Clavulanic acid effect on the liver. Clavulanic acid. Influence on the ability to drive vehicles and complex mechanisms

Clavulanic acid was first discovered in 1974-1975 in the UK. It is produced by bacteria Streptomyces clavuligerus. Chemically, it is a bicyclic beta-lactam containing neither a penicillin nor a cephalosporin core. Clavulanic acid is active against some bacteria, including chlamydia, Neisseria, streptococci,. However, it is not used as an independent antibiotic. The most important property of clavulanic acid is the ability to inhibit beta-lactamase. These are enzymes that protect bacteria from action. They destroy beta-lactams before they can damage the bacterial cell wall. It is beta-lactamases that provide bacterial resistance to penicillins and cephalosporins. They are produced by both Gram-positive and Gram-negative bacteria.

Clavulanic acid is used in combination with beta-lactams. They are used to treat meningitis, endocarditis, sepsis, bronchitis and pneumonia, peritonitis, bacterial kidney diseases, urinary tract and reproductive system, skin infections. In addition, combined agents are also used for the prevention of diseases, for example, before surgical operations. Of these, the most famous is "Amoxiclav" ("Panklav", "Augmentin", "Verklav", "Amovikomb") containing amoxicillin. In veterinary medicine, Amoxiclav is used to treat infections in dogs and cats, as well as pigs, sheep, cows and poultry. It should not be used for rabbits, hamsters, guinea pigs and laying hens whose eggs are intended for food.

In addition to reducing the activity of beta-lactamase, clavulanic acid enhances the immune response to infection, which increases the effectiveness combined drugs. For example, in studies of penicillin-resistant Staphylococcus aureus amoxicillin reduced the degree of its phagocytosis - absorption and digestion of bacteria by cells immune system. The addition of clavulanic acid, on the contrary, stimulated this process. However, this is true only for bacteria resistant to beta-lactams: studies on strains that do not produce beta-lactamase did not reveal significant differences in the intensity of phagocytosis under the action of amoxicillin alone and its combination with clavulanic acid.

When administered orally, clavulanic acid is absorbed in the digestive tract and then rapidly excreted in the urine. It is also rapidly excreted from the tissues, including after injections. Small amounts of clavulanic acid are excreted in milk.

Clavulanic acid is used in combination with other drugs. Therefore, side effects are usually considered for the drug as a whole, and not for individual substances. Combination therapy with beta-lactams and clavulanic acid has been associated with an increased risk of developing cholestasis and medicinal hepatitis occurring during or shortly after treatment. These conditions are usually not life threatening. There are cases of allergic reactions caused by clavulanic acid.

The LD50 of clavulanic acid in rats and mice exceeds 2000 mg/kg body weight, which means little toxicity to mammals. In case of poisoning with this substance, nausea, diarrhea and abdominal pain are observed. Rarely, rash, hyperactivity, or drowsiness have been reported in addition to these symptoms. Clavulanic acid does not show genotoxic and carcinogenic properties. However, experiments on rats and mice have shown its reproductive toxicity.

In the European Union, maximum levels of clavulanic acid in food products of animal origin are limited by law. So, in pork, beef and fat of these animals there should not be more than 100 mcg / kg of this substance. The content of clavulanic acid in pork and beef liver should not exceed 200 mcg / kg, in the kidneys - 400 mcg / kg, in cow's milk- 200 mcg/kg. AT Russian Federation and the countries of the EAEU, the maximum permissible levels of clavulanic acid in food products have not been established.

Literature

1. Amoxicillin + Clavulanic acid. Register of medicines of the Russian Federation.
2. clavulanic acid. PubChem.
3. clavulanic acid. Summary Report (2). Committee for Veterinary Medical Products. EMEA/MRL/776/01-FINAL. February 2001
4. Finlay J, Miller L, Poupard JA. A review of the antimicrobial activity of clavulanate. J Antimicrob Chemother. 2003 Jul;52(1):18-23. Epub 2003 May 29.
5. Dufour V, Millon L, Faucher JF, Bard E, Robinet E, Piarroux R, Vuitton DA, Meillet D. Effects of a short-course of amoxicillin/clavulanic acid on systemic and mucosal immunity in healthy adult humans. Int Immunopharmacol. 2005 May;5(5):917-28.
6. Tortajada Girbés M, Ferrer Franco A, Gracia Antequera M, Clement Paredes A, García Muñoz E, Tallón Guerola M (2008). Hypersensitivity to clavulanic acid in children. Allergol Immunopathol (Madr). 36(5): 308-10.

Catad_pgroup Antibiotics penicillins

Amoxiclav tablets - instructions for use

INSTRUCTIONS
by application medicinal product
for medical use

Read this leaflet carefully before you start taking/using this medication.
Save the instructions, they may be needed again.
If you have any questions, please contact your doctor.
This medicine has been prescribed for you personally and should not be given to others as it may harm them even if they have the same symptoms as you.

Registration number

Tradename

Amoxiclav ®

grouping name

Dosage form

Compound

Active substances (core): each 250mg+125mg tablet contains 250mg amoxicillin trihydrate and 125mg clavulanic acid potassium salt;
each 500mg+125mg tablet contains 500mg amoxicillin trihydrate and 125mg clavulanic acid potassium salt;
Each 875mg+125mg tablet contains 875mg amoxicillin trihydrate and 125mg clavulanic acid potassium salt.
Excipients(respectively for each dosage): colloidal silicon dioxide 5.40 mg / 9.00 mg / 12.00 mg, crospovidone 27.40 mg / 45.00 mg / 61.00 mg, croscarmellose sodium 27.40 mg / 35.00 mg / 47.00, magnesium stearate 12.00 mg / 20.00 mg / 17.22 mg, talc 13.40 mg (for a dosage of 250 mg + 125 mg), microcrystalline cellulose up to 650 mg / up to 1060 mg / up to 1435 mg;
film-coated tablets 250mg+125mg- hypromellose 14.378 mg, ethylcellulose 0.702 mg, polysorbate 80 - 0.780 mg, triethyl citrate 0.793 mg, titanium dioxide 7.605 mg, talc 1.742 mg;
film-coated tablets 500mg+125mg- hypromellose 17.696 mg, ethylcellulose 0.864 mg, polysorbate 80 - 0.960 mg, triethyl citrate 0.976 mg, titanium dioxide 9.360 mg, talc 2.144 mg;
film-coated tablets 875mg+125mg- hypromellose 23.226 mg, ethylcellulose 1.134 mg, polysorbate 80 - 1.260 mg, triethyl citrate 1.280 mg, titanium dioxide 12.286 mg, talc 2.814 mg.

Description

Tablets 250 mg + 125 mg: white or off-white, oblong, octagonal, biconvex film-coated tablets, debossed with "250/125" on one side and "AMC" on the other side.
Tablets 500 mg + 125 mg: white or almost white, oval, biconvex film-coated tablets.
Tablets 875 mg + 125 mg: white or off-white, oblong, biconvex film-coated tablets, scored and debossed "875/125" on one side and "AMC" on the other side.
Fracture view: yellowish mass.

Pharmacotherapeutic group

ATX code: J01CR02.

Pharmacological properties

Distribution
Both components are characterized by a good volume of distribution in various organs, tissues and body fluids (including lungs, organs abdominal cavity; fat, bone and muscle tissues; pleural, synovial and peritoneal fluids; skin, bile, urine, purulent discharge, sputum, interstitial fluid).
Plasma protein binding is moderate: 25% for clavulanic acid and 18% for amoxicillin.
The volume of distribution is about 0.3-0.4 l/kg for amoxicillin and about 0.2 l/kg for clavulanic acid.
Amoxicillin and clavulanic acid do not cross the blood-brain barrier in non-inflamed meninges.
Amoxicillin (like most penicillins) is excreted in breast milk. Trace amounts of clavulanic acid have also been found in breast milk. Amoxicillin and clavulanic acid cross the placental barrier.
Metabolism
About 10-25% of the initial dose of amoxicillin is excreted by the kidneys as inactive penicillic acid. Clavulanic acid in the human body undergoes intensive metabolism with the formation of 2,5-dihydro-4-(2-hydroxyethyl)-5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butan-2-one and excreted by the kidneys, through the gastrointestinal tract, as well as with exhaled air, in the form of carbon dioxide.
breeding
Amoxicillin is excreted primarily by the kidneys, while clavulanic acid is eliminated via both renal and extrarenal mechanisms. After a single oral administration of one tablet of 250 mg / 125 mg or 500 mg / 125 mg, approximately 60-70% of amoxicillin and 40-65% of clavulanic acid are excreted unchanged by the kidneys during the first 6 hours.
The mean half-life (T1 / 2) of amoxicillin / clavulanic acid is approximately one hour, the average total clearance is approximately 25 l / h in healthy patients.
The largest number clavulanic acid is excreted within the first 2 hours after ingestion.

The total clearance of amoxicillin / clavulanic acid decreases in proportion to the decrease in renal function. The decrease in clearance is more pronounced for amoxicillin than for clavulanic acid, tk. Most amoxicillin is excreted by the kidneys. Doses of the drug in renal failure should be selected taking into account the undesirability of cumulation of amoxicillin against the background of maintaining normal level clavulanic acid.

In patients with impaired liver function, the drug is used with caution, it is necessary to constantly monitor liver function.
Both components are removed by hemodialysis and minor amounts by peritoneal dialysis.

Indications for use

Contraindications

Carefully

History of pseudomembranous colitis, diseases of the gastrointestinal tract, liver failure, severe renal dysfunction, pregnancy, lactation, while the use of anticoagulants.

Use during pregnancy and during breastfeeding

Dosage and administration

inside.
The dosage regimen is set individually depending on the age, body weight, kidney function of the patient, as well as the severity of the infection.
Amoxiclav ® is recommended to be taken at the beginning of a meal for optimal absorption and to reduce possible side effects. digestive system.
A course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. Treatment should not be continued for more than 14 days without re- medical examination.
Adults and children 12 years of age or older or weighing 40 kg or more:
For the treatment of mild to moderate infections - 1 tablet 250 mg + 125 mg every 8 hours (3 times a day).
For the treatment of severe infections and infections of the respiratory system - 1 tablet 500 mg + 125 mg every 8 hours (3 times a day) or 1 tablet 875 mg + 125 mg every 12 hours (2 times a day).
Since the 250 mg + 125 mg and 500 mg + 125 mg tablets of the combination of amoxicillin and clavulanic acid contain the same amount of clavulanic acid - 125 mg, then 2 tablets of 250 mg + 125 mg are not equivalent to 1 tablet of 500 mg + 125 mg.
Patients with impaired renal function
Dose adjustments are based on the maximum recommended dose of amoxicillin and are based on creatinine clearance (CC) values.

Tablets 875 mg + 125 mg should only be used in patients with CC> 30 ml / min.
Patients with impaired liver function
Reception of the drug Amoxiclav ® should be carried out with caution. It is necessary to conduct regular monitoring of liver function.
Does not require correction of the dosing regimen for elderly patients. In elderly patients with impaired renal function, the dose should be adjusted as for adult patients with impaired renal function.

Side effect

Overdose

Interaction with other drugs

Antacids, glucosamine, laxative drugs, aminoglycosides delay absorption, vitamin C - increases absorption. Diuretics, allopurinol, phenylbutazone, non-steroidal anti-inflammatory drugs (NSAIDs) and other drugs that block tubular secretion (probenecid), increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration). The simultaneous use of the drug Amoxiclav ® and probenecid can lead to an increase and persistence in the blood of the level of amoxicillin, but not clavulanic acid, therefore, simultaneous use with probenecid is not recommended. Simultaneous use of the drug Amoxiclav ® and methotrexate increases the toxicity of methotrexate.
The use of the drug in conjunction with allopurinol may lead to allergic skin reactions. Currently, there is no data on the simultaneous use of a combination of amoxicillin with clavulanic acid and allopurinol. Avoid concomitant use with disulfiram.
Reduces the effectiveness of drugs, during the metabolism of which para-aminobenzoic acid is formed, ethinyl estradiol - the risk of bleeding "breakthrough".
The literature describes rare cases of an increase in international normalized ratio (INR) in patients with joint application acenocoumarol or warfarin and amoxicillin. If necessary, simultaneous use with anticoagulants, it is necessary to regularly monitor the prothrobin time or INR when prescribing or discontinuing the drug, it may be necessary to adjust the dose of anticoagulants for oral administration.
When used simultaneously with rifampicin mutual weakening of the antibacterial effect is possible. The drug Amoxiclav ® should not be used simultaneously in combination with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of the drug Amoxiclav ® .
The drug Amoxiclav ® reduces the effectiveness oral contraceptives.
In patients receiving mycophenolate mofetil, after the start of the use of the combination of amoxicillin with clavulanic acid, a decrease in the concentration of the active metabolite, mycophenolic acid, was observed, before taking regular dose drug by about 50%. Changes in this concentration may not accurately reflect overall changes in mycophenolic acid exposure.

special instructions

Special precautions for the disposal of unused medicinal product.

There is no need for special precautions when destroying the unused drug Amoxiclav ® .

Impact on ability to drive vehicles, mechanisms

With the development of adverse reactions from nervous system(for example, dizziness, convulsions), you should refrain from driving and engaging in other activities that require increased concentration and speed of psychomotor reactions.

Release form

Storage conditions

In a dry place at a temperature not exceeding 25°C.
Keep out of the reach of children.

Shelf life

2 years.
Do not use the drug after the expiration date indicated on the package.

Holiday conditions

Manufacturer

People often face bacterial infections that pose a danger to humans. When such diseases appear, it is necessary to immediately begin to eliminate them. Among the drugs that effectively fight bacterial pathologies, there are "Amoxicillin". Before using such a combined remedy, you need to understand the instructions for the use of "Amoxicillin" and clavulanic acid.

Each person who is going to use the drug for the treatment of infectious diseases in the future must determine what it is made of.

When creating a drug, two active components are combined at once. The first substance is sodium amoxicillin, and the second is potassium clavulanate. It is worth noting that the drug "Ecoclave Plus" is also made from these components.

The medicine is produced in various forms, which is better to familiarize yourself with in advance. Pharmacies sell tablets in film sheath, as well as powder to create a suspension or injection solution.

Pharmacological properties

When familiarizing yourself with the features of "Amoxicillin" with clavulanic acid, you should understand their pharmacological properties. This will help to understand the effect of the drug on the human body.

Pharmacodynamics

Such a combined remedy is characterized by a bactericidal effect, with the help of which pathogens are eliminated. The drug is especially effective in the fight against gram-positive bacteria, which include lactamases and strains.

Pharmacokinetics

When using the drug, its main components quickly penetrate the body. Due to this, the effect of the reception is manifested within an hour. The kidneys are responsible for the excretion of the drug, which completely cleanse the body in 4-5 hours.

Indications for use

Before using any medicine, it is necessary to determine the scope of its application. Amoxicillin with acid is used to combat infectious diseases that have appeared due to the effects of bacteria on the body. Most often, the remedy is used to eliminate respiratory diseases, but there are other pathologies that can be cured by it. These include:

• damage to the respiratory tract and respiratory organs;
• skin infectious diseases;
• gynecological or urological pathologies;
• bone tissue damage.

Also, the drug is regularly used to get rid of the symptoms of diseases that affect the urinary organs:

• urethritis;
• cystitis;
• salpingitis;
• prostatitis.

How correctly and in what doses is the medicine used?

It is necessary to understand in advance the nuances of the use of a bactericidal drug. To do this, you will have to consider separately each method of its use.

Film-coated tablets

Often, a drug that is available in the form of tablets is used for therapy. Three tablets are taken daily after or before meals. The duration of therapy depends on the characteristics of the disease and possible complications.

Powder for suspension preparation

The suspension is used in the treatment of newborns and children under ten years of age. A solution prepared from a powder is taken orally after a meal. It is necessary to familiarize yourself with the optimal dosage, since it directly depends on the age of the child. The daily dose of children up to a year is 25 mg / kg, from one to three years - 35 mg / kg, from three to ten years - 40 mg / kg.

Powder for solution for intravenous administration

You should not independently engage in the introduction of an injection solution, as this should be done by medical personnel. Accurate dosage The drug is determined by the doctor, based on the diagnosis and the patient's well-being.

Consequences of an overdose

If during therapy you do not comply correct dosage certain complications may arise. Due to the use of the drug in large doses, sleep problems appear, which lead to insomnia. Also, patients who have experienced an overdose complain of convulsions, nervous disorders, dizziness and disturbances in water and electrolyte balance.

Abuse of the drug is accompanied by crystalluria of amoxicillin, which leads to the development of renal failure. All of these symptoms are very dangerous, and therefore, in case of an overdose of the drug, immediately seek help from a doctor.

Possible unwanted effects

It is no secret that after the use of drugs, side effects may appear that disrupt the functioning of some body systems.

Gastrointestinal tract

Problems with the digestive system are manifested in the form of jaundice, diarrhea, vomiting and nausea. Occasionally, patients develop hemorrhagic-type colitis and hepatitis.

Hematopoietic organs

People complain about thrombocytosis, hemolytic anemia and leukopenia. There are also symptoms of thrombocytopenia and eosinophilia.

central nervous system

Due to the improper use of "Amoxicillin" with clavulanic acid, problems with the central nervous system may occur. These include anxiety, depression, hyperactivity.

allergies

Allergic reactions are among the most common side effects of the drug. They manifest as swelling, urticaria and dermatitis.

Influence on the ability to control mechanisms

The drug has a negative effect on the management of mechanisms, only if taken in large doses.

Contraindications to the use of the drug

Before using the drug, be sure to study its contraindications. This will help you figure out in which cases it can not be used. "Amoxicillin" is contraindicated in patients who are allergic to any of the components of the drug. Also, doctors do not advise taking the remedy for people with lymphocytic leukemia and infectious mononucleosis.

Use of the drug for violations of kidney or liver function

People who have problems with the functioning of the liver or kidneys should use Amoxicillin with caution. With such diseases, the excretion of drug components from the body slows down, which often leads to an overdose. Therefore, in order to protect yourself from complications, it is recommended to take the medicine in reduced doses. Also, between each dose of the drug, you will have to take a break of 10-12 hours.

Special instructions for medication

Everyone who plans to use this or that medicine should familiarize himself with special instructions to its application.

Application in childhood

Amoxicillin and clavulanic acid are used to treat children from three months. In this case, not tablets are used, but powder for making syrup.

During pregnancy and lactation

It is better for pregnant girls to refrain from using this remedy, as this can lead to the development of enterocolitis in the baby. However, some girls still use the drug after prior consultation with a doctor.

Use in the elderly

There are no restrictions on taking medication for people in old age. Therefore, during treatment, they must comply with the usual dosage for adults.

Compatibility with other drugs and alcohol

It is known that the drug can be combined with other medicines and used for complex therapy. However, before that, it is necessary to determine its compatibility with drugs.

"Amoxicillin" can not be used together with laxatives, glucosamine and antacids. These funds reduce the absorption of the drug and reduce its effectiveness. To increase the therapeutic effect of tablets or injections, they must be combined with anticoagulants.

Amoxicillin is incompatible with alcohol, and therefore it is impossible to drink alcohol during therapy.

Terms of sale of medicine

To purchase "Amoxicillin", you will have to consult a doctor for diagnostic procedures. After confirming the diagnosis, the doctor will be able to decide on the treatment and write out prescriptions for the purchase of the necessary medicines. It is impossible to buy the drug in a pharmacy without a doctor's prescription.

Terms and conditions of storage

Everyone should familiarize themselves with the rules for storing medicines at home, as this will extend the shelf life of medicines. "Amoxicillin" in the form of tablets should be stored in a dimly lit place at a temperature of 15-25 degrees.

Under sunbeams It is contraindicated to store tablets, because the properties of the drug change due to bright lighting.

Prepared injection solutions are best stored in the refrigerator at a temperature of 1-2 degrees Celsius.

Analogues of the drug "Amoxicillin" + clavulanic acid

Patients who cannot be treated with Amoxicillin use similar means. Among them, Amoxiclav can be distinguished, which has the same pharmacological properties. This drug helps to get rid of acute otitis, chronic bronchitis and pneumonia. "Amoxiclav" is taken twice a day in the amount of 200-300 mg.

Conclusion

"Amoxicillin" with clavulanic acid is considered excellent combined remedy against bacterial diseases. Before using such a medicine, it is better to familiarize yourself with its indications, pharmacological properties and shelf life.

Broad-spectrum antibiotics are designed to suppress pathogenic microflora that has entered the patient's body. Commonly prescribed drugs include amoxicillin-clavulanic acid. Experts believe that the drug is quite safe and has a gentle effect on the patient. The drug is a semi-synthetic, penicillin-containing substance.

General information

The main composition of the drug is represented by two active ingredients:

• Amoxicillin;
• clavulanic acid.

Manufacturers produce medicines in various forms:

1. syrupy;
2. Suspension;
3. drip;
4. powdered;
5. Tableted.

The active ingredients included in the main structure are contained in various volumes:

• 250 and 125 mg each;
• 500 and 125 mg each;
• 875 and 125 mg each.

Associated with the severity of the development of the disease, the drug is prescribed with different dosage levels.

Permissions and prohibitions on use

The drug is often prescribed for certain types of lesions:

• lung abscesses;
• bronchitis;
• As preventive measures in surgical practice;
• Vaginitis of a bacterial nature;
• inflammation of the middle ear;
• Inflammation of the cervical canal;
• gonorrheal infection;
• Dermatoses with secondary infection;
• Impetigo;
• Infections on wound surfaces;
• Soft chancres;
• osteomyelitis;
• Pelvioperitonitis;
• Pyelitis;
• Pyelonephritis;
• Pneumonia;
• Postpartum variants of septic lesions;
• Joined infections in the postoperative period;
• prostatitis;
• Erysipelas;
• Salpingitis;
• Salpingoophoritis;
• Spontaneous febrile abortion;
• sinusitis;
• tonsillitis;
• tubo-ovarian abscesses;
• Urethritis of various etiologies;
• Phlegmon;
• cystitis;
• Empyema of pleural tissues;
• Endometritis.

Taking the drug is prohibited under certain conditions:

1. High sensitivity in relation to the active ingredients that make up the drug;
2. Mononucleosis of infectious etiology;
3. Phenylketonuria;
4. jaundice;
5. Disorders of the functionality of the liver caused by the introduction of similar pharmacological preparations.

Increased caution in prescribing is required in the treatment of diseases during the periods of gestation, feeding the baby, with the existing insufficient functionality of the liver in severe forms, with certain diseases of the digestive department.

Negative reactions

When prescribing amoxicillin-clavulanic acid, various side effects on the patient's body are possible.

Digestive department:

• Gastroduodenitis;
• Hepatitis;
• Glossitis;
• Diarrhea;
• Jaundice of the cholestatic type;
• Changing the shade of tooth enamel to dark colors;
• Colitis of hemorrhagic and pseudomembranous variants - their appearance may be caused by therapy with the desired drug;
• Insufficiency of liver functionality, especially in the elderly age period in males, with prolonged therapy;
• Increased activity of liver enzymes;
• Stomatitis;
• Nausea with the transition to vomiting;
• Blackish tinge of the tongue;
• Enterocolitis.

1. Reversible increase in the prothrombotic period;
2. Prolongation of the bleeding period;
3. thrombocytopenia;
4. thrombocytosis;
5. eosinophilia;
6. Decrease in the number of leukocytes;
7. Agranulocytosis;
8. Hemolytic type of anemic disorder.

• Headaches;
• Increased activity;
• dizziness;
• Unreasonable anxiety;
• Changing the standard behavior;
• Convulsive syndrome.

Allergic manifestations:

• Allergic type of vasculitis;
• Anaphylactic shock;
• Angioedema;
• Eruptions of an erythematous appearance;
• Reddish papules on the skin;
• Multiform exudative erythema;
• Acute phase of generalized exanthematous papulosis;
• Symptomatic manifestations similar to serum sickness;
• Exudative erythema of a malignant nature is a symptom of Stevens-Johnson;
• Exfoliative subtype of dermatitis.

Other manifestations:

1. The development of secondary infection with pathogenic microflora;
2. Interstitial nephritis;
3. The appearance of salt crystals in the urine;;
4. Presence of blood particles in urine;
5. Candidiasis.

Local microreactions of the body can manifest at the points of intravenous injection in the form of phlebitis.

Amoxicillin Clavulanic acid instructions for use

A pharmacological agent is introduced into the patient's body in two ways - intravenously or orally. The required volumes of the drug are set taking into account the general condition of the body, data laboratory research and degree of injury. All dosages are calculated in relation to amoxicillin.

Oral administration

For babies under 12 years of age, the medication is prescribed in the form of drops, suspension or syrup for oral use. One-time amount corresponds to the age period:

• Until the first quarter of life - 30 mg per kg of body weight per day;
• After 3 months - 25 mg per kg of body weight, twice in 24 hours or 20 mg per kg, three times a day (calculation for mild degree lesions);
• After the first quarter with a severe variant of the disease - 45 mg per kg twice a day or 40 mg per kg three times a day.

The maximum amount of the permitted volume of "Amoxicillin" is 45 mg per kg of the child's weight, "Clavulanic acid" - 10 mg per kg of body weight.

After 12 years and the adult population (total body weight exceeds 40 kilograms), the drug is prescribed in proportions:

1. For mild lesions - 500 mg twice a day or 250 mg three times a day;
2. With complex courses of the disease - 875 mg twice a day or 500 mg three times a day.

The highest one-time measure for the adult population and babies after 12 years of "Amoxicillin" includes 6 g, "Clavulanic acid" - 600 mg.

In cases of problems with swallowing liquids and solids in older people, they are advised to use suspensions.

In the manufacture of syrups, suspensions and drops, drinking pure water is the main solvent.

Introduction to the veins

Produced according to age:

• For the adult and adolescent period (over 12 years), 1 g is prescribed three times a day, four times a day is allowed in some cases;
• Babies after the first three months - 25 mg per kg of body weight, three times (lightened variants of ailments) or four times a day for severe forms of illness;
• Until the first quarter of life - with prematurity or in the perinatal period - 25 mg per kg, twice, or in the postperinatal period - 25 mg per kg three times a day.

The average duration of the therapeutic effect is up to two calendar weeks, with inflammation in the middle ear area - up to 10 days.

Preventive actions

The appointment of an agent to prevent the occurrence of postoperative processes (with manipulations that take at least an hour) is carried out at the time of induction anesthesia at a dosage of 1 g (intravenously). At high risk possible subinfection will be allowed to carry out manipulation for several days.

Patients undergoing hemodialysis have their own volumes of prescribed medications:

1. Orally - 250 or 500 mg at a time;
2. In the veins - 500 mg of the substance.

At the time of manipulation and after its completion, an additional one dose of the medicinal substance is administered.

Overdose

• Nausea with transition to vomiting;
• Diarrhea;
• Violations in the water and electrolyte balance - as a result of dehydration of the body due to vomiting, diarrhea;
• neurotoxic reactions;
• thrombocytopenia.

The latter disappear after cancellation pharmacological agent and are reversible.

If signs of poisoning are detected, patients are applied

1. Gastric lavage;
2. The introduction of activated carbon;
3. Salt laxatives;
4. Correction of water and electrolyte balance;
5. Hemodialysis.

Immediately after the occurrence of an overdose, the patient must be taken to medical institution to provide professional assistance.

Possible interaction

When carrying out the treatment of "amoxicillin with clavulanic acid", the drug may react with other drugs:

1. Antacids, laxatives, aminoglycosides and Glucosamine, when combined with the parent substance, cause a slowdown and decrease in the absorption of active ingredients;
2. Ascorbic acid, taken at the same time, increases absorption;
3. Macrolides, chloramphenicols, lincosamides, sulfonamides, tetracycline drugs with simultaneous administration exhibit an antagonistic effect;
4. Anticoagulants of the indirect type increase their effectiveness, while there is a suppression of beneficial microflora in the intestine, a decrease in the synthesis of vitamin K and the prothrombin index;
5. The beneficial effects of oral contraceptives, ethinyl estradiol, are significantly reduced;
6. Pharmacological agents, during the processing of which PABA is produced, reduce their spectrum of action, which can cause the formation of spontaneous bleeding;
7. Diuretic drugs and drugs that block calcium secretion increase the total concentration of the original substance.

Before using the medicine, it is necessary to inform the attending doctor about all previously prescribed drugs - in order to avoid the occurrence of unforeseen reactions and the development of complications.

Features of use

The therapeutic course is carried out under constant control functionality of the hematopoietic systems, liver and kidneys. To reduce the risk of developing pathologies in the gastrointestinal tract, medication taken only at the time of eating.

With the gradual development of resistance of pathogenic microflora to active ingredients, the development of secondary sub-infection with pathogenic microorganisms may begin. It requires specialized antibacterial therapy. In some cases, false analyzes may be recorded when determining the amount of glucose in urine.

The suspension prepared at home must be stored in a refrigerator for up to one week, avoiding freezing.

At the time of the use of the medicinal substance "amoxicillin-clavulanic acid", the use of any alcoholic and low-alcohol drinks is strictly prohibited.

Ethyl alcohol has a diuretic effect and will weaken the therapeutic effects of the treatment. Alcohol can cause various complications during therapy with the desired medication.

Similar drugs

With existing contraindications or arising side effects, the agent is replaced by similar drugs, with the same therapeutic effect. Common types include:

• "Amocomb";
• "Amoxivan";
• "Amoxicillin trihydrate + potassium clavulanate";
• "Ranclave";
• "Rapiclav";
• "Arlet";
• "Bactoclav";
• "Verklav";
• "Liklav";
• "Fibell";
• "Flemoklav Solutab";

The cost of the drug "Amoxicillin Clavulanic acid" depends on the number of capsules and ampoules in the package, the manufacturer and ranges from 60 to 800 rubles. Typical remedies can either exceed the price of the desired remedy, or be much cheaper. The option required by the pricing policy can be purchased at the pharmacy network, if you have a prescription for the main antibiotic.

Combined preparations based on clavulanic acid have a wide antimicrobial action by inhibiting beta-lactamase. Used for treatment infectious diseases respiratory and genitourinary system, soft tissues and skin.

Description of clavulanic acid

Clavulanic acid is a beta-lactamase inhibitor due to its beta-lactam structure, which makes it similar in structure to antibiotics.

This feature allows the substance to combine with penicillin-binding protein structures located on the walls of gram-positive or gram-negative bacteria, which contributes to their destruction.

What does acid do?

Clavulanic acid is able to show low activity against Pseudomonas aeruginosa, enterococci, medium activity against Enterobacteria and Haemophilus influenzae, and strong activity against bacteroids, moraxella, staphylococci and streptococci. This beta-lactam compound affects gonococci and atypical bacteria of the class Chlamydia and Legionella.

Clavulanic acid preparations

Antibiotics of the beta-lactam series are well combined with this substance, which allows you to create combined antibacterial medicines with different trade names, for example, drugs "Amoxil-K", "Augmentin", "Amoxiclav".

The main drug is the drug "Amoxicillin + clavulanic acid". Available in the form of tablets, powder for suspensions (with regular dosage and "forte"), powder for syrup and injections. The composition includes amoxicillin trihydrate and clavulanic acid in the form of a potassium salt in different quantities. The tablets contain 500 or 250 mg of antibiotic and 125 mg of salt, while the total content of active ingredients can be 625 mg, 1 g, 375 mg.

Mechanism of action

The active substance amoxicillin is a semi-synthetic antibiotic with a wide spectrum of action against gram-positive and gram-negative microorganisms. The compound can be destroyed with the participation of β-lactamases, so it does not act on microorganisms that produce these enzymes.

Clavulanic acid refers to β-lactam compounds that block a wide range of enzymes by forming stable inactivated complexes. This action prevents the enzymatic destruction of the amoxicillin antibiotic and contributes to the expansion of its activity on microorganisms that are usually resistant to its influence.

What heals

The drug "Amoxicillin + clavulanic acid" can treat bacterial diseases of the upper and lower respiratory tract, skin and muscle tissue.

The remedy actively fights against infection in the genitourinary tract in the form of cystitis, urethritis, pyelonephritis, sepsis that has developed after an abortion or childbirth, diseases of the pelvic organs. The drug is used for osteomyelitis, blood poisoning, inflammation of the peritoneum, postoperative diseases, animal bites.

How to take pills

For each patient, the dose is selected individually, for which the severity of the disease, its location and the sensitivity of the bacteria affected by clavulanic acid are taken into account. Tablets with a total content of active substances of 0.375 g for adults and children over 12 years of age, taking into account the mild or moderate course of the disease, are prescribed 1 piece 3 times a day. If the total content of active ingredients in a tablet is 1 g, they are taken 1 piece 2 times a day.

Severe infectious lesions are treated with a dose of 1 tablet with a total dosage of 0.625 g or 2 tablets of 0.375 g, taken 3 times a day.

Preparations that contain clavulanic acid, instructions for use recommend taking only as directed by your doctor.

The use of other forms of the drug

The dose of the drug is given on the basis of the recalculation of the content of the antibiotic in it. For children under 12 years of age, the drug "Amoxicillin + clavulanic acid" instruction does not advise prescribing tablets. It is better to use a suspension, syrup or drops for internal use.

One-time and daily dose amoxicillin is selected by age categories:

• babies who are under three months old are prescribed 0.03 g per 1 kg of weight per day for 2 times;
• from 3 months of life and with mild infection, 0.025 g per 1 kg of weight is used per day for 2 times or 0.02 g per 1 kg of weight for 3 times;
• severe infections require 0.045 g per 1 kg of body weight per day for 2 times or 0.04 g per 1 kg of body weight per day for 3 times;
• adults and children from 12 years of age, whose weight is from 40 kg and above, can take a dose of 0.5 g 2 times or 0.25 g 3 times;
• in case of severe infections or diseases of the respiratory organs, 0.875 g is prescribed 2 times a day or 0.5 g 3 times a day.

The maximum daily dosage of amoxicillin for adults and children over 12 years of age is 6 g, and for children under 12 years of age - no more than 0.045 g per 1 kg of body weight.

The maximum allowable daily amount of clavulanic acid has also been established: for adults and children over 12 years old - 600 mg, for babies under 12 years old - 0.01 g per 1 kg of body weight.

If swallowing is difficult, a suspension is also recommended for adults. For the preparation of liquid dosage forms the solvent is pure water.

Intravenous administration for adults and adolescents over 12 years of age allows a dosage of 1 g of amoxicillin 4 times a day. The maximum amount per day is not more than 6 g. For children who have reached three months, up to 12 years of age, 0.025 g per 1 kg is administered in 3 doses, with complex lesions, 4 injections are used per day.

Infants under 3 months old, premature babies are administered 0.025 g per 1 kg for 2 doses per day, in the postperinatal period of development, 0.025 mg per 1 kg for 3 doses is prescribed.

The duration of therapy is two weeks, with acute otitis media - about 10 days.

Prevention of infections after surgical intervention in operations that last no more than 60 minutes, it is carried out by intravenous administration of 1 g of the drug at the time of preliminary anesthesia. Longer operations require the use of 1000 mg after 6 hours throughout the day. If the likelihood of infection is high, the use of the medication is continued for the next two or three days.

Patients with hemodialysis are prescribed orally at 0.25 g or 0.5 g per application or 500 mg is administered intravenously. An additional action is the use of 1 dose at the time of dialysis and 1 dose at the end of the manipulation.