Amoxicillin/Clavulanate: Difference between revisions
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==General==
==General==
*Type:  
*Type: Amino-[[Is DrugClass::Penicillin]] with a bacterial [[Is PenicillinType::beta-lactamase inhibitor]]
*Dosage Forms:
*Dosage Forms: oral suspension, tablet, extended release tablet, chewable tablet
*Common Trade Names:  
*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==
==Adult Dosing==
===Infection, Bacterial===
*500mg-875mg PO q12h
===[[Pneumonia]], community-acquired===
*2000mg ER PO q12h x 7-10 days


==Pediatric Dosing==
==Pediatric Dosing==
===Infection, Bacterial===
*25-45mg/kg PO divided q12h
===[[Otitis media]]===
*90mg/kg/day PO divided q12h x 10 days


==Special Populations==
==Special Populations==
*Pregnancy:
*[[Drug pregnancy categories|Pregnancy risk]]: B
*Lactation:
*Lactation: probably safe
*Renal Dosing
*Renal Dosing
**Adult
**Adult: CrCl 10-30: give q12h, CrCl < 10, give q24h
**Pediatric
**Pediatric: CrCl 10-30: give q12h, CrCl < 10, give q24h
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult: none
**Pediatric
**Pediatric: none


==Contraindications==
==Contraindications==
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==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*[[Anaphylaxis]]
*[[Steven Johnson syndrome]]
*C. diff associated diarrhea
*Hemolytic anemia
*Leukopenia
*Thrombocytopenia
*Hepatitis
*[[Seizures]]


===Common===
===Common===
*[[Diarrhea]]
*[[Nausea and vomiting]]
*[[Rash]]
*Pruritus
*Glossitis
*Transaminitis


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 1.1 hour
*Metabolism:  
*Metabolism: Liver
*Excretion:  
*Excretion: urine
*Mechanism of Action:
*Mechanism of Action:Bactericidal, inhibits cell wall mucopeptide synthesis, inhibits beta lactamases
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''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===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
 
<references/>
<references/>
[[Category:Drugs]]
[[Category:Pharmacology]] [[Category:ID]]

Latest revision as of 17:44, 18 July 2025

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

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

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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