ZANITIN INJECTION 1.2G INJECTION

Indications

• Infections due to beta-lactamase-producing strains
• Mixed infections involving respiratory tract
• Bone and joint infections
• Genitourinary tract infections
• Abdominal infections
• Skin and soft tissue infections

Dosage

Children: For children aged 1

Adults: For oral administration, the usual dose is 500 mg/125 mg every 8 hours, which may be increased to 1 g/125 mg every 8 hours in severe infections. For intravenous administration, the recommended dose is 1.2 g every 8 hours.

Mechanism of action

Amoxicillin exerts its antibacterial effect by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins, leading to cell lysis and death. Clavulanic acid acts as a beta-lactamase inhibitor, protecting amoxicillin from degradation by beta-lactamase enzymes produced by resistant bacteria. This combination enhances the efficacy of amoxicillin against resistant strains.

Pharmacodynamics

Co-amoxiclav demonstrates a time-dependent bactericidal effect, with its efficacy linked to the duration of time the drug concentration remains above the minimum inhibitory concentration (MIC) for the target pathogens. Its broad-spectrum activity covers both Gram-positive and Gram-negative bacteria, making it useful in empirical therapy for various infections.

Pharmacokinetics

Co-amoxiclav is well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 1-2 hours after oral administration. The presence of clavulanic acid does not significantly alter the pharmacokinetics of amoxicillin. It is widely distributed throughout body tissues and fluids, including the lungs, bile, and urine. The half-life of amoxicillin is approximately 1 hour, while clavulanic acid has a similar half-life. Both components are primarily excreted by the kidneys, necessitating dose adjustments in renal impairment.

Contra-indications

• Hypersensitivity to penicillins or cephalosporins
• History of jaundice or hepatic dysfunction associated with flucloxacillin
• Severe renal impairment without appropriate monitoring

Adverse effects

• Gastrointestinal disturbances
• Erythema nodosum
• Bronchospasm
• Hepatic dysfunction
• Electrolyte imbalance
• Eosinophilia
• Hallucinations
• Purpura

Interactions

• Probenecid may increase plasma concentrations of co-amoxiclav
• Anticoagulants may have their effects altered
• Other antibiotics may reduce the efficacy of co-amoxiclav

Precautions

• Caution in patients with a history of allergic reactions to beta-lactam antibiotics
• Use with caution in patients with hepatic or renal impairment
• Monitor for signs of superinfection during prolonged therapy

Pregnancy

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

Breast-feeding

Amoxicillin and clavulanic acid are excreted in breast milk; monitor for potential effects on the infant.

Storage

Store below 25°C. Protect from light. Once reconstituted, use within 24 hours if kept at room temperature.

Formulations

• Powder for solution for injection
• Oral suspension 125 mg/125 mg per 5 mL
• Tablets 250 mg/125 mg and 500 mg/125 mg