Amoxicillin dosage. Antibiotics revew.

The only penicillin available in an oral combination with a beta-lactamase inhibitor is amoxicillin-clavulanic acid (also called Co-amoxiclav). This combination was invented by British scientists working at Beecham.

Clavulanic acid is a beta-lactam, structurally related to the penicillins, which possesses the ability to inactivate a wide range of beta-lactamase enzymes commonly found in micro-organisms resistant to penicillins and cephalosporins. In particular, it has good activity against the clinically important plasmid mediated beta-lactamases frequently responsible for transferred drug resistance.

The combination of amoxicillin, a beta-lactam antibiotic, with clavulanic acid, a beta-lactamase inhibitor, results in an antibiotic with an increased spectrum of action and restored efficacy against beta-lactamase producing amoxicillin-resistant bacteria. This drug provides increased antimicrobial coverage of beta-lactamase­ producing strains of S. aureus, H. influenzae, N. gonorrhoeae, E. coli, M. catarrhalis and Proteus, Klebsiella and Bacteroides species. It has little activity against Pseudomonas or methicillin-resistant S. aureus.

On the other hand, broad spectrum of antimicrobal activity of amoxicillin-clavulanic acid increases the risk of development of the resistance.

In clinical situations in which there is increased development of beta-lactamase­ producing organisms, amoxicillin-clavulanate may be the first choice for the treatment of otitis media, sinusitis, bronchitis, urinary tract infections and skin and soft tissue infections. Amoxicillin-clavulanate is an excellent drug for treating infections caused by human and animal bites.

Most common side effects with amoxicillin-clavulanate include diarrhea (alleviated by taking the drug with food or water), nausea, rashes and Candida superinfection.

The main drawback of amoxicillin/clavulanate is an increased rate of gastrointestinal side effects, than with amoxicillin alone. This medication can produce a wide range of liver injuries including intrahepatic cholestasis without hepatitis, acute hepatocellular injury, and cholestatic hepatitis with hepatocellular necrosis. The most important predisposing factor is age more than 65.

Amoxicillin-clavulanate is more expensive than amoxicillin.

Yury Bayarski is the contributing author of eMedExpert.com.

More information about Augmentin [http://www.emedexpert.com/products/augmentin.shtml] is available on author’s website.

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