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amoxicillin/clavulanate potassium (amoxycillin/
clavulanate potassium)

Augmentin, Clavulin†

Pregnancy Risk Category B

How supplied
Tablets (chewable):
125 mg amoxicillin trihydrate, 31.25 mg clavulanic acid; 200 mg amoxicillin trihydrate, 28.5 mg clavulanic acid; 250 mg amoxicillin trihydrate, 62.5 mg clavulanic acid
Tablets (film-coated):
250 mg amoxicillin trihydrate, 125 mg clavulanic acid; 500 mg amoxicillin trihydrate, 125 mg clavulanic acid; 875 mg amoxicillin trihydrate, 125 mg clavulanic acid
Oral suspension:
125 mg amoxicillin trihydrate and 31.25 mg clavulanic acid/5 ml (after reconstitution); 200 mg amoxicillin trihydrate and 28.5 mg clavulanic acid/5 ml (after reconstitution); 250 mg amoxicillin trihydrate and 62.5 mg clavulanic acid/5 ml (after reconstitution); 400 mg amoxicillin trihydrate and 57 mg clavulanic acid/5 ml (after reconstitution)

Action
An aminopenicillin that prevents bacterial cell-wall synthesis during replication. Clavulanic acid increases amoxicillin effectiveness by inactivating beta-lactamases, which destroy amoxicillin.

Indications & dosage
Lower respiratory infections, otitis media, sinusitis, skin and skin-structure infections, and urinary tract infections due to susceptible strains of gram-positive and gram-negative organisms-

Adults and children weighing 40 kg (88 lb) or over:
250 mg (based on the amoxicillin component) P.O. q 8 hours; or 500 mg q 12 hours. For more severe infections, 500 mg q 8 hours or 875 mg P.O. q 12 hours.
Children ages 3 months and older and weighing under 40 kg:
20 to 45 mg/kg (based on the amoxicillin component and severity of infection) P.O. daily in divided doses q 8 to 12 hours.
Children under age 3 months:
30 mg/
kg/day P.O. divided q 12 hours based on the amoxicillin component. The 125 mg/
5-ml oral suspension is recommended.
Adjust-a-dose:
Don't give the 875-mg tablet to patients with renal impairment and creatinine clearance under 30 ml/minute. If creatinine clearance is 10 to 30 ml/minute, dosage is 250 to 500 mg P.O. q 12 hours. If creatinine clearance is under 10 ml/minute, dosage is 250 to 500 mg P.O. q 24 hours. Give hemodialysis patients 250 to 500 mg P.O. q 24 hours with an additional dose both during and at the end of dialysis.

Adverse reactions
CNS:
agitation, anxiety, insomnia, confusion, behavioral changes, dizziness.
GI:
nausea, vomiting, diarrhea, indigestion, gastritis, stomatitis, glossitis, black "hairy" tongue, enterocolitis, pseudomembranous colitis.
GU:
vaginitis.
Hematologic:
anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, agranulocytosis.
Other:
hypersensitivity reactions, anaphylaxis, overgrowth of nonsusceptible organisms.

Interactions
Drug-drug.
Allopurinol: increased incidence of rash. Monitor patient.
Oral contraceptives:
efficacy of oral contraceptives may be decreased. Recommend additional form of contraception during penicillin therapy.
Probenecid:
increased blood levels of amoxicillin and other penicillins. Probenecid may be used for this purpose.

Effects on diagnostic tests
Amoxicillin/clavulanate potassium alters results of urine glucose tests that use cupric sulfate (Benedict's reagent or Clinitest). Make urine glucose determinations with glucose oxidase methods (Chemstrip uG). Positive Coombs' tests have occurred with other clavulanate combinations.

Contraindications
Contraindicated in patients with hypersensitivity to drug or other penicillins and in those with a previous history of amoxicillin-associated cholestatic jaundice or hepatic dysfunction.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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