CLAVMARK 625

Indications

• Respiratory tract infections
• Urinary tract infections
• Skin and soft tissue infections
• Otitis media
• Sinusitis
• Bone and joint infections

Dosage

Children: Pediatric dosing is also contingent on the type of infection and the child's age and weight. Consultation with the BNF for Children is advised for accurate dosing.

Adults: For adult patients, the typical dosing regimen may vary based on the severity and type of infection. It is recommended to refer to specific guidelines or the BNF for precise dosing information.

Mechanism of action

Amoxicillin exerts its antibacterial effect by inhibiting the synthesis of bacterial cell walls, leading to cell lysis and death. Clavulanic acid, by inhibiting beta-lactamase enzymes, prevents the breakdown of amoxicillin, thereby extending its antimicrobial spectrum against resistant strains of bacteria.

Pharmacodynamics

Co-amoxiclav displays bactericidal activity against a wide range of gram-positive and gram-negative bacteria. The pharmacodynamic profile of the combination allows for effective treatment of infections caused by organisms that would otherwise be resistant to amoxicillin alone, due to the presence of beta-lactamase enzymes.

Pharmacokinetics

Co-amoxiclav is well absorbed from the gastrointestinal tract. The presence of clavulanic acid does not significantly affect the absorption of amoxicillin. Peak plasma concentrations of amoxicillin occur within 1-2 hours after oral administration. Both amoxicillin and clavulanic acid are widely distributed in body tissues and fluids, and they are predominantly excreted unchanged in urine. The half-life of amoxicillin is about 1 hour, while clavulanic acid has a half-life of approximately 1 hour as well.

Contra-indications

• Hypersensitivity to co-amoxiclav or any of its components
• History of jaundice or hepatic impairment associated with previous use of co-amoxiclav
• Severe renal impairment (creatinine clearance less than 30 mL/min) without dosage adjustment

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Rash
• Urticaria
• Hepatic dysfunction
• Anaphylaxis
• Clostridium difficile-associated diarrhea

Interactions

• Allopurinol may increase the risk of skin rashes
• Probenecid may increase levels of amoxicillin
• Anticoagulants may have altered effects due to changes in gut flora or vitamin K synthesis

Precautions

• Use with caution in patients with a history of allergy or asthma
• Monitor liver function tests in patients with hepatic impairment
• Use cautiously in patients with renal impairment, adjusting dosage as necessary
• Consider potential for antibiotic resistance with prolonged use

Pregnancy

Co-amoxiclav is generally considered safe during pregnancy, but should be used only if clearly needed.

Breast-feeding

Co-amoxiclav is excreted in breast milk, caution is advised when administering to nursing mothers.

Storage

Store at room temperature, protect from light and moisture. Reconstituted solutions should be stored in a refrigerator and used within a specified time frame.

Formulations

• Tablets
• Oral suspension
• Injectable solution