Amoxicillin-Clavulanate (Oral)

C. diff Risk

Medium

Oral Bioavailability

Excellent

Approximate Cost

$2/day

Spectrum Of Activity

Dosing

  • 500 mg PO TID

  • 875 mg PO BID

15 mg/kg/dose PO BID
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 500/125 mg

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

Tablet 875 mg/125 mg

  • Containing: Amoxicillin 875 mg and Clavulanic Acid 125 mg (7:1 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)