Amoxicillin-Clavulanate

C difficile risk
Medium
Oral Bioavailability
Excellent

Dosing

Mild to moderate infectionsSevere infections(Immediate Release) 500 mg (amoxicillin component) orally every 12 hours or 250 mg (amoxicillin component) orally every 8 hours(Immediate Release) 875mg PO BID or 500mg PO TID of the amoxicillin component

(Extended-release tablets) 2 tablets (2000 mg amoxicillin component) orally every 12 hours for 7 to 10 days

<3 months old>/=3 months (<40 kg)>/=3 months (<40 kg) Recurrent Otitis Media2-5 years old6-12 years old(4:1 AND 7:1 FORMULATIONS) 30 mg/kg/day divided q 12h(4:1 AND 7:1 FORMULATIONS) 20-40 mg/kg/day divided q8h for 10 days OR 25-45 mg/kg/day divided q12h for 10 days(14:1 FORMULATION)90mg/kg/daily divided q12h x 10 days(14:1 FORMULATION) 90 mg/kg/day divided q12h for 7 days (5 years and older max dose 4g/24hr)(14:1 FORMULATION) 90 mg/kg/day divided q12h for 5-7 days (max dose 4g/24hr)

>/=3 months (<40 kg)(14:1 FORMULATION) 90mg/kg/daily divided q12h

5 years old and older(14:1 FORMULATION) 90 mg/kg/daily divided q12h; Max dose is 4 grams/24hr.

(4:1 AND 7:1 FORMULATIONS) 25 mg/kg/day divided q12h for 7 days

<3 months old>/=3 months (<40 kg)40 kg or >; Mild to Moderate Infection40 kg or >; Severe Infection(4:1 AND 7:1 FORMULATIONS) 30 mg/kg/day divided q 12h(4:1 AND 7:1 FORMULATIONS) 20-40 mg/kg/day divided q8h OR 25-45 mg/kg/day divided q12h500 mg q12h or 250 mg q8h875 mg q12h or 500 mg q 12h

<3 months old>/=3 months (<40 kg)40 kg or >; Mild to Moderate Infection40 kg or >; Severe Infection(4:1 AND 7:1 FORMULATIONS) 30 mg/kg/day divided q 12h(4:1 AND 7:1 FORMULATIONS) 20-40 mg/kg/day divided q8h for OR 25-45 mg/kg/day divided q12h500 mg q12h or 250 mg q8h875 mg q12h or 500 mg q 12h

Use with caution and monitor hepatic function with prolonged therapy

eGFR/eCRCL 0 - 10eGFR/eCRCL 10 - 30250-500mg PO amox component q24h; do not use 875 mg dose250-500mg PO amox component q12h; Do not use 875 mg dose

250-500mg PO amox component q24h; Consider supplement during or after dialysis if next maintenance dose not due right after dialysis

250 mg q12h; No supplement, do not use 875 mg tabs

General Information

Prophylaxis/treatment of bite wounds.

Polymicrobial infections of the respiratory tract or abdomen.

Skin and soft tissue infections.

For prolonged therapy, monitor liver enzymes and function.

  • Allergy/rash (immediate or delayed)

  • Note EBV related rash

  • Cytopenias

  • Diarrhea

  • Hepatotoxicity due to clavulinate - usually mild, liver failure is rare.

Increased risk of rash with allopurinol

  • All strengths of immediate-release, non-chewable amoxicillin/clavulanate tablets contain 125 mg of clavulanic acid (as the potassium salt). Therefore, two '250-mg' tablets are not equivalent to one '500-mg' tablet

  • Augmentin ES-600(R) suspension contains 42.9 mg of clavulanic acid per 5 mL and is not interchangeable with other strengths of oral suspensions for substitution and also should not be used in adults 

  • Children under 40 kg: Do not give the 250 mg film-coated tablet due to the increased amount of clavulanic acid compared to the chewable tablet

Antimicrobial class: Aminopenicillin + Beta-lactamase inhibitor

Pregnancy category: B

Average serum half life: 1 hour

Urine penetration: Therapeutic

Lung penetration: Therapeutic

Biliary penetration: Therapeutic

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