Amoxicillin/Clavulanate: Difference between revisions

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==General==
==General==
*Type: Amino-[[Is DrugClass::Penicillin]]
*Type: Amino-[[Is DrugClass::Penicillin]] with a bacterial [[Is PenicillinType::beta-lactamase inhibitor]]
*Dosage Forms: oral suspension, tablet, extended release tablet, chewable tablet
*Dosage Forms: oral suspension, tablet, extended release tablet, chewable tablet
*Dosage Strengths: oral suspension: (125/31.25mg)/5mL, (200mg/28.5mg)/5mL, (250mg/62.5mg)/5mL, (400mg/57mg)/5mL, (600mg/42.9mg)/5mL; tablet: 250mg/125mg, 500mg/125mg, 875mg/125mg; extended release tablet: 1000mg/62.5mg; chewable tablet: 200mg/28.5mg, 400mg/57mg
*Dosage Strengths: oral suspension: (125/31.25mg)/5mL, (200mg/28.5mg)/5mL, (250mg/62.5mg)/5mL, (400mg/57mg)/5mL, (600mg/42.9mg)/5mL; tablet: 250mg/125mg, 500mg/125mg, 875mg/125mg; extended release tablet: 1000mg/62.5mg; chewable tablet: 200mg/28.5mg, 400mg/57mg
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==Adult Dosing==
==Adult Dosing==
===Infection, Bacterial===
===Indications by Disease===
*500mg-875mg PO q12h
{{#ask: [[Has DrugName::Amoxicillin/Clavulanate]] [[Has Population::Adult]]
 
|?Treats disease=Disease
===[[Pneumonia]], community-acquired===
|?Has Dose=Dose
*2000mg ER PO q12h x 7-10 days
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
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*25-45mg/kg PO divided q12h
*25-45mg/kg PO divided q12h


===[[Otitis media]]===
===Indications by Disease===
*90mg/kg/day PO divided q12h x 10 days
{{#ask: [[Has DrugName::Amoxicillin/Clavulanate]] [[Has Population::Pediatric]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Special Populations==
==Special Populations==

Latest revision as of 02:57, 20 March 2026

General

  • Type: Amino-Penicillin with a bacterial beta-lactamase inhibitor
  • Dosage Forms: oral suspension, tablet, extended release tablet, chewable tablet
  • Dosage Strengths: oral suspension: (125/31.25mg)/5mL, (200mg/28.5mg)/5mL, (250mg/62.5mg)/5mL, (400mg/57mg)/5mL, (600mg/42.9mg)/5mL; tablet: 250mg/125mg, 500mg/125mg, 875mg/125mg; extended release tablet: 1000mg/62.5mg; chewable tablet: 200mg/28.5mg, 400mg/57mg
  • Routes of Administration: PO
  • Common Trade Names: Augmentin, Augmentin XR, Augmentin ES-600

Adult Dosing

Indications by Disease

DiseaseDoseContext
Acute necrotizing ulcerative gingivitis875 mg PO two times dailyUncomplicated
Dental abscess875 mg PO q12 hours x 7-14 daysOutpatient
Diabetic foot infection875/125mg PO q12hrsModerate DFI
Diverticulitis875/125mg PO Q8hrs x 5 daysUncomplicated, Preferred
Endocarditis12g/day in 4 dosesNative Valve Endocarditis
Erysipelas500mg PO BID x 10 daysTreatment Failure
Impetigo875mg (12.5mg/kg) PO q12hrs x 10 daysOral therapy
Mammalian bites875mg PO BID x 5-7 daysHuman bites
Mammalian bites875mg PO BID x 5-7 daysCat and dog bites
Mastitis875mg PO q12hrsAlternative
Neutropenic fever875mg PO q12hrs x 7 daysOutpatient with Ciprofloxacin
Peritonsillar abscess875 mg PO BID x 7-10dOutpatient
Pneumonia (main)500 mg/125 mg TID OR amox/clav 875 mg/125 mg BID OR 2,000 mg/125 mg BIDOutpatient, Unhealthy
Suppurative parotitis875mg (45mg/kg) PO BIDOutpatient

Pediatric Dosing

Infection, Bacterial

  • 25-45mg/kg PO divided q12h

Indications by Disease

DiseaseDoseContext
Acute otitis media80-90mg of amoxicillin per kg/day PO divided BID x 7-10 daysTreatment Failure
Dental abscess25-45mg/kg/day PO divided BID x 7-10 days (max 875mg/dose)Pediatric Outpatient
Impetigo25mg/kg/day PO divided BID x 7-10 daysPediatric Oral
Mammalian bites25-45mg/kg/day PO divided BID x 5-7 daysPediatric cat and dog bites
Mammalian bites25-45mg/kg/day PO divided BID x 5-7 daysPediatric Human bites
Peritonsillar abscess45mg/kg/day PO divided BID (max 875mg/dose)Pediatric Outpatient
Suppurative parotitis45mg/kg/day PO divided BID (max 875mg/dose)Pediatric Outpatient

Special Populations

  • Pregnancy risk: B
  • Lactation: probably safe
  • Renal Dosing
    • Adult: CrCl 10-30: give q12h, CrCl < 10, give q24h
    • Pediatric: CrCl 10-30: give q12h, CrCl < 10, give q24h
  • Hepatic Dosing
    • Adult: none
    • Pediatric: none

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 1.1 hour
  • Metabolism: Liver
  • Excretion: urine
  • Mechanism of Action:Bactericidal, inhibits cell wall mucopeptide synthesis, inhibits beta lactamases

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium S
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes X2
Gram Negatives N. gonorrhoeae S
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. I
Citrobacter freundii R
Citrobacter diversus R
Citrobacter sp. R
Aeromonas sp S
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica I
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi S
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces S
Bacteroides fragilis S
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum S
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
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