Amoxicillin-Clavulanate: IV

C difficile risk
High
Oral Bioavailability
N/A

Dosing

Defined criteria for use and/or important safety considerations. See below for more information.

2000 mg/200 mg q8h to q12h

  • Use q8h for severe infections

CrCl 10-30 CrCl < 10 HD PD CRRT
1000 mg/200 mg initial dose, then 500 mg/100 mg q12h 1000 mg/200 mg initial dose, then 500 mg/100 mg q12h-q24h  1000 mg/200 mg initial dose, then 500 mg/100 mg q12h - q24h given after HD sessions 1000 mg/200 mg initial dose, then 500 mg/100 mg q12h (expert opinion) Unknown

General Information

  • Best reserved for those few indications where it is necessary, so that it remains an effective antibiotic when needed and the adverse effects associated with the use of broad-spectrum antibiotics are avoided.
  • Narrower spectrum antibiotics, used in combination if necessary, should be used in preference to amoxicillin-clavulanic acid when possible, such as:
    • Ampicillin + metronidazole
    • Cefazolin + metronidazole
    • Ceftriaxone + metronidazole

Pseudomonas infections

  • Intravenous amoxicillin-clavulanic acid for adults may appropriately be used instead of other broad spectrums such as piperacillin-tazobactam or carbapenems for polymicrobial infections requiring coverage for multiple causative microorganisms such as Enterococcus faecalis, S. aureus, Gram-negatives (except Pseudomonas), and anaerobes. Some examples include
    • Late onset diabetic foot infectious without Pseudomonas aeruginosa among the expected or isolated pathogens
    • Polymicrobial intra-abdominal infection with Enterococcus faecalis among the expected or isolated pathogens
    • Hospital acquired pneumonia managed outside of critical care without Pseudomonas aeruginosa among the expected or isolated pathogens

  • Associated with cholestatic jaundice (pre-existing hepatic impairment is not a contraindication)
  • Antibiotic related diarrhea and C. difficile infection
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