Amoxicillin/Clavulanate

From WikEM
Jump to: navigation, search

General

  • Type: Amino-Penicillin
  • 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

Infection, Bacterial

  • 500mg-875mg PO q12h

Pneumonia, community-acquired

  • 2000mg ER PO q12h x 7-10 days

Pediatric Dosing

Infection, Bacterial

  • 25-45mg/kg PO divided q12h

Otitis media

  • 90mg/kg/day PO divided q12h x 10 days

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

  • anaphylaxis
  • steven johnson syndrome
  • c.diff associated diarrhea
  • hemolytic anemia
  • leukopenia
  • thrombocytopenia
  • hepatitis
  • seizures

Common

  • diarrhea
  • nausea
  • rash
  • pruritus
  • vomiting
  • glossitis
  • transaminitis

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