amoxicillin

Overview

Amoxicillin is a widely used β-lactam antibiotic in the penicillin class. It acts by inhibiting bacterial cell-wall synthesis through binding to penicillin-binding proteins, thereby impairing peptidoglycan cross-linking and leading to bacterial growth inhibition and cell death in susceptible organisms. Clinically, it is used for a range of bacterial infections, and its role in therapy is often considered alongside related agents such as amoxicillin-clavulanate, cefiderocol, and ceftazidime-avibactam when resistance patterns or infection severity influence antibiotic selection.

Beyond its established antimicrobial use, amoxicillin has also been studied as a biologically active exposure in developmental and environmental contexts. Recent work has examined its effects on dental enamel formation, where it was considered alongside fluoride, calcium, and vitamin D in a rat incisor model. Other studies have used amoxicillin as a model compound in analytical chemistry and environmental monitoring, reflecting its relevance as both a pharmaceutical and a contaminant of interest.

Focus of Latest Publications

Recent publications on amoxicillin have focused on its role in clinical therapy, its effects in combination settings, and its use as a reference compound in analytical and environmental studies. In infected diabetic foot ulcers, amoxicillin/clavulanate was evaluated alongside ceftazidime in the DFIATIM trial to assess whether bolus or continuous administration better achieved sufficient serum and peripheral tissue concentrations for bactericidal activity. In pediatric acute otitis media, amoxicillin remained the most frequently prescribed first-line antimicrobial in two Finnish hospitals, with more than 80% of children receiving it and most treated with a short 5-day course. A separate adult acute sinusitis publication highlighted ongoing uncertainty about whether amoxicillin or amoxicillin-clavulanate should be preferred as first-line treatment for uncomplicated disease.

Beyond therapeutic use, amoxicillin was examined for potential biological effects during enamel development. In a rat incisor model, combined exposure to fluoride and amoxicillin was associated with disorganized enamel prisms, increased ameloblast apoptosis marked by caspase-3 and TUNEL labeling, reduced KLK4 within ameloblasts, and altered abundance of enamel matrix proteins including AMBN, AMTN, and ODAM. The authors reported that vitamin D and calcium supplementation did not significantly reverse these changes under the conditions tested, suggesting that amoxicillin may contribute to disrupted amelogenesis when combined with fluoride exposure.

Amoxicillin was also used as a model analyte in a graphene-based electrochemical sensing platform for water contaminants. Using laser-induced graphene and screen-printed graphene electrodes with hydrogen peroxide-assisted redox mediation, the system detected amoxicillin at sub-ppb levels and showed strong agreement with HPLC-MS. Mass spectrometry identified peroxide-driven transformation products, including hydroxylated derivatives and β-lactam ring-opened intermediates, consistent with reactive oxygen species chemistry. The same platform responded to other oxidizable contaminants such as Diclofenac and ibuprofen, supporting its broader use for screening cumulative oxidizable organic burden in wastewater.

No recent publication in this set directly studied amoxicillin in relation to Pseudomonas aeruginosa resistance evolution, but the broader antimicrobial literature emphasized how treatment pressure can drive β-lactam resistance and within-patient adaptation in this pathogen.

Key Publications

Jul Tissue and Serum Concentrations of Time-Dependent Antibiotics in Infected Diabetic Foot Ulcers by Bolus or Continuous Administration: The Randomised DFIATIM Trial. (Diabetes/metabolism research and reviews, 2026, PMID 42218112): "This study evaluated the availability and bactericidal activity of the time-dependent ATBs-ceftazidime (CTZ) and amoxicillin/clavulanate (AMC) in serum and peripheral tissues by comparing bolus versus continuous administration."
May Morphological, Histochemical, and Proteomic Analysis of the Effects of Fluoride and Amoxicillin, with Calcium and Vitamin D Supplementation, on Dental Enamel Formation. (Calcified tissue international, 2026, PMID 42184017): "Although genetically regulated, amelogenesis is susceptible to environmental modulation by agents such as fluoride and amoxicillin."
May Graphene-Based Electrochemical Sensors for the Determination of Pharmaceutical- and Agricultural-Based Emerging Contaminants in Water. (Analytical chemistry, 2026, PMID 42060697): "Using amoxicillin (AMX) as a model compound, the system achieved sub-ppb sensitivity (LOD = 0.085 ppb) with excellent linearity (r2 > 0.99) across a wide dynamic range and strong agreement with HPLC-MS analysis."
Apr Antibiotic use and adherence to Finnish treatment guidelines in pediatric acute otitis media. (European journal of pediatrics, 2026, PMID 42036512): "Our hypothesis was that amoxicillin is the most frequently prescribed antimicrobial agent."
May Amoxicillin-Clavulanate vs Amoxicillin for Acute Sinusitis in Adults. (JAMA, 2026, PMID 41999289): "There is no consensus regarding whether amoxicillin-clavulanate or amoxicillin should be first-line treatment for uncomplicated acute sinusitis in adults."
May Ceftazidime-avibactam resistance evolution in Pseudomonas aeruginosa and implications for cross-resistance to other novel β-lactams. (Antimicrobial agents and chemotherapy, 2026, PMID 41940815): "Resistance was associated with amino acid substitutions in ampC and OXA β-lactamases, or mutations in regulatory genes conferring hyper-production of AmpC and MexAB-OprM efflux pumps."
Apr Within-patient evolution of Pseudomonas aeruginosa populations during antimicrobial treatment. (mSphere, 2026, PMID 41837616): "Mutations in genes associated with β-lactam resistance, including ampC, ftsI, and mexR, arose over time and corresponded with changes in antimicrobial susceptibility in single-colony isolates."