Co-amoxiclav

Co-amoxiclav

Combination of
Amoxicillin	Penicillin antibiotic
Potassium clavulanate	Beta-lactamase inhibitor
Clinical data
Pregnancy category	US: B (No risk in non-human studies)
Routes of administration	oral, iv
Legal status
Legal status	UK: POM (Prescription only) US: ℞-only
Identifiers
CAS Number	74469-00-4
ATC code	J01CR02 (WHO)
PubChem	CID 6435924

Co-amoxiclav is the British Approved Name for the combination antibiotic containing amoxicillin trihydrate, a β-lactam antibiotic, with 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.

This name; Co-amoxiclav, unlike co-trimoxazole, has not been widely adopted internationally and the combination product is usually referred to by various names such as amoxicillin with clavulanic acid or amoxicillin+clavulanate or simply by a trade name such as Augmentin (by GlaxoSmithKline formerly Beecham), Clavamox (for veterinary use by Pfizer).

History

Co-amoxiclav was invented around 1977/78 by British scientists working at Beecham, which filed for US patent protection for the drug combination in 1979. US 4441609  was granted in 1984. Augmentin is the original name used by its inventor (GlaxoSmithKline formerly Beecham).

Dosage

The proportions of the two constituents are expressed as x/y where x and y are the strengths in milligrams of amoxicillin and clavulanic acid respectively. However, the branded products indicate their strengths as the quantity of amoxicillin, hence co-amoxiclav 250/125 ≡ Augmentin 250 and contains 250 mg of amoxicillin with 125 mg of clavulanic acid.

Standard adult dosages for respiratory tract, urinary, abdominal, and dental infections as well as animal bites is co-amoxiclav 250/125 (one tablet Augmentin 250) taken every 8 hours, which may be doubled in severe infections (as a single tablet of co-amoxiclav 500/125 ≡ Augmentin 500, but not as two co-amoxiclav 250/125 tablets which would double the maximum recommended dose of clavulanic acid). In the US, Augmentin XR (co-amoxiclav 1000/62.5) is marketed for use in community acquired pneumonia with two tablets taken twice a day (giving 4000 mg total daily dose of amoxicillin).

From the prescribing information for Augmentin, the usual adult dose is one 500-mg tablet of Augmentin every 12 hours or one 250-mg tablet of Augmentin every 8 hours. For more severe infections and infections of the respiratory tract, the dose should be one 875-mg tablet of Augmentin every 12 hours or one 500-mg tablet of Augmentin every 8 hours.

Dosages for children are also given three times a day using suspensions containing co-amoxiclav 250/62 in each 5 mL (Augmentin '250/62 SF') for those between the ages of 6–12 years and co-amoxiclav 125/31 (Augmentin '125/31 SF') for those between the ages of 1–6 years. A more concentrated solution, co-amoxiclav 400/57 (Augmentin '400/57 SF'), may be administered more conveniently just twice daily to children from as young as 2 months of age; quantities are based on body weight with 2.5 mL from the age of 2 years and 5 mL after the age of 6 years.

An intravenous preparation of Co-amoxiclav has been available in the UK since 1985, but there is no parenteral preparation available in the US: the nearest equivalent is ampicillin-sulbactam.

Side effects

Amongst the possible side-effects of this medication are diarrhea, vomiting, 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, it is necessary to contact a doctor immediately. As with all antimicrobial agents, pseudomembranous colitis has been associated with the use of amoxicillin-clavulanate. Amoxicillin is known to have caused liver failure in some patients. Amoxicillin is a member of the penicillin family of antibiotics, and therefore should not be taken by patients allergic to penicillin.

Veterinary use

The amoxicillin/clavulanic acid combination is also used in the treatment of, among other infections, periodontitis and kennel cough in dogs and skin infections in cats. The preparation for veterinary use is commonly marketed under the trade names Clavaseptin, and Clavamox. Amoxicillin/clavulanic acid is banned from use in domestic-food animals (cattle, swine, etc.) in both the US and Europe.

Storage notes

Liquid co-amoxiclav must be refrigerated to maintain effectiveness.

Synonyms

• Amoksiklav (Romania)
• Amoxycillin-clavulanate (US)
• Amoxicillin-clavulanate (rINN)
• Amoxicilline-clavulanique (France)
• Amoxiclav (Belgium)
• Amoxi Clav (Canada)
• Co-amoxiclav (UK & Ireland)
• Moxiclav Duo (Australia)
• Augmentin (GlaxoSmithKline; originally Beecham, 1981)

External links

• Augmentin website GlaxoSmithKline

bg:Аугментин fa:کوآموکسی کلاو