- You can take amoxicillin with or without food.
- Capsules: swallow the capsules with a glass of water or milk. Do not chew them.
- Liquid: shake the medicine well. Measure the right amount using an oral syringe or medicine spoon. You can get these from your pharmacy. Do not use a kitchen spoon as it will not give you the right amount. Read more: Tips on how to give medicines to babies and children.
- Amoxicillin is usually given 3 times a day. Try to space the doses evenly throughout the day, such as the first thing in the morning, early afternoon and at bedtime. Ideally these times should be at least 4 hours apart.
- If you forget to take your dose at the correct time, take one as soon as you remember. Try to take the correct number of doses each day, leaving at least 4 hours between doses. Do not take 2 doses at the same time to make up for a forgotten dose.
- If you are sick (vomit) less than 30 minutes after having a dose of amoxicillin, take the same dose again. But, if you are sick (vomit) and it is more than 30 minutes after having a dose of amoxicillin, you do not need to take another dose. Wait until the next normal dose.
- Store your capsules in a cool, dry place, away from direct heat and light. if you have been given liquid medicine, this will have been made up by the pharmacy and you may need to keep it in the fridge – check the instructions on the bottle. Make sure the medicine does not freeze.
- It is best to take the whole course of antibiotics for the number of days your doctor has told you to. Do not stop taking it, even if you feel your infection has cleared up.
Precautions – before starting amoxicillin
- Do you have glandular fever?
- Have ever had an allergic reaction to a medicine, especially a penicillin antibiotic?
- Are you pregnant or breastfeeding?
- Do you have problems with the way your kidneys work?
- Are you taking any other medicines? This includes any medicines you are taking that you can buy without a prescription, as well as herbal and complementary medicines.
If so, it’s important that you tell your doctor or pharmacist before you start amoxicillin. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.
Possible side effects
Like all medicines, amoxicillin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.
|Side effects||What should I do?|
Amoxicillin may interact with some medicines and herbal supplements, so check with your doctor or pharmacist before starting amoxicillin. If you are taking the contraceptive pill, its effectiveness can be reduced if you have a bout of being sick (vomiting) or diarrhoea that lasts for more than 24 hours. If this happens, ask your doctor or pharmacist for advice about contraception over the following few days.
The following links have more information on amoxicillin.
New Zealand Formulary Patient Information:
- Amoxicillin New Zealand Formulary
- Antibiotics – choices for common infections BPAC, NZ, 2017
Dosage information for amoxicillin
▪️ The dose of amoxicillin and how long you need to take it for depends on the type and severity of infection you have, your age, weight and kidney function. Always follow the instructions given by your doctor. These will be printed on the label that your pharmacist has put on the packet of medicine.
▪️ Amoxicillin is usually taken three times a day. Space your doses evenly over the day (during the hours you are awake). For example, adults who’ve been prescribed a dose three times a day could take one dose at 7am, one at 3pm and one at 11pm. However, children prescribed a dose three times a day could be given the medicine at 7am, 1pm and 7pm.
▪️ A typical dose to treat infection in an adult is 250mg to 500mg three times a day. For some infections, such as treatment for H pylori eradication you may be advised to take amoxicillin twice a day in combination with other antibiotics.
▪️ Amoxicillin capsules should be swallowed with a drink of water. Amoxicillin sachets should be mixed into half a glass of water just before taking.
▪️ Amoxicillin can be taken either with or without food.
▪️ It is safe to drink alcohol while taking amoxicillin – it won’t affect the medicine.
▪️ Missed dose: If you forget to take a dose of amoxicillin at the correct time, take it as soon as you remember and then space the rest of your doses over the remaining part of the day. Always try to take the correct number of doses each day, leaving at least four hours between doses. Don’t take two doses together to make up for a missed dose.
▪️ It is important that you finish the prescribed course of amoxicillin, even if you feel better or it seems the infection has cleared up. Stopping the course early makes it more likely that your infection will come back and that the bacteria will grow resistant to the antibiotic.
Read more about amoxicillin
What is amoxicillin used for and how does it work?
What should I know before taking amoxicillin?
Can I take amoxicillin while pregnant or breastfeeding?
What are the possible side effects of amoxicillin?
Can I take other medicines with amoxicillin?
Last updated: 01/05/2019
Rita Ghelani (BPharm, MRPharmS) Pharmacist A UK registered practising pharmacist with over 20 years’ experience, Rita is a member of the medical journalists’ association (MJA) and has a wealth of experience in community pharmacy.
Generic Name: amoxicillin (am OX i sil in)
Brand Names: Amoxil, Trimox, Moxatag
Medically reviewed by Kaci Durbin, MD Last updated on Jan 12, 2020.
- Side Effects
Amoxicillin is a penicillin antibiotic that fights bacteria.
Amoxicillin is used to treat many different types of infection caused by bacteria, such as tonsillitis, bronchitis, pneumonia, and infections of the ear, nose, throat, skin, or urinary tract.
Amoxicillin is also sometimes used together with another antibiotic called clarithromycin (Biaxin) to treat stomach ulcers caused by Helicobacter pylori infection. This combination is sometimes used with a stomach acid reducer called lansoprazole (Prevacid).
There are many brands and forms of amoxicillin available and not all brands are listed on this leaflet.
Before using amoxicillin, tell your doctor if you are allergic to cephalosporins such as Omnicef, Cefzil, Ceftin, Keflex, and others. Also tell your doctor if you have asthma, liver or kidney disease, a bleeding or blood clotting disorder, mononucleosis (also called “mono”), or any type of allergy.
Amoxicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking this medicine. Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Amoxicillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.
Antibiotic medicines can cause diarrhea. This may happen while you are taking amoxicillin, or within a few months after you stop taking it. This may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking this medicine and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Before taking this medicine
You should not use amoxicillin if you are allergic to any penicillin antibiotic, such as ampicillin, dicloxacillin, oxacillin, penicillin, or ticarcillin.
To make sure this medicine is safe for you, tell your doctor if you have:
mononucleosis (also called “mono”);
diarrhea caused by taking antibiotics; or
food or drug allergies (especially to a cephalosporin antibiotic such as Omnicef, Cefzil, Ceftin, Keflex, and others).
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Amoxicillin can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
How should I take amoxicillin?
Take amoxicillin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Take amoxicillin at the same time each day.
Some forms of amoxicillin may be taken with or without food. Check your medicine label to see if you should take your mediicne with food or not.
Shake the oral suspension (liquid) before you measure a dose.
Measure liquid medicine with the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). You may mix the liquid with water, milk, baby formula, fruit juice, or ginger ale. Drink all of the mixture right away. Do not save for later use.
You must chew the chewable tablet before you swallow it.
Swallow the regular tablet whole and do not crush, chew, or break it.
You will need frequent medical tests.
If you are taking amoxicillin with clarithromycin and/or lansoprazole to treat stomach ulcer, use all of your medications as directed. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice.
Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Amoxicillin will not treat a viral infection such as the flu or a common cold.
Do not share this medicine with another person, even if they have the same symptoms you have.
This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using this medicine .
Store at room temperature away from moisture, heat, and light.
You may store liquid amoxicillin in a refrigerator but do not allow it to freeze. Throw away any liquid mediicne that is not used within 14 days after it was mixed at the pharmacy.
What happens if I miss a dose?
Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking amoxicillin?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor before using anti-diarrhea medicine.
Amoxicillin side effects
Get emergency medical help if you have signs of an allergic reaction to amoxicillin (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Call your doctor at once if you have:
severe stomach pain; or
diarrhea that is watery or bloody (even if it occurs months after your last dose).
Common amoxicillin side effects may include:
nausea, vomiting, diarrhea; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect amoxicillin?
Tell your doctor about all your other medicines, especially:
any other antibiotics;
a blood thinner – warfarin, Coumadin, Jantoven.
This list is not complete. Other drugs may interact with amoxicillin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use amoxicillin only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2020 Cerner Multum, Inc. Version: 10.01.
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More about amoxicillin
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Patient Tips
- Drug Images
- Drug Interactions
- Compare Alternatives
- Support Group
- Pricing & Coupons
- En Español
- 234 Reviews
- Drug class: aminopenicillins
- Amoxicillin Capsules and Tablets
- Amoxicillin Chewable Tablets
- Amoxicillin Extended-Release Tablets
- Amoxicillin Suspension
- Amoxicillin (Advanced Reading)
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