Amoxicillin-Clavulanate

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$2/day

Spectrum Of Activity

Dosing

For high dose, to keep clavulanic acid dose < 12.5 mg/kg/DAY, 14:1 formulation (90mg/kg/DAY) can be achieved by combining 45mg/kg/DAY of 7:1 formulation & 45mg/kg/DAY of plain amoxicillin.

Max daily dose of amoxicillin is 4g/day

Max daily dose of clavulanate is 12.5 mg/kg/day.

High dose: PO 80-90 mg/kg/DAY divided q12h

PO Low dose: 40-50 mg/kg/DAY divided q8h

Dosing based on amoxicillin component.

PO 30 mg amoxicillin/kg/DAY divided q12h

Use with caution. Use contraindicated in patients with a history of amoxicillin and clavulanate-associated hepatic dysfunction.

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

General Information

Common Usage

Prophylaxis/treatment of bite wounds

Polymicrobial infections of the respiratory tract or abdomen

Skin and soft tissue infections

Drug Monitoring

For prolonged therapy, monitor liver enzymes and function

Adverse Effects

Diarrhea (common)

Allergy/rash, cytopenias.

Hepatotoxicity due to clavulinate is usually mild, liver failure is rare. EBV related rash (not allergy).

Pharmacology

Antimicrobial class: Aminopenicillin + Beta-lactamase inhibitor

Average serum half life: Adults: ~1 hour. Amoxicillin pharmacokinetics are not affected by clavulanic acid

Route of Elimination: Urine (amoxicillin 50% to 70% unchanged drug; clavulanic acid 25% to 40% unchanged drug)