Amoxicillin/clavulanic acid ( INN) or co-amoxiclav ( BAN) is an antibiotic useful for the treatment of a number of bacterial infections. It is a combination antibiotic consisting of amoxicillin trihydrate, a β-lactam antibiotic, and potassium clavulanate, a β-lactamase inhibitor. This combination results in an antibiotic with an increased spectrum of action and restored efficacy against amoxicillin-resistant bacteria that produce β-lactamase.
Side effects include an increased risk of
yeast infections and diarrhea. [1 ]
It is on the
World Health Organization's List of Essential Medicines, a list of the most important medications needed in a basic health system. The BAN has not been widely adopted internationally. Amoxicillin/clavulanic acid was developed at [2 ] Beecham Pharmaceuticals and marketed under the trade name Augmentin. It is now available as a generic and marketed under a variety of trade names worldwide. [3 ] Medical uses [edit ]
Amoxicillin/clavulanic acid is widely used to treat or prevent many infections caused by susceptible bacteria, such as:
Adverse effects [edit ]
Possible side effects include
diarrhea, vomiting, nausea, thrush, and skin rash. These do not usually require medical attention. As with all antimicrobial agents, antibiotic-associated diarrhea due to infection—sometimes leading to Clostridium difficile pseudomembranous colitis—may occur during or after treatment with amoxicillin/clavulanic acid. [4 ]
cholestatic jaundice (also referred to as cholestatic hepatitis, a form of liver toxicity) has been associated with amoxicillin/clavulanic acid. The reaction may occur up to several weeks after treatment has stopped, and usually takes weeks to resolve. It is more frequent in men, older people, and those who have taken long courses of treatment; the estimated overall incidence is one in 100,000 exposures. In the United Kingdom, co-amoxiclav carries a warning from the [4 ] Committee on Safety of Medicines to this effect. [3 ]
aminopenicillins, amoxicillin has been associated with Stevens–Johnson syndrome/ toxic epidermal necrolysis, although these reactions are very rare. [4 ] [5 ] History [edit ]
The combination was invented around 1977/78 by
British scientists working at Beecham (now part of GlaxoSmithKline), which filed for US patent protection for the drug combination in 1979.
A patent was granted in 1985.
Augmentin is the original name used by its inventor.
Preparations [edit ]
Many branded products indicate their strengths as the quantity of amoxicillin. Augmentin 250, for example, contains 250 mg of amoxicillin and 125 mg of
clavulanic acid. [3 ] [7 ]
An intravenous preparation has been available in the UK since 1985,
but no [8 ] parenteral preparation is available in the US; the nearest equivalent is ampicillin/sulbactam. Suspensions of amoxicillin/clavulanic acid are available for use in children. They must be refrigerated to maintain effectiveness. Veterinary use [edit ]
Amoxicillin/clavulanic acid is used in numerous animals for a variety of conditions.
Dogs [9 ] [10 ] Cats urinary tract infections skin and soft tissue infections Calves Cattle Pigs
In combination with
prednisolone, it is used for intramammary infusion for the treatment of mastitis in lactating cows. Trade names include Clavaseptin, Clavamox, and Synulox.
Amoxicillin/clavulanic acid is banned from use in domestic-food animals (cattle, swine, etc.) in both the US and Europe; in the UK, Synulox can be used in domestic-food animals as long as a specified withdrawal period is observed.
Bacterial resistance [edit ]
antibiotic resistance is a growing problem in veterinary medicine. Amoxicillin/clavulanic acid is reported to be effective against clinical infections, but is not efficacious against Klebsiella infections. Pseudomonas [11 ] Trade names [edit ] This is an incomplete list that may never be able to satisfy particular standards for completeness. You can help by expanding it with reliably sourced entries. ACINET (Siam Medicare Co., Ltd (Thailand)) Axitin (Clarion medicals Limited (Nigeria) Amokav (Kepler Healthcare Pvt. Ltd.,India) Alviclav 625 (Alvis Health Care; India) Amoclav (Rowex Ltd., Ireland) Amoklavin-BID (deva, Turkey) Amoksiklav (Lek Slovenia, Serbia, Bulgaria) Amorion Comp (by Orion Corporation Finland) AMOX/K CLAV (875mg, Sandoz; US) Amoxi Clav (Canada) Amoxicilina-Clavulánico (Spain, Mexico) Amoxicillin-clavulanate (rINN) Amoxicilline-clavulanique (France) Amoxiclav (by Teva; Belgium, Israel) Amoxiclavulan (by 1A Pharma; Austria) Amoxycillin-clavulanate (AU) AugMaxcil (Triomed; South Africa) Augmentin ( GlaxoSmithKline [originally Beecham]; Hungary; Pakistan, Romania, Philippines; United States, Australia, Switzerland, Czech Republic, Turkey) Augmentin Chewable (GlaxoSmithKline, United States) AugmentinXR (GlaxoSmithKline, United States) Augmentin XR(GlaxoSmithKline, United States) Augpen (Zuventus; India) Clamovid (Hovid) Clamoxyl Duo Oral Suspension (Australia) Topclav 625/375 (Indswift; India) CLAMP ( Dr. Reddy's, India) [12 ] Claneksi (Sanbe Farma, Indonesia) Clavamox (Sandoz, Austria) Clavituf (Intas, India) Clavulin (Canada, Brazil) Co-amoxiclav (UK, KSA, Ireland, South Africa, Iran) [13 ] Curam (Sandoz) Curam Duo (New Zealand) Clavam (Alkem Laboratories Ltd; India) Dafraclav (Dafra Pharma) Enhancin (Ranbaxy, Malaysia) Fleming (Medreich, India) Finemox (Finecure, India) [14 ] Forcid (Astellas) Julmentin 2x (Julphar; Egypt; UAE) Klamentin (CTCP Duoc Hau Giang, Vietnam) Klamoks ( Bilim Pharmaceuticals, Turkey) Klavocin (Pliva - Croatia) Klavon ( Bilim Pharmaceuticals, Turkey) Klavox (Bahrain and Oman) Mega-CV (Aristo, India) megamox(ksa,egypt,sudan) Magnabiotic (Egypt, Sedico) MoxClav (Ranbaxy, India) Moxiclav (Medochemie LTD, Cyprus) Moxiclav Duo (Australia) Moxikind (Mankind Pharma, India) Natravox (Natrapharm, Inc., Philippines) Noroclav (Norbrook, UK) New-Clav (Egypt, Alandalous) Panklav (Hemofarm - Serbia) Optamox (Laboratorios Roemmers, Argentina) Penilan DT (Portugal) Polyclav 625 (India) Sinergia (LIFE, Ecuador) Ticasse (Dafra Pharma) Ratio Aclavulanate 500/125 (Canada) xcilan (ovia pharma pvt. ltd. India) Xiclav (GL-Pharma, Austria) Аугментин (Russia) Zakutex (South Korea) Klavox (Kingdom of Saudi Arabia) Penom Clav 625 (India) References [edit ] ^ Gillies, M; Ranakusuma, A; Hoffmann, T; Thorning, S; McGuire, T; Glasziou, P; Del Mar, C (17 November 2014). "Common harms from amoxicillin: a systematic review and meta-analysis of randomized placebo-controlled trials for any indication.". CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. PMID 25404399. ^ "WHO Model List of EssentialMedicines". World Health Organization. October 2013 . Retrieved . 22 April 2014 ^ a b c d (57 ed.). March 2009. British National Formulary ^ a b c d Gordon D (2010). "Amoxicillin–Clavulanic Acid (Co-Amoxiclav)". In Grayson ML et al (eds). Kucers' the Use of Antibiotics: a Clinical Review of Antibacterial, Antifungal, Antiparasitic and Antiviral Drugs. London: Hodder Arnold/ASM Press. pp. 193–4. ISBN 0-340-92767-4. ^ Harr T, French LE (2010). "Toxic epidermal necrolysis and Stevens-Johnson syndrome". Orphanet J Rare Dis 5: 39. doi: 10.1186/1750-1172-5-39. PMC 3018455. PMID 21162721. ^ US 4441609 ^ "Augmentin -- Prescribing Information" (PDF). December 2006. ^ Davies BE, Boon R, Horton R, Reubi FC, Descoeudres CE (October 1988). "Pharmacokinetics of amoxycillin and clavulanic acid in haemodialysis patients following intravenous administration of Augmentin". Br J Clin Pharmacol 26 (4): 385–90. doi: 10.1111/j.1365-2125.1988.tb03395.x. PMC 1386558. PMID 3190988. ^ "Canine Infectious Tracheobronchitis (Kennel Cough)". Archived from the original on 2006-05-21 . Retrieved . 2013-05-30 ^ "Kennel Cough - Symptoms and Treatment" . Retrieved . 2013-05-30 ^ Federation of Veterinarians in Europe Position Paper: Antibiotic Resistance & Prudent Use of Antibiotics in Veterinary Medicine ^ "India Product List". Dr. Reddy's . Retrieved . 2011-07-24 ^ "Gererics Product List C-E". Almus . Retrieved . 2014-02-06 ^ "Amoxy Clav Formulations". Finecurepharmaceuticalsltd . Retrieved . 2012-03-27 External links [edit ]