Amoxicillin/clavulanic acid

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Amoxicillin/clavulanic acid
Combination of
AmoxicillinPenicillin antibiotic
Clavulanic acidBeta-lactamase inhibitor
Clinical data
Trade namesAugmentin
AHFS/Drugs.commonograph
MedlinePlusa685024
Licence dataUS FDA:link
Pregnancy cat.B (US)
Legal statusPOM (UK) -only (US)
Routesoral, intravenous
Identifiers
CAS number74469-00-4 N
ATC codeJ01CR02
PubChemCID 6435923
ChemSpider4940608 YesY
ChEMBLCHEMBL1697738 N
 N (what is this?)  (verify)
 
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Amoxicillin/clavulanic acid
Combination of
AmoxicillinPenicillin antibiotic
Clavulanic acidBeta-lactamase inhibitor
Clinical data
Trade namesAugmentin
AHFS/Drugs.commonograph
MedlinePlusa685024
Licence dataUS FDA:link
Pregnancy cat.B (US)
Legal statusPOM (UK) -only (US)
Routesoral, intravenous
Identifiers
CAS number74469-00-4 N
ATC codeJ01CR02
PubChemCID 6435923
ChemSpider4940608 YesY
ChEMBLCHEMBL1697738 N
 N (what is this?)  (verify)

Amoxicillin/clavulanic acid (INN) or co-amoxiclav (BAN) 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.

Unlike co-trimoxazole, the BAN has not been widely adopted internationally. Trade names include Augmentin (by GlaxoSmithKline),[1] Enhancin/Mox Clav by Ranbaxy Labs Limited, Finemox CV by Finecure Pharmaceuticals Ltd,[2] Clavamox (by Pfizer), CLAVITUF (INTAS)and CLAMP (by Dr. Reddy's Laboratories).[3]

Contents

History

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 1984.[4] Augmentin is the original name used by its inventor.

Preparations

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.[1][5]

An intravenous preparation has been available in the UK since 1985,[6] but there is no parenteral preparation 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.

Side effects

Possible side-effects include diarrhea, vomiting, nausea, thrush, and a few other conditions. These do not usually require medical attention. However, if the patient experiences an allergic reaction to the medication, jaundice, fever, or severe diarrhea, a doctor should be contacted immediately. As with all antimicrobial agents, pseudomembranous colitis has been associated with the use of amoxicillin/clavulanic acid. Amoxicillin is known to cause liver failure in some patients.[citation needed]

Amoxicillin is a member of the penicillin family of antibiotics, and therefore should not be taken by patients allergic to penicillin.[7]

Veterinary use

The amoxicillin/clavulanic acid combination is also used in the treatment of, among other infections, periodontitis and kennel cough[8][9] in dogs; urinary tract infections, skin and soft tissue infections in cats; enteritis and navel ill in calves; respiratory tract infections, soft tissue infections, metritis and mastitis in cattle; respiratory tract infections, colibacillosis, mastitis, metritis and agalactia in pigs. In combination with prednisolone it is used for intra-mammary 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 adhered to.

Bacterial resistance

Bacterial antibiotic resistance is a growing problem in veterinary medicine. Amoxicillin/clavulanic acid is reported to be effective against clinical Klebsiella infections, but is not efficacious against Pseudomonas infections.[10]

Trade names

References

  1. ^ a b British National Formulary (54 ed.). September 2007.
  2. ^ "Amoxy Clav Formulations". Finecurepharmaceuticalsltd. http://www.finecurepharma.com/beta-lactamase-lnhibitors.htm. Retrieved 2012-03-27.
  3. ^ "India Product List". Dr. Reddy's. http://www.drreddys.com/products/popups/gen_ind_productlist.html. Retrieved 2011-07-24.
  4. ^ US 4441609 
  5. ^ "Augmentin -- Prescribing Information" (PDF). GlaxoSmithKline. December 2006. Archived from the original on 7 March 2008. http://us.gsk.com/products/assets/us_augmentin.pdf. Retrieved 2008-01-28. [dead link]
  6. ^ 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. PMC 1386558. PMID 3190988. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1386558/.
  7. ^ "Amoxicillin/ Clavulanic Acid: Precautions when taking". itsmyhealth.com.au. http://www.itsmyhealth.com.au/medicines/apo-amoxycillin-clavulanic-acid-500-125/precautions-when-taking. Retrieved 14 April 2012.
  8. ^ , http://www.sheltermedicine.com/portal/is_infectious_tracheobronchitis_canine.shtml[dead link]
  9. ^ , http://www.dogchatforum.com/kennel-cough2.htm
  10. ^ Federation of Veterinarians in Europe Position Paper: Antibiotic Resistance & Prudent Use of Antibiotics in Veterinary Medicine

External links