AMOXICILLIN/CLAVULANIC ACID = CO-AMOXICLAV injectable

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    Prescription under medical supervision

     

    Therapeutic action

    • 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.