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- Penicillin antibacterial, combined with a beta-lactamase inhibitor. The addition of clavulanic acid to amoxicillin extends its spectrum of activity to cover beta-lactamase producing Gram-positive and Gram-negative organisms, including some Gram-negative anaerobes.
Indications
- Erysipelas and cellulitis
- Necrotizing infections of the skin and soft tissues (necrotizing fasciitis, gas gangrene, etc.), in combination with clindamycin
- Severe postpartum upper genital tract infection, in combination with gentamicin
Forms and strengths, route of administration
- Powder for injection, in vials containing 1 g amoxicillin/100 mg clavulanic acid and 1 g amoxicillin/200 mg clavulanic acid, to be dissolved in 20 ml water for injection or 0.9% sodium chloride, for slow IV injection (3 minutes) or IV infusion (30 minutes). DO NOT DILUTE IN GLUCOSE.
Dosage
Doses expressed in amoxicillin:
Erysipelas, cellulitis
- Child under 3 months: 30 mg/kg every 12 hours
- Child 3 months and over: 20 to 30 mg/kg every 8 hours (max. 3 g daily)
- Adult: 1 g every 8 hours
Necrotizing infections
- Child under 3 months: 50 mg/kg every 12 hours
- Child 3 months and over and < 40 kg: 50 mg/kg every 8 hours (max. 6 g daily)
- Child 40 kg and over and adult: 2 g every 8 hours
Upper genital tract infection
- Adult: 1 g every 8 hours
For administration by IV infusion, dilute each dose of amoxicillin/clavulanic acid in 5 ml/kg of 0.9% sodium chloride in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride in children 20 kg and over and in adults.
Duration
- Erysipelas, cellulitis: 7 to 10 days
- Necrotizing infections: 14 days
- Upper genital tract infection: depending on clinical response
Change to oral treatment as soon as possible.
Contra-indications, adverse effects, precautions
- Do not administer to penicillin-allergic patients, patients with history of hepatic disorders during a previous treatment with co-amoxiclav, patients with infectious mononucleosis.
- Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur), patients with hepatic impairment or severe renal impairment (reduce dosage and give every 12 to 24 hours).
- May cause: diarrhoea; hepatic disorders (avoid treatments longer than 14 days); allergic reactions sometimes severe.
- Do not combine with methotrexate (increased methotrexate toxicity).
- Pregnancy: no contra-indication
- Breast-feeding: no contra-indication
Remarks
- Preferably use 1 g amoxicillin/100 mg clavulanic acid, especially in children.
- Do not mix with other drugs in the same syringe or infusion bag.
Storage
Below 25 °C
Once reconstituted, the solution must be used immediately; discard any unused open vial.