The Indian Council of Medical Research (ICMR) has recently released a revised, updated version of guidelines for antimicrobial treatment in India.

The guideline has been revised from the 2017 National Action Plan for Antimicrobial Resistance (NAP-AMR) initiative.

2019 saw the release of the second edition of this, which contained revised advice on best practices for treating infections, including those of the skin, soft tissues, and central nervous system.

It included their dosage, method of administration, and length of therapy.

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The purpose of the recommendation is to give medical professionals a useful manual for caring for patients and using antimicrobial agents properly.

The guidelines will also aid in effective antimicrobial prescription and dispensing, improving patient care, and, most importantly, lowering the burden of antimicrobial resistance (AMR) in the country, which is a threat at the moment and has overshadowed the possibility of lowering infection-related death rates.

Amoxicillin

In this article, evidential light is shed on Amoxicillin, the most commonly prescribed antimicrobial agent in outpatient settings and the first choice for treating common infections.

Since Amoxicillin has been extensively prescribed, it is expected that refinements in its evidential use could significantly enhance practitioners' prescribing practices.

According to the latest guideline, the following are the indications for the use of Amoxicillin as the first choice of treatment:

- Bacterial sinusitis: The guideline laid down Amoxicillin as the first choice of treatment in mild bacterial sinusitis for an adult with a treatment duration of 5-7 days and in children 10-14 days.

- Acute otitis media: Children between 2 and 5 years with mild disease can be treated for 7 days and those above 5 years with 5-7 days of therapy.

- Pediatric community-acquired pneumonia (CAP): For children aged > 1 month, Amoxicillin is the first choice of therapy.

- Urinary tract infection (UTI) in Children: The guideline recommended Amoxicillin as the first choice of therapy, and the treatment regime can be for 5-7 days.

In addition, the guideline also added Amoxicillin as the second/alternate therapy for Streptococcal pharyngitis for a treatment duration of 10 days.

Recommended Dosage of Amoxicillin

500 – 1000 mg thrice daily (PO or IV) in adults and 15-20 mg/kg twice daily oral, 30-35 mg/kg thrice daily IV in paediatrics.

Note: This is a summary of the guidelines without interpretation or commentary.

For further information, please refer to the full details of the guidelines in the reference.

Reference: Treatment Guidelines for Antimicrobial Use in Common Syndromes 2022

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