Clavulanate/Amoxicillin

Allopurinol, amoxicillin/clavulanic acid, dicloxacillin, erythromycin derivatives, halothane, phenytoin, and trimethoprim/sul-famethoxazole... 

Uncomplicated exacerbation Not requiring hospitalization Less than 3 exacerbations per year No comorbid illness I I V, greater than 50% predicted No recent antibiotic therapy Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis Oral Macrolide (azithromycin, clarithromycin) Second- or third-generation cephalosporin (cefuroxime, cefpodoxime, cefdinir, cefprozil) Doxycycline Ketolide (telithromycin) P-Lactam/P-Iactamase inhibitor (amoxicillin-clavulanate) Intravenous Not recommended... 

The comorbid conditions that can affect therapy and outcomes in patients with CAP include diabetes mellitus, COPD, congestive heart failure, and renal failure.27,28 If the patient has not received antibiotics in the past 3 months, then clarithromycin or azithromycin is the recommended first-line therapy by the IDSA. If the patient has received antibiotics in the last 3 months, then the IDSA recommends using either a respiratory fluoroquinolone alone or a combination of an oral P-lactam and an advanced macrolide/azalide (e.g., clarithromycin/azithromydn). The ATS recommends combination therapy or monotherapy with a respiratory fluoroquinolone for all patients with comorbidities. The p-lactam agents recommended include high-dose amoxicillin, high-dose amoxicillin-clavulanate, cefpodoxime, cefprozil, and cefuroxime. 

Amoxicillin and amoxicillin-clavulanate are first-line antibiotics for acute otitis media. 

Amoxicillin- clavulanate 80-90 mg/kg per day in 2-3 doses (adult 875 mg twice daily) Nausea, vomiting, diarrhea, rash, diaper rash J) J) J)— More diarrhea than amoxicillin, Augmentin ES formulation preferred owing to lower daily clavulanate component... 

Amoxicillin-clavulanate 1.75-4 g/day in 2-3 doses 90 mg/kg per day in 2 doses Broad coverage particularly with high doses Augmentin XR (2 g every 12 hours) targeted toward PRSP... 

Moxifloxacin 400 mg once daily Not available rupture, photosensitivity, QT prolongation possible cost similar to amoxicillin/clavulanate... 

As such, patients with penicillin allergies should be treated with a first-generation cephalosporin (if non-type I allergy), a macrolide/azalide, or clindamycin. Recurrent infections caused by reinfection, poor adherence to therapy, or true penicillin failure can be treated with amoxicillin-clavulanate, clindamycin, or penicillin G benzathine.45... 

Injection drug use MSSA GAS Gram-negatives Anaerobes CA-MRSAd Amoxicillin-clavulanate 500 mg every 8 hours Fluoroquinolone + clindamycin 300 mg every 6 hours TMP-SMX DS 1-2 tabs every 12 hours + clindamycin 300 mg every 6 hours Ampicillin-sulbactam 3 g every 6 hours Piperacillin-tazobactam 3.375 g every 6 hours Ceftriaxone 1 g daily + clindamycin 600 mg every 8 hours Ertapenem 1 g daily... 

The most effective agent for the treatment (and prophylaxis) of human and animal bite-wound infections is amoxicillin-clavulanate. Alternatives for patients with significant penicillin allergies include either a fluoroquinolone or TMP-SMX in combination with clindamycin. Doxycycline also may be prescribed. The durations of prophylaxis and treatment generally are 3 to 5 and 10 to 14 days, respectively.3... 

For most patients, antimicrobial treatment can be completed orally with amoxicillin-clavulanate or the combination of ciprofloxacin and metronidazole. 

Ampicillin is the standard penicillin that has broad-spectrum activity, and is the drug of choice for enterococci sensitive to penicillin. Amoxicillin is frequently used as well. Increasing E. coli resistance has limited amoxicillin use in acute cystitis. Amoxicillin-clavulanate is empirically preferred due to resistance. 

Amoxicillin-clavulanate 500 mg Twice a day Every 8 hours 14 days 14 days... 

Low-risk oral regimen Ciprofloxacin 750 mg PO every 12 hours and amoxicillin-clavulanate 500-875 mg PO every 12 hours For patients with MASCC score of 21 or greater not receiving fluoroquinolone prophylaxis. 

As stated earlier, low-risk patients fulfilling the MASCC criteria (see Table 96-3) maybe treated empirically as an outpatient with a regimen combining amoxicillin-clavulanic acid... 

Based on the experimental observation of a beneficial effect of intracolonic amoxicillin-clavulanic acid in a rat model of colitis, Casellas et al. [33] used an enteric-coated amoxicillin-clavulanic acid (1 g amoxicillin plus 250 mg clavulanic acid, t.i.d.) in active UC. They also evaluated the release of inflammatory mediators (IL-8, TXB2, PGE2) in rectal dialysates. After short-term treatment, this formulation decreased intraluminal release of IL-8 and other inflammatory mediators and led to an improvement of patients with active UC. 

Casellas F, Borruel N, Papo M, Guarner F, Antolin M, Videla S, Malagelada JR Antiinflammatory effects of enterically coated amoxicillin-clavulanic acid in ulcerative colitis. Inflamm Bowel Dis 1998 4 1-5. 

Amoxicillin-clavulanic acid Attar etal., 1999 [45] 500 mg t.i.d. 10 GI surgery or intestinal stasis 50%... 

In a recent study, the bacterial populations contaminating the upper gut in SIBO patients and their antibiotic susceptibility were determined. Amoxicillin-clavulanic acid and cefoxitin were effective against >90% of anaerobic strains, while aminopenicillins, cephalosporins and cotrimoxazole were effective against the microaerophilic population. Erythromycin, clindamycin and rifampicin were ineffective. Data on metronidazole and fluoroquinolones are not available [32]. 

Another recent controlled trial showed a good therapeutic effect of both amoxicillin-clavulanic acid and norfloxacin in SIBO patients [45]. However, a rapid relapse of diarrhea just few days after the withdrawal of antibiotics was evident. In this paper, the efficacy of probiotics in SIBO patients was also evaluated, but no significant effect was described. While on the one hand these results confirm the frequent need of several courses of antibiotic therapy in SIBO patients, on the other they support the idea that rifaximin may represent a good choice on the basis of its excellent tolerability. 

GS-Lactamase inhibitor combination-IV ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanate po amoxicillin-clavulanate. Cefoxitin. 

Amoxicillin amoxicillin-clavulanate or a mac-rolid azalide if bacterial infection is suspected/doc-umented... 

A macrolide0 or doxycycline A respiratory fluoroquinolone0 alone, an advanced macrolide1 plus high-dose amoxicillin, or an advanced mac-rolide plus high-dose amoxicillin-clavulanate... 

Amoxicillin-clavulanate or clindamycin A /J-lactame or a respiratory fluoroquinolone... 

Mild infection Amoxicillin-clavulanate 0.875 g orally every 12 hours Amoxicillin-clavulanic acid 20 mg/kg/day orally in three divided doses... 

Amoxicillin-clavulanate is the agent of choice for oral outpatient treatment however, this agent does not cover P. aeruginosa. Fluoroquinolones with metronidazole or clindamycin are reasonable alternatives. 

The role of antimicrobials for noninfected dog bite wounds remains controversial because only 20% of wounds become infected. Antibiotic recommendations for empiric treatment include a 3- to 5-day course of therapy. Amoxicillin-clavulanic acid is commonly recommended for oral outpatient therapy. Alternative agents include doxycycline, or the combination of penicillin VK and dicloxaciHin. 

Patients with noninfected bite injuries should be given prophylactic antibiotic therapy for 3 to 5 days. Amoxicillin-clavulanic acid (500 mg every 8 hours) is commonly recommended. Alternatives for penicillin-allergic patients include fluoroquinolones or trimethoprim-sulfamethoxazole in combination with clindamycin or metronidazole. First-generation cephalosporins, macrolides, clindamycin alone, or aminoglycosides are not recommended, as the sensitivity to E. corrodens is variable. 

Uncomplicated coli Gram-positive bacteria 1. Quinolone x 14 days (A, II)0 2. Trimethoprim-sulfamethoxazole (if susceptible) x 14 days (B, II)0 1. Amoxicillin or amoxicillin-clavulanic acid x 14 days (B, III)0 Can be managed as outpatient... 

In patients with significant bacteriuria, symptomatic or asymptomatic, treatment is recommended in order to avoid possible complications during the pregnancy. Therapy should consist of an agent with a relatively low adverse-effect potential (a sulfonamide, cephalexin, amoxicillin, amoxicillin/clavulanate, nitrofurantoin) administered for 7 days. 

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