Amoxicillin-Clavulanate

C. diff Risk

Medium

Oral Bioavailability

Excellent

Approximate Cost

$2/day

Dosing

500 mg PO q8h

30 mg/kg/24h PO divided q12h **
Use 25 mg/mL suspension (4:1 formulation)

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

General Information

Common Usage

Prophylaxis and treatment of bite wounds

Polymicrobial infections of the respiratory tract or abdomen

Skin and soft tissue infections

Adverse Effects

Diarrhea (common)
Allergy/rash
Cytopenias
Hepatotoxicity due to clavulanate is usually mild. EBV related rash (not allergy)

Oral Liquids

Concentration: 125 mg/31.25 mg Each 1 mL contains: Amoxicillin 25 mg and Clavulanic Acid 6.25 mg (4:1 ratio)
Stable for 10 days in refrigerator after reconstitution.

Concentration: 400 mg/57 mg Each 1 mL contains: Amoxicillin 80 mg and Clavulanic Acid 11.4 mg (7:1 ratio)
Stable for 7 days in refrigerator after reconstitution.
Taste: palatable
Not all strengths of oral liquids are listed nor are available on IWK formulary

Tablet/Capsule Strengths

Tablet 250/125 mg
Containing: Amoxicillin 250 mg and Clavulanic Acid 125 mg (2:1 ratio)

Tablet 500/125 mg
Containing: Amoxicillin 500 mg and Clavulanic Acid 125 mg (4:1 ratio)

Tablets and capsules are preferred especially over an unpleasant tasting liquid.
Not all strengths of oral tablets/capsules are listed and they are not all available on the IWK formulary.

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)