Amoxicillin-Clavulanate

C difficile risk
Medium
Oral Bioavailability
N/A

Dosing

  • Dosing based on amoxicillin component

  • Max daily dose of amoxicillin is 4g/day

  • Max daily dose of clavulanate is 12.5 mg/kg/day (preferred 10mg/kg/day) Low dose: 40-50 mg/kg/DAY PO divided q8h

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

Term to 3 moInfant 3 mo to child less than 40kgChild/Adolescent greater than or equal to 40kg or greater than or equal to 16 years old4:1 30mg/kg/DAY PO divided q12h- 4:1 25-45mg/kg/DAY PO divided q8h

  • 7:1 25-45mg/kg/DAY PO divided q12h- 4:1 500mg PO q8-12h

  • 7:1 875mg PO q12h

Term to 3 mo:Infant 3 mo to child less than 40kgChild/Adolescent greater than or equal to 40kg or greater than or equal to 16 years old4:1 30mg/kg/DAY PO divided q12h- 7:1 45-60mg/kg/DAY PO divided q8h

  • 14:1 90mg/kg/DAY PO divided q8-12h (max 4g/day)- 4:1 500mg PO q8h

  • 7:1 875mg PO q12h

Term to 3 moInfant 3 mo to child less than 40kgChild/Adolescent greater than or equal to 40kg or greater than or equal to 16 years old4:1 30mg/kg/DAY PO divided q12h- 7:1 45-60mg/kg/DAY PO divided q8h

  • 14:1 90mg/kg/DAY PO divided q8h (max 4g/day)- 4:1 500mg PO q8h

  • 7:1 875mg PO q12h

To achieve 90mg/kg/day at a 14:1 ratio, combine the following:

  • Amoxicillin/Clavulanic Acid 7:1 formulation 45mg/kg/DAY PO divided q8-12h

WITH

  • Amoxicillin 45mg/kg/DAY PO divided q8-12h Example Order: Amox/Clav 200 mg (7:1 ratio) PO q8h WITH Amoxicillin 200 mg PO q8h for total 14:1 ratio

4:1 30 mg amoxicillin/kg/DAY PO 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

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

Diarrhea (common).

Allergy/rash, cytopenias.

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

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)