Amoxiclav

Co-amoxiclav

Co-amoxiclav is the British Approved Name, in the British Pharmacopoeia, for the combination antibiotic containing amoxicillin trihydrate a β-lactam antibiotic with clavulanate potassium a β-lactamase inhibitor. This combination results in an antibiotic with an increased spectrum of action and restored efficacy against β-lactamase producing amoxicillin-resistant bacteria.

This name, 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 CLAMP (228.5mg, 457mg & 625mg)(FGP), Augmentin (by GlaxoSmithKline formerly Beecham), and Exclav (by Neomed) Clavamox (for veterinary use by Pfizer), or Clavamel.

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. U.S. Patents 4,441,609 was granted in 1984.

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 cellulitis and 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).

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 and Australia 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 diarrhoea, vomiting 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 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, amongst other infections, periodontitis 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.

In popular culture

In the Scrubs episode "My Musical", one of the songs describing J.D. and Elliot's friendship contains the lyrics:

J.D.: We're best friends just like --

Eliot: Amoxicillin and clavulanic acid!

Synonyms

  • CLAMP (Dr Reddy's - India)- FGP
  • Amoclan (Sudan)
  • Amoxycillin-clavulanate (US)
  • Amoxicillin-clavulanate (rINN)
  • Augmentin (GlaxoSmithKline; originally Beecham, 1981)
  • Clamoxin (Mexico)
  • Co-amoxiclav (UK)
  • Klavocin (Croatia)
  • Xiclav (Bosnia and Herzegovina)

References

External links

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