Amoxicillin Clavulanate

Mechanism :

Amoxicillin, a semisynthetic antibiotic, and clavulanate a beta-lactamase inhibitor. Amoxycillin-clavulanate is effective against both gram positive and beta lactam producing gram negative organisms.

Indication :

Infections of the genitourinary tract
Infections of the skin and skin structure
Infections of the lower respiratory tract
Intra-abdominal infections
Acute otitis media
Sinusitis

Contraindications :

A history of hypersensitivity to any penicillin is a contraindication. Infectious mononucleosis patients develop a rash, and therefore use is avoided. Renal and hepatic function should be monitored.

Dosing :

<40 kg:

Dosing based on the amoxicillin content:

Neonates and Infants:

<3 months:

30 mg/kg/day (Oral) divided every 12 hourly.

>3 months of age:

Less severe infections: 20-25 mg/kg/day orally, divided into 8-12 hourly doses.

Moderate infections, lower respiratory tract infections, sinusitis, otitis media: 40-45 mg/kg/day orally, divided into 8-12 hourly doses.

Severe infections, otitis media, pneumonia: 80-90 mg/kg/day orally, divided into 12 hourly doses for 10 days. Maximum dose: 4000 mg/day f.

IV: 100 mg/kg/day in 8-12 hourly divided doses for 7-14 days.

For >40 kg:

Dose same as that for adults.

Adverse Effect :

Diaper rash, nausea, vomiting, diarrhea, serum sickness-like reactions, erythematous maculopapular rashes, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, hypersensitivity vasculitis and urticaria, thrombocytopenia, hypotension.

Interaction :

Chloramphenicol, Macrolides, Sulphonamides, And Tetracyclines: Interfere with bactericidal action of amoxycillin.
Probenecid: Decreases the renal tubular secretion of amoxicillin, concurrent use may result in increased and prolonged blood levels of amoxicillin.

Hepatic Dose :

No dosage adjustments are recommended. Use is contraindicated in patients with a history of amoxicillin and clavulanate-associated hepatic dysfunction.