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What is Augmentin?
Among antimicrobial stewardship efforts, Augmentin retains importance as a beta-lactamase-inhibited broad-spectrum aminopenicillin. This evidence-based review provides pharmacologic and clinical insights on amoxicillin-clavulanate for informing prescribing practices.
Pharmacodynamic Profile of Augmentin
Augmentin couples amoxicillin with clavulanate potassium, acting as an irreversible inhibitor of bacterial beta-lactamases. This restores amoxicillin’s efficacy against resistant organisms expressing these enzymes.
On its own, amoxicillin exhibits time-dependent bactericidal killing and moderate post-antibiotic effect against susceptible pathogens. Its rapid absorption confers high oral bioavailability. However, food modestly delays peak serum concentrations.
Without intrinsic antibacterial properties, clavulanate serves strictly to bind and deactivate bacterial beta-lactamase enzymes. This prevents amoxicillin hydrolysis, overcoming beta-lactamase-mediated resistance.
Clinical Applications of Augmentin
Augmentin is principally used for mild to moderate systemic infections caused by susceptible bacteria. Its antibacterial spectrum includes diverse gram-positive cocci, gram-negative rods, and anaerobic speciesFDA-approved indications include acute sinusitis, otitis media, lower respiratory infections, skin infections, and urinary tract infections. Evidence also supports the use of Augmentin for dental infections, pyelonephritis, bone and joint infections, intra-abdominal infections, animal bites, and Lyme disease.
However, accelerating antibiotic resistance threatens Augmentin’s viability against certain organisms like S. pneumoniae, E. coli, and Klebsiella species.
Augmentin provides a broad spectrum encompassing gram-positive cocci, gram-negative rods, and anaerobic species. Indications for use include:
- Acute bacterial sinusitis
- Otitis media
- Lower respiratory infections
- Skin and soft tissue infections
- Urinary tract infections
- Dental infections
- Bone and joint infections
However, accelerating resistance threatens Augmentin’s viability against certain pathogens like S. pneumoniae, E. coli, and Klebsiella spp.
Recommended Prescribing and Dosing
In adults, Augmentin is typically dosed at 875mg amoxicillin/125mg clavulanate twice daily or 500mg/125mg three times daily. For more severe infections, intravenous dosing achieves higher therapeutic concentrations.
To optimize pharmacodynamics, evenly spaced interval dosing every 8 to 12 hours is imperative. Absorption can be enhanced by administration with food.
Patients must complete the full course of Augmentin to prevent recurrent infection. Early discontinuation promotes antimicrobial resistance.
Adverse Effects and Considerations
Augmentin is generally well-tolerated, with gastrointestinal symptoms being most common, including diarrhea, nausea, vomiting, and abdominal discomfort. Headache, dizziness, vaginitis, and skin rashes may also occur.
Hypersensitivity reactions are rare but require prompt discontinuation. Renal function merits monitoring with dose adjustments as appropriate. Probiotic supplements can counteract gut microbiome disruption.
Reduced oral contraceptive efficacy is common; alternate birth control methods should be recommended.
Interactions and Use Considerations
Various pharmacodynamic interactions can occur with Augmentin coadministration. Probenecid can inhibit amoxicillin’s renal excretion. Tetracyclines and chloramphenicol may act antagonistically. Bacteriostatic drugs can interfere with its bactericidal action.
Augmentin may also reduce oral contraceptive efficacy. Alternate birth control methods should be used. Probiotic supplements can counteract gut microbiome disruption. Given rising resistance, use should be limited to proven susceptible infections.
What Strengths and Forms of Augmentin are Available?
Canadian pharmacies carry Augmentin in multiple strengths and formulations to suit different treatment needs:
- 875mg/125mg tablets – For many common infections
- 500mg/125mg tablets – Lower strength option
- 250mg/125mg per 5mL suspension – For pediatric dosing
- 250mg/62.5mg chewable tablets – For children who can’t swallow pills
- 200mg/28.5mg per 5mL suspension – Low strength pediatric option
- IV injection – For hospital or severe infections
