AMOXICILLIN AND
CLAVULANIC ACID

Augmentin®, M-Amoxiclav, Amoxicillin clavulanate, Synermox®, Co-Amoxiclav, Curam

Reviewed by Brenda Hughes (Pharmacist), Natasha Pool (Pharmacist ID) & Dr Elizabeth Wilson (ID SCH)
July 2017
Administration Newborn Drug Protocol Index Newborn Services Home Page

 

Dose and Administration

 

Intravenous Dose: 30mg/kg/dose
(N.B the dose is based on TOTAL drug not the amoxicillin component)
 

Postmenstrual Age
(weeks)

Postnatal Age
(days)

Dosing Interval
(hr)

<37

Until term corrected

12

37 to 44

0 to 6

12

≥ 7 days

8

Oral Dose:
(N.B the dose is based on TOTAL drug not the amoxicillin component)

Postnatal Age
(days)

Dose

Dosing Interval
(hrs)

>7

30mg/kg

every 8 hrs

 

Indications

Amoxicillin+clavulanic acid should be reserved for treatment of infections where amoxicillin alone is ineffective due to inactivation by beta lactamase enzymes. It may be used to rationalise antibiotics when infants are receiving amoxicillin and require additional cover against staphylococci that would normally be provided by adding flucloxacillin.

Contraindications3

  1. Hypersensitivity to penicillins / cephalosporins.

  2. Previous history of jaundice / hepatic dysfunction associated with Augmentin (or
    amoxicillin/clavulanic acid combination).

Precautions1,3

  1. Renal impairment -

    1. mild renal impairment : no change to dosing schedule;

    2. moderate renal impairment : increase the dosing interval. Maintain adequate fluid intake, especially with IV doses, to reduce the possibility of amoxicillin crystalluria.

  2. Hepatic dysfunction- monitor liver function tests

  3. Cholestatic jaundice – although rarely reported in children.

  4. Cytomegalovirus – increased risk of rash

  5. Oral suspension - contains aspartame (source of phenylketonuria) , therefore use with caution in patients with phenylketonuria.

Clinical Pharmacology3,4

The clavulanic acid component protects the amoxicillin from degradation by beta-lactamases, thus extending the spectrum of the amoxicillin. The predominant route of elimination is renal. Oral absorption is enhanced by the presence of food.

Possible Adverse Effects3,4

  1. Oral candida

  2. Diarrhoea and vomiting, review therapy if this occurs.

  3. Hepatic events - although rarely reported in children. Consult with ID service for use greater than 14 days.

  4. CNS toxicity with high doses or severe renal impairment.

  5. Rashes

Special Considerations3,4

  1. Not suitable for intramuscular administration4

  2. Monitor: renal & hepatic function and FBC if on prolonged therapy.