Co-Amoxiclav (Augmentin)

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Co-amoxiclav, commonly known by the brand name Augmentin, is a widely used antibiotic combination of amoxicillin and clavulanic acid. It is suggested for the management of a range of bacterial infections.  This article provides a detailed insight into co-amoxiclav, including its drug class, mechanism of action, uses, side effects, contraindications, interactions, and a table of popular brand names with specifications.

Drug Class

Co-amoxiclav belongs to the penicillin class of antibiotics. It is a combination drug, combining:

• Amoxicillin: A broad-spectrum beta-lactam antibiotic.
• Clavulanic acid: A beta-lactamase inhibitor that aids in the prevention of bacterial resistance.

Mechanism of Action of Augmentin(Co-amoxiclav)

Co-amoxiclav works through a dual mechanism:

1. Amoxicillin: It inhibits the synthesis of bacterial cell walls by binding to penicillin-binding proteins (PBPs) inside the bacterial cell wall. Consequently, this causes the bacteria to weaken and ultimately undergo lysis.
2. Clavulanic Acid: Clavulanic acid inhibits beta-lactamase enzymes produced by resistant bacteria. Generally, these enzymes are responsible for the breakdown of beta-lactam antibiotics, including amoxicillin, which leads to a loss of their effectiveness. thus,  Clavulanic acid increases amoxicillin’s effectiveness by obstructing these enzymes’ action.

Uses of Co-Amoxiclav

Co-amoxiclav is prescribed for a variety of bacterial infections, including:

1. Respiratory Tract Infections

• Pneumonia
• Bronchitis
• Sinusitis

2. Urinary Tract Infections (UTIs)

• Cystitis
• Pyelonephritis

3. Skin and Soft Tissue Infections

• Cellulitis
• Abscesses

4. Ear Infections

• Otitis media

5. Dental Infections

• Periodontal abscesses

Side Effects of Co-Amoxiclav

Like all medications, co-amoxiclav may cause side effects. Notable side effects that are both common and severe include:

Common Side Effects:

• Gastrointestinal symptoms: Nausea, vomiting, diarrhea
• Rash
• Headache

Severe Side Effects:

• Allergic reactions: Anaphylaxis, hives, difficulty breathing
• Liver damage: Jaundice, liver function abnormalities

• Diarrhea caused by Clostridium difficile is a critical and serious manifestation that has association with the consumption of antibiotics.

Contraindications of Augmentin(Co-amoxiclav)

Co-amoxiclav should not be used in the following cases:

1. Allergic Reaction to Penicillins or Beta-lactam Antibiotics

Patients with a confirmed allergy to penicillin or cephalosporins  not take co-amoxiclav.

2. Liver Dysfunction

• Individuals with a history of liver problems caused by antibiotics should not use co-amoxiclav.

3. Mononucleosis

• The use of co-amoxiclav is contraindicated in patients with mononucleosis, as it may cause a severe rash.

Drug Interactions of Augmentin(Co-amoxiclav)

Co-amoxiclav may interact with several other medications, altering its effectiveness or increasing the risk of adverse effects. Some significant drug interactions include:

1. Oral Contraceptives

• Co-amoxiclav may reduce the effectiveness of oral contraceptives, leading to an increased risk of pregnancy.

2. Anticoagulants (e.g., Warfarin)

• Co-amoxiclav may enhance the effects of anticoagulants, increasing the risk of bleeding.

3. Probenecid

• Probenecid may increase the levels of amoxicillin in the blood, raising the risk of side effects.

Popular Brand Names of Co-Amoxiclav

The table below presents a selection of well-known brands along with their respective specifications.

Brand Name	Strength	Dosage Form	Country	Manufacturer
Augmentin	250 mg/125 mg	Tablets	USA, UK, India	GlaxoSmithKline (GSK)
Augmentin Duo	500 mg/125 mg	Tablets	South Africa	GlaxoSmithKline (GSK)
Clavulin	250 mg/125 mg	Tablets, Suspension	Canada	GlaxoSmithKline (GSK)
Amoxil + Clavulanate	875 mg/125 mg	Tablets	Philippines	Various manufacturers
Synermox	500 mg/125 mg	Tablets	Turkey	Abdi İbrahim

Dosage of Co-amoxiclav

The appropriate dose of Augmentin (amoxicillin/clavulanate) depends on the patient’s age, weight, and the condition of disease. Below are the general dosing guidelines:

For Children:

1. Standard Dosing for Children:

• For children weighing 40 kg (88 lbs) or more, the dose is similar to that for adults, which is generally 500 mg every 8 hours or 875 mg every 12 hours depending on the formulation (e.g., Augmentin 250 mg/125 mg, Augmentin 500 mg/125 mg).
• For children weighing less than 40 kg, the dose is based on weight:
  • Amoxicillin component: 20 mg/kg to 40 mg/kg per day, divided into doses every 8 hours or 12 hours (depending on severity).
  • Clavulanate component: 5 mg/kg to 10 mg/kg per day, also divided.

  The maximum dose should generally not exceed 1,000 mg of amoxicillin and 200 mg of clavulanate per dose for any child.

2. Specific Age-based Recommendations:

• Infants (up to 12 weeks old): Augmentin is generally not recommended for infants under 3 months unless advised by a healthcare provider.
• Children 2 to 12 years old: The dose is typically around 25 mg/kg/day to 45 mg/kg/day of amoxicillin, divided into two doses daily, depending on the severity of the infection.

For Adults:

• For mild to moderate infections (e.g., respiratory infections, skin infections):
  • 500 mg every 8 hours (with the 250 mg/125 mg formulation) or
  • 875 mg every 12 hours (with the 500 mg/125 mg formulation).
• For more severe infections:
  • 1,000 mg every 12 hours (with the 500 mg/125 mg formulation), or
  • 875 mg every 8 hours.
• For complicated infections (e.g., sinusitis, pneumonia): The dose can be adjusted to a higher dosage based on the severity of the infection.

Important Notes:

• Augmentin should be taken with food to help prevent stomach upset.
• Always follow the dosage instructions provided by the prescribing doctor or pharmacist, as they may vary depending on the condition being treated and the specific formulation of Augmentin.
• If you are treating a child, always calculate the dose based on their weight and age, and use the appropriate pediatric suspension if available

Conclusion

Co-amoxiclav (Augmentin) is a highly effective antibiotic that combines amoxicillin with clavulanic acid to treat a wide variety of bacterial infections. Its ability to combat both susceptible and resistant bacteria makes it a valuable tool in the medical field. However, like all medications, use it with caution, particularly in individuals with a history of allergies or liver problems. Understanding its uses, side effects, contraindications, and interactions can ensure its safe and effective use. One should always engage with a healthcare professional for advice before beginning any form of antibiotic therapy.