X
More than 60,000 patients use Brite
4.6 stars
Your health finally understandable with Brite
Enter email and you're done. No subscription, no credit card.
Search, tap and you're done. Over 3,400 medicines.
Check, remind, get an overview.
Sarah K., 34
I finally understand my therapy. The app reminds me, answers my questions — and I don't feel alone with it anymore.
Amoxicillin is one of the most commonly prescribed antibiotics worldwide — and for good reason: It is effective against many bacterial infections, is well tolerated, is gastro-safe and can also be given to children and pregnant women. The WHO classifies it as an “access” antibiotic — meaning that it should be used preferentially as a first-line treatment.
See more detail.gif)
This article is for information only and does not replace medical advice. Amoxicillin is prescription only. Never take antibiotics on your own initiative, stop them early, or take them from other people.
Amoxicillin is one of the most prescribed antibiotics worldwide and belongs to the WHO category of Access antibiotics – the agents that should be used as first choice for many infections. The overview below shows the most important pharmacological key facts.
| Property | Details |
|---|---|
| Active substance | Amoxicillin (as trihydrate) |
| ATC code | J01CA04 |
| Drug class | Aminopenicillin (beta-lactam antibiotic) |
| Available forms | Tablets (250 mg, 500 mg, 750 mg, 1,000 mg), capsules, syrup/suspension for children, effervescent tablets |
| Half-life | approx. 1 hour |
| Bioavailability | 72–94% (very good for an antibiotic!) |
| Type of action | Bactericidal (kills bacteria) |
| Intake | Independent of meals |
| WHO classification | Access antibiotic (1st choice for many infections) |
| Prescription only | Yes |
Amoxicillin is one of the beta-lactam antibiotics and attacks the cell wall of bacteria. It binds to so-called penicillin-binding proteins (PBPs) – enzymes that are indispensable for building and repairing the bacterial cell wall. When these enzymes are blocked, the cell wall can no longer be maintained: the bacterium bursts and dies.
This mechanism explains two important points: first, amoxicillin only works against actively growing bacteria – dormant germs are not affected. Second, it works exclusively against bacteria, not against viruses. For a cough caused by colds, flu, or COVID-19, amoxicillin is ineffective – and even does harm through unnecessary resistance development.
Amoxicillin works against a clearly defined spectrum of bacteria. Crucially: pathogens without a cell wall (such as mycoplasma or chlamydia) are naturally resistant – so amoxicillin does not work for atypical pneumonia or sexually transmitted infections.
| Susceptible (amoxicillin works) | Naturally resistant (does NOT work) |
|---|---|
| Streptococci (incl. pneumococci) | Staphylococci (many MRSA strains) |
| Enterococci | Klebsiella, Enterobacter |
| Haemophilus influenzae (95–97% susceptible) | Pseudomonas aeruginosa |
| Helicobacter pylori | Mycoplasma, chlamydia (no cell wall!) |
| Listeria | Legionella |
| Borrelia (Lyme disease) | Beta-lactamase-producing strains |
| Proteus mirabilis | – |
Amoxicillin is the first-choice agent for a wide range of bacterial infections – from streptococcal tonsillitis to community-acquired pneumonia. What always matters is evidence of, or reasonable suspicion of, a bacterial cause. The table below shows the most important indications according to current guidelines.
| Infection | Role of amoxicillin | Guideline status |
|---|---|---|
| Acute middle ear infection (otitis media) | 1st choice in children > 6 months with severe symptoms | DGPI guideline 2024 (Germany) |
| Acute sinusitis (bacterial) | 1st choice when an antibiotic is indicated | S2k ENT guideline 2025 (Germany) |
| Streptococcal tonsillitis | 1st choice | DEGAM guideline (Germany) |
| Community-acquired pneumonia (mild) | 1st choice (high dose: 3×1 g) | S3 respiratory medicine guideline (Germany) |
| Helicobacter pylori eradication | Part of triple therapy | S2k gastroenterology guideline (Germany) |
| Lyme disease (erythema migrans) | 1st choice (alternatively doxycycline) | S3 Lyme disease guideline (Germany) |
| Urinary tract infections (targeted) | Only with confirmed susceptibility | AWMF guideline (Germany) |
| Dental abscess / odontogenic infections | 1st choice | S3 dentistry guideline (Germany) |
| Endocarditis prophylaxis | Single dose 2 g before the procedure | ESC guideline |
The right dose depends on the type of infection, body weight (in children), and kidney function. Important: amoxicillin should always be taken at the prescribed dose and for the entire prescribed duration – even if symptoms ease earlier. Only then are all bacteria reliably killed and resistance prevented. Record your dosage in your digital medication plan.
| Infection | Dose | Frequency | Duration |
|---|---|---|---|
| Streptococcal tonsillitis | 3× 1,000 mg or 2× 750–1,000 mg | Every 8h or 12h | 5–7 days |
| Acute sinusitis (bacterial) | 3× 500–750 mg | Every 8h | 5–7 days |
| Community-acquired pneumonia | 3× 1,000 mg | Every 8h | 5–7 days |
| Helicobacter pylori eradication | 2× 1,000 mg (+ PPI + clarithromycin) | Every 12h | 7–14 days |
| Lyme disease (erythema migrans) | 3× 500–1,000 mg | Every 8h | 14–21 days |
| Endocarditis prophylaxis | 2,000 mg single dose | 30–60 min before the procedure | Once |
| Dental abscess | 3× 500–750 mg | Every 8h | 5–7 days |
In children, amoxicillin is dosed by body weight. A syrup (suspension) is available for intake, which must be kept in the fridge after it has been made up. Parents should use the dose reminder so as not to miss a dose.
| Infection | Dose | Intake | Duration |
|---|---|---|---|
| Otitis media (mild) | 40–50 mg/kg/day | In 2–3 single doses | 5–7 days |
| Otitis media (severe) | 80–90 mg/kg/day | In 2–3 single doses | 7–10 days |
| Streptococcal tonsillitis | 50 mg/kg/day (max. 3 g) | In 2–3 single doses | 5–7 days |
| Pneumonia | 50–90 mg/kg/day | In 3 single doses | 5–7 days |
As amoxicillin is excreted predominantly via the kidneys, the dose must be adjusted in impaired kidney function. Patients with chronic kidney disease should discuss the dose with their doctor.
| GFR (ml/min) | Recommendation |
|---|---|
| > 30 | No adjustment required |
| 10–30 | Max. 500 mg every 12 hours |
| < 10 / dialysis | Max. 500 mg every 24 hours, additional dose after dialysis |
The effectiveness of antibiotic therapy depends not only on the right substance but also on correct use. These five rules decide whether amoxicillin really works – and whether you avoid resistance. Use the medication dose reminder from brite so you do not miss a dose.
Amoxicillin is well tolerated – but not free of side effects. The most common side effects affect the gastrointestinal tract and the skin. Particularly important: not every rash on amoxicillin is an allergy – this distinction can determine a lifelong misdiagnosis.
| Side effect | Frequency | What to do? |
|---|---|---|
| Diarrhoea | Common (5–10%) | Amoxicillin also kills useful gut bacteria. Yoghurt/probiotics (2h apart) can help. If bloody or >5×/day: see a doctor (rule out C. difficile!) |
| Nausea, vomiting | Common | Taking it with meals can help |
| Skin rash (maculopapular) | Common (5–10%) | Often NOT allergic! Typically a late exanthem from day 5–11. Must be distinguished from an allergic rash |
| Vaginal thrush (candidiasis) | Common | Through disruption of the vaginal flora. Antifungal (clotrimazole) from the doctor/pharmacist |
| Allergic rash (urticaria) | Occasional | Itching + weals, usually immediately (<1h after intake). Stop + see a doctor at once! |
| Anaphylaxis | Very rare (<0.05%) | Life-threatening! Shortness of breath, circulatory collapse, swelling → emergency services (112; or 999/112 in the UK) |
The most important takeaway from the table: a skin rash on amoxicillin is common – but usually harmless. A late, blotchy rash from day 5 is almost never a true allergy. Anyone who does not know this distinction risks a lifelong misdiagnosis with far-reaching consequences for future therapies.
Hardly any other topic in antibiotic therapy is as misunderstood as penicillin allergy. The clinical reality is clear: the vast majority of documented allergies are not true allergies – with considerable consequences for those affected.
The problem has real consequences: patients with a "penicillin allergy" instead receive broad-spectrum antibiotics (fluoroquinolones, cephalosporins) that have more side effects and promote resistance. Anyone who is unsure should have allergy testing carried out – in many cases the penicillin allergy can then be "de-labelled". Use the interaction check from brite to review your medications.
| True allergy (immediate type) | Non-allergic exanthem | Intolerance | |
|---|---|---|---|
| Timing | Minutes to 1 hour | Day 5–11 after starting therapy | Throughout the whole therapy |
| Symptoms | Urticaria, angio-oedema, shortness of breath, anaphylaxis | Blotchy, non-itchy rash | Diarrhoea, nausea, abdominal pain |
| Dangerous? | Yes – potentially life-threatening | No – harmless, resolves | No – unpleasant but harmless |
| Amoxicillin in future? | Contraindicated (without allergy testing) | Can be given again | Can be given again |
The bottom line: anyone who received amoxicillin in childhood and developed a rash should not automatically interpret this as a penicillin allergy. An allergy assessment is worthwhile – it can prevent lifelong restrictions in the choice of antibiotics.
