Amoxicillin/clavulanic acid

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

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. 

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

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... 

Amoxicillin clavulanic acid Chlorthalidone Fentanyl citrate... 

Ulcus molle/chancroid is treated with a single dose of either ceftriaxone i.m. or with azithromycin 1 g orally. Three days of oral ciprofloxacin 2 x 500 mg daily or 7 days of amoxicillin/clavulanic acid 3 X 500/125 mg orally or erythromycin 4 x 500 mg orally are alternatives. 

Obstetric infections can be treated with penicillin-beta-lactamase inhibitors such as amoxicillin-clavulanic acid, with extended spectrum penicillins (with or without beta-lacamase inhibitors if justified by local resistance surveillance data), with a first or second generation cephalosporin combined with metronidazole. In severe cases of streptococcal infection high doses of penicillin in combination with clindamycin is the treatment of choice. In amnionitis, maternal morbidity resolves with delivery. In endometritis, antibiotics should be stopped after the... 

As mentioned in the Introduction, bacterial resistance to currently used antibacterial agents poses a major threat to their continued effectiveness [2]. Interestingly, a number of enzymes are involved in the development of antibacterial resistance via several mechanisms. For example, there are enzymes that catalyze the inactivation of antibacterial agents [47], 3-Lactamases are the best-known examples of this class of enzymes and have been studied extensively as targets for new inhibitors that are used in combination with 3-lactams to prevent their inactivation [48], Several [3-lactamase inhibitors have been developed and are used in combination with [3-lactams (e.g., amoxicillin/clavulanic acid, piperacillin/tazo-bactam, and others) [49,50],... 

Current commercial inhibitors of /3-lactamases include clavulanic acid (an oxapenam see Table 1), sulbactam, and tazobactam (two penam sulfones see Table 1). They are effective only against the class A serine /3-lactamases and they are administrated in the form of antibiotic/inhibitor combinations <2006BP930> Augmentin (amoxicillin/clavulanic acid), Timentin (ticarcillin/clavulanic acid), Unasyn (ampicillin/Sulbactam), Zosyn (piperacillin/tazobactam). 

If a patient has cholestasis careful consideration must be given to the use of any drug that can cause biliary problems. Several drugs are known to cause cholestatic hepatitis, including the antibiotics flucloxacillin, erythromycin and co-amoxiclav (amoxicillin/clavulanic acid). Although a patient with cholestasis is no more likely to suffer from this idiosyncratic reaction than a patient without liver impairment, it will be of greater concern if it does occur. 

Many bite wounds can be treated on an outpatient basis with amoxicillin-clavulanic acid. 

Amoxicillin-clavulanic acid 875 mg/125 mg every 12 hours Doxycycline 100-200 mg every 12 hours" ... 

Amoxicillin clavulanic acid 40 nrrg/kg (of the amoxicillin component) in hvo divided doses... 

Amoxicillin-clavulanic acid 20 mjVksVday orally in three divided doses... 

Grosser, U. Amoxicillin-clavulanic acid therapy may be associated with severe side effects-review of the literature. Eur. J. Med. Res. 2001 6 139-149... 

Rlchardet, J.P, Mallat, A., Zafranl, E.S., Blazquez, M., Bognel, J.C., Campillo, B. Prolonged cholestasis with ductopenia after administration of amoxicillin/clavulanic acid. Dig. Dis. Sci. 1999 44 1997—2000... 

Maggini M, Raschetti R, Agostinis L, Cattaruzzi C, Troncon MG, Simon G. Use of amoxicilhn and amoxicillin-clavulanic acid and hospitalization for acute liver injury Ann 1st Super Sanita 1999 35(3) 429-33. 

Soza A, Riquelme F, Alvarez M, Duarte I, Glasinovic JC, Arrese M. Hepatotoxicidad por amoxicilina/acido clavula-nico caso clinico. [Hepatotoxicity by amoxicillin/clavulanic acid case report.] Rev Med Chil 1999 127(12) 1487-91. 

Richardet JP, Mallat A, Zafrani ES, Blazquez M, Bognel JC, Campillo B. Prolonged cholestasis with ducto-penia after administration of amoxicillin/clavulanic acid. Dig Dis Sci 1999 44(10) 1997-2000. 

Nathani MG, Mutchnick MG, Tynes DJ, Ehrinpreis MN. An unusual case of amoxicillin/clavulanic acid-related hepatotoxicity. Am J Gastroenterol 1998 93(8) 1363-5. 

Chawla A, Kahn E, Yunis EJ, Daum F. Rapidly progressive cholestasis an unusual reaction to amoxicillin/clavulanic acid therapy in a child. J Pediatr 2000 136(l) 121-3. 

Poirel L, Guibert M, Bellais S, Naas T, Nordmann P. Integron- and carbenicillinase-mediated reduced susceptibility to amoxicillin-clavulanic acid in isolates of multidrug-resistant Salmonella enterica serotype typhimurium DT104 from French patients. Antimicrob Agents Chemother 1999 43(5) 1098-104. 

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