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Antibiotic Augmentin (Amoxicillin Clavulanate)
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Basic information
- Generic name: Amoxicillin Calvulanic acid
- Brand/Trade names: Augmentin, Co-amoxiclav
- Dosages:
Tablets: 250 mg amoxicillin and 125 mg clavulanic acid;
500 mg amoxicillin and 125 mg clavulanic acid; 875 mg amoxicillin
and 125 mg clavulanic acid
Chewable tablets: 125 mg amoxicillin and 31.25 mg clavulanic
acid; 200 mg amoxicillin and 28.5 mg clavulanic acid; 250 mg
amoxicillin and 62.5 mg clavulanic acid; 400 mg amoxicillin
and 57 mg clavulanic acid
- Powder for oral suspension: 125 mg amoxicillin and
31.25 mg clavulanic acid per 5 mL; 200 mg amoxicillin and 28.5
mg clavulanic acid per 5 mL; 250 mg amoxicillin and 62.5 mg
clavulanic acid per 5 mL ; 400 mg amoxicillin and 57 mg clavulanic
acid per 5 mL
- Pharmacologic category: Penicillin antibiotic
(Beta-Lactam and Beta-Lactamase Inhibitor Combination)
- Habit forming? No
- Pregnancy risk factor: B
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Medical uses
Augmentin is a beta-lactam antibacterial penicillin co-formulated
with a beta-lactamase inhibitor. Addition of clavulanic acid to
amoxicillin in Augmentin enhances the effectiveness of this antibiotic
against many bacteria that are ordinarily resistant to amoxicillin.
Augmentin is indicated for the treatment of the infections caused
by susceptible strains of specific organisms:
- Otitis media
- Sinusitis
- Lower respiratory tract infections
- Skin and skin structure infections
- Urinary tract infections
Most common side effects of Augmentin are diarrhea, nausea, vomiting,
rashes and Candida superinfection. Nausea, vomiting, and diarrhea
may be lessened by taking the combination with food.
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Pharmacological characteristics
- Absorption: Amoxicillin and clavulanate potassium are
well absorbed from the gastrointestinal tract.
- Elimination half-life: The half-life of amoxicillin
is 1.3 hours and the half-life of clavulanic acid is 1 hour.
- Excretion: As with other penicillins, the major route
of elimination for amoxycillin is via the kidney, whereas for
clavulanate it is by both renal and non-renal mechanisms. Approximately
60-70% of the amoxycillin and approximately 40-65% of the clavulanic
acid are excreted unchanged in urine during the first 6 hours
after administration.
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Benefits
- Can be given without regard to meals
- Effective against beta-lactamase-producing bacteria.
The beta-lactamase inhibitory action of clavulanate extends
the spectrum of amoxicillin to embrace a wider range of organisms,
including many beta-lactamase producing strains of S. aureus,
H. influenzae, N. gonorrhoeae, E. coli, M. catarrhalis and Proteus,
Klebsiella and Bacteroides species.
- Safe for use by pregnant women who are not allergic to penicillin.
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Concerns
- Frequent gastrointestinal side effects, such as nausea, vomiting,
and diarrhea. Augmentin is more likely to cause diarrhea than
amixicillin.
- There have been a rare cases of severe allergic reactions
including angioneurotic oedema, anaphylaxis, serum sickness,
hypersensitivity vasculitis and interstitial nephritis.
- Risk of liver injury. Combination of amoxicillin and clavulanic
acid is a known drug of having adverse hepatic effects, mainly
by three mechanisms: Cholestasis, Hepatocellular injury and
Mixed mechanism. Those aged more than 65 years are more prone
to the liver damage caused by this drug.
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Unlabeled uses
- Antimicrobial prophylaxis in gynecologic surgery2
- Pelvic inflammatory diseas3
- Chlamydia
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Mode of action
Augmentin is bactericidal antibiotic.
Clavulanic acid binds and inhibits beta-lactamases that inactivate
amoxicillin resulting in amoxicillin having an expanded spectrum
of activity. Amoxicillin inhibits bacterial cell wall synthesis
by binding to one or more of the penicillin-binding proteins (PBPs)
which in turn inhibits the final transpeptidation step of peptidoglycan
synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis.
Bacteria eventually lyse due to ongoing activity of cell wall
autolytic enzymes (autolysins and murein hydrolases) while cell
wall assembly is arrested.
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Augmentin Reviews, Discussion Boards, Forums
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References
- 1. U.S. Food and Drug Administration.
Amoxicillin Clavulanate (Augmentin) U.S. Prescribing Information.
Available at (PDF format): Prescribing
Information
- 2. Cormio
G, Vicino M, Loizzi V, Tangari D, Selvaggi L. Antimicrobial
prophylaxis in vaginal gynecologic surgery: a prospective randomized
study comparing amoxicillin-clavulanic acid with cefazolin.
J Chemother. 2007 Apr;19(2):193-7. PubMed
- 3. Cirau-Vigneron N, Barrier J, Becue J,
Chartier M, Giraud JR, Landes P, Leng J, Raudrant D, Reme JM.
Amoxycillin/clavulanic acid ('Augmentin') compared with a combination
of aminopenicillin, aminoglycoside and metronidazole in the
treatment of pelvic inflammatory disease. Pharmatherapeutica.
1989;5(5):312-9. PubMed
- 4. Mann MS, Faro S, Maccato ML, Kaufman
RH. Treatment of cervical chlamydial infection with amoxicillin/clavulanate
potassium. Mann MS, Faro S, Maccato ML, Kaufman RH. Infect Dis
Obstet Gynecol. 1993;1(2):104-7. PubMedCentral
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Interesting Amoxicillin facts
- Potassium clavulanate is a beta-lactamase inhibitor, which, in
combination, expands the spectrum of amoxicillin to include many
amoxicillin-resistant organisms.
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