Should I be treated with Amoxiclav? After all, the time of using the generation of antibiotics of the penicillin series has long since passed, they have lost their effectiveness and relevance. Nevertheless, the agent under consideration is actively prescribed by doctors to suppress pathogenic microbial flora.
Let's figure out what Amoxiclav is! The preparation includes antibiotic amoxicillin trihydrate and potassium salt of clavulanic acid, which is an inhibitor of enzymes. The agent belongs to the pharmacological group of penicillins.
Today we will tell you about the pharmacological action of the drug, indications and contraindications to its use, possible side effects, instructions for the use of drugs in tablets and powders. How is it used to treat children and adults, what dosages are produced, does it interact with other drugs? In the end, what is better to use Amoxiclav, Augmentin, Flemoxinum or Sumamed? Okay, about everything in order.
Amoxiclave: formulation and composition
Available in the form of tablets, powders for drinking and special powder for injectionsintramuscularly:
- tablets, film-coated;
- powder for suspensions;
- lyophilized powder for injection.
One tablet of 375 mg contains 250 mg of amoxicillin and 125 mg of clavulanic acid.
The 625 mg tablet contains 500 mg of amoxicillin, 125 mg of clavulonic acid.
Excipients are: silicon dioxide( colloid);croscarmellose( sodium salt);magnesium stearate;talc;hypromellose;ethylcellulose;polysorbate;titanium dioxide;triethyl citrate.
Tablets are packed in vials, 15 pieces in each. One box contains one medicine bottle.
Powder for suspension is available in dark glass bottles, one in a box. There is also a measuring spoon. The composition of the usual finished suspension includes 125 and 31.25 mg of active substances, respectively. When preparing the suspension "Amoxiclav Forte", in 5 ml of it contains twice as much active substances - 250 and 62.5 mg respectively. Excipients are: citric acid;sodium citrate;sodium benzoate;carmellose sodium;colloid of silicon dioxide;sodium saccharinate;mannitol;flavors of strawberries and wild cherries.
A lyophilized powder is dispensed in 0.6 and 1.2 g bottles for injection. The content of amoxicillin sodium in solution is 500 or 1000 mg, and the potassium salt of clavulanic acid is 100 and 200 mg, respectively. In one box there are 5 bottles.
Pharmacological action of the drug
The combination of amoxicillin with clavulanic acid creates a certain uniqueness of the drug.
Amoxicillin and other antibiotics of the penicillin group cause the death of bacterial cells by binding their surface receptors. However, most bacteria during the time of application of the drug have learned to destroy this antibiotic with the help of the enzyme beta-lactamase.
Just clavulanic acid reduces the activity of this enzyme, due to this the drug has a wide range of action. It is even capable of killing strains of bacteria resistant to amoxicillin.
The drug has a pronounced bacteriostatic and bactericidal effect on all kinds of streptococci( except methicillin-resistant strains), echinococci, listeria. Sensitive to amoxiclav and gram-negative bacteria: bordetella;brucella;Gardnerella;Klebsiella;moraxella;salmonella;Proteus;shigella;clostridium and others.
Thus, the modern purpose and application of Amoxiclav justifies itself.
Regardless of the combination with food intake, the drug is well absorbed into the body, its maximum concentration is reached already in the first hour after taking. Has a high speed and volume of distribution in the body - in the lungs, pleural, synovial fluids, tonsils, prostate gland, muscle and adipose tissue, sinuses of the nose, middle ear.
In tissues, the highest concentrations of amoxiclav are observed one hour after the maximum in blood plasma.
And pay attention, in breast milk the drug gets in inessential quantities.
Amoxicillin undergoes partial destruction in the body, and clavulanic acid is metabolized very intensively. It is excreted by the kidneys. Insignificant excretion is carried out by the lungs and intestines. Half-life with healthy kidneys is 1-1.5 hours. Slightly excreted from the blood during dialysis.
When is the amoxicar shown for use?
The use of this antibiotic is prescribed for the treatment of various infectious diseases:
- Diseases of the respiratory tract - sinusitis( acute or chronic), inflammation of the middle ear, retropharyngeal abscess, bronchitis, tonsilopharyngitis, pneumonia and others.
- Diseases of the urinary tract - cystitis, pyelonephritis, urethritis and others.
- Gynecological infections, endometritis, septic abortion, salpingitis, and others.
- Inflammations of the biliary tract( cholangitis, cholecystitis).
- Infections of connective and bone tissue.
- Infections of soft tissues and skin( bites, phlegmon, wound infection).
- Sex infections( chancroid, gonorrhea).
- Odontogenic infections, in which the pathogen enters the body through cavities in the teeth.
Amoxiclav in tablets and powder: instruction for use
Amoxiclav is assigned in different ways.
The method of taking depends on the age and weight of the patient, the severity of the infection, the condition of the kidneys and liver. The optimal time to use the drug is the start of the meal.
The course of taking this medication lasts from 5 to 14 days, you can not use it longer.
For children up to 12 years - 40 mg per kilogram of weight per day. Children whose weight exceeds 40 kg, the drug is prescribed as an adult.
Adult is prescribed: 375 mg tablets are taken every 8 hours round the clock, 625 mg tablets every 12 hours. When prescribing a drug for the treatment of serious infections, doses of 625 mg after 8 hours, or 1000 mg every 12 hours are used.
It should be noted that tablets can differ in the proportions of active substances. Therefore, you can not replace the tablet 625 mg( 500 g amoxicillin and 125 g clavulanic acid) with two 375 mg tablets( 250 g amoxicillin and 125 g clavulanic acid).
For the treatment of odontogenic infections the following scheme is used. Tablets 375 mg are taken every 8 hours, round the clock. Tablets 625 mg after 12 hours. If a drug is needed to treat patients with kidney disease, creatinine in the urine is necessarily taken into account. Patients with liver diseases need constant monitoring of its function.
Powder for the preparation of suspensions used for newborns and for children up to 3 months .Dosage is carried out using a special measuring pipette or spoon. Dosage - 30 mg of amoxicillin per kilogram of weight, twice a day.
For children older than three months, for mild and moderate infections - 20 mg / kg of weight, and for severe - 40 mg / kg. The second dose is also used in the treatment of deep infections - inflammation of the middle ear, sinusitis, bronchitis, inflammation of the lungs.
This medication is accompanied by an instruction in which there are special tables that allow to calculate the dose of the preparation necessary for children as precisely as possible. The maximum permissible daily dosage of amoxicillin for children is 45 mg / kg of weight, for adults - 6 grams. Clavulanic acid can be taken a day no more than 600 mg for adults, and 10 mg / kg for children.
Form release with description: suspension, tablets
Suspension. Powder for obtaining a suspension for oral use is used for prescribing to children. In five milliliters of the finished suspension, amoxicillin trihydrate 250 mg and clavulanic acid potassium salt 62.5 mg are contained. Or in 5 ml can contain 125 mg of amoxicillin and 31.5 mg of clavulanic acid.
To give the suspension a pleasant taste, it includes sweet substances and fruit flavors. Powder for the preparation of the suspension is packaged in dark glass bottles. The volume of vials is 35, 50, 70 or 140 ml. In the box with the bottle is inserted a spoon-dispenser.
Tablets. This medication is available in the form of film-coated tablets that have a white or beige-white color. Tablets have an oval biconvex shape. One 625 mg tablet contains 500 mg of amoxicillin trihydrate with 125 mg of clavulanic acid( potassium salt).Tablets can be produced in plastic cans( 15 tablets each) or in aluminum blisters for 5 or 7 pieces. Tablets 1000 mg are also coated, have an oblong shape with bevelled edges. On them, on the one hand, there is an impression of "AMC", on the other - "875/125".They include 875 mg of antibiotic and 125 mg of clavulanic acid.
Amoxiclav 125 .This is the so-called powder for the preparation of a suspension containing 125 mg of amoxicillin and 31.5 mg of clavulanic acid in 5 ml. Produced in bottles of 100 ml, in a cardboard box with a dosing spoon. The dosage is indicated in the section "Amoxiclav - instructions for use".
Amoxiclav 250 ( "Amoxiclav Forte ").This is also a powder for the preparation of a suspension, but it contains a double dose of amoxicillin - 250 mg in 5 ml and 62.5 mg of clavulanic acid. This suspension is called "Amoxiclav Forte" because of the increased dose of antibiotic in its composition. The dosage is indicated in the section "Amoxiclav - instructions for use".
Amoxiclav 500 .These Amoxiclav tablets are 625 mg, containing 500 mg of the actual antibiotic. Applications and doses are listed in the section "Amoxiclav instructions for use", and the composition and properties - in the section "Amoxiclav tablets".
Amoxiclav 875 .These Amoxiclav tablets are 1000 mg, containing 875 mg of the actual antibiotic, and 125 mg of clavulanic acid. The use and dosage are indicated in the section on the method of administration of the drug, and the composition and properties are in the section "Amoxiclav tablets".
Amoxiclav 625 .Tablets contain 500 mg of amoxicillin and 125 mg of clavulanic acid. The use and dosage are indicated in the section on the method of administration of the drug, and the composition and properties are in the section "Amoxiclav tablets".
Amoxicraft 1000 .Tablets contain 875 g of amoxicillin and 125 mg of clavulanic acid. The use and dosage are indicated in the section on the method of administration of the drug, and the composition and properties are in the section "Amoxiclav tablets".
Amoksiklav Kviktab .Instant fruit tablets with a fruit flavor containing either 500 mg of amoxicillin and 125 mg of clavulanic acid, or 875 mg of amoxicillin and 125 mg of clavulanic acid.
Contraindications to the use of
When taking medication, there may be a violation of liver function and jaundice( cholestatic), if previously this drug has already been used and the patient has an increased sensitivity to the components of the drug, or to all penicillins.
In patients who are allergic to cephalosporins, or in the presence of pseudomembranous colitis, insufficiency of liver function or severe renal dysfunction, the drug is prescribed cautiously.
In patients with mononucleosis or lymphocytic leukemia, previously prescribed ampicillin, there may be a rash of the erythematous type. In this case, the antibiotic should be discarded.
What side effects can there be?
Usually easy to pass and easily tolerated by patients. Side effects are more likely in elderly patients, as well as in those patients who use Amoxiclav for a long time.
Most often, side effects occur either during or after the completion of treatment, but sometimes their development occurs a few weeks after the completion of taking the drug.
Digestive system .Typically, it is diarrhea, nausea, vomiting, and dyspepsia. Less common meteorism, stomatitis or gastritis, a discoloration of the tongue or glossitis, enterocolitis. During or after the completion of treatment with this medication, pseudomembranous colitis, a disease caused by one of the bacteria of the clostridium genus, may occur.
Blood System .Anemia can also occur( including hemolytic), eosinophilia, a decrease in the number of platelets and / or leukocytes, agranulocytosis.
The nervous system may respond to headache, dizziness, agitation, insomnia, seizures, inadequate behavior or hyperactivity.
Liver .The parameters of liver samples are increasing, including the asymptomatic increase in activity of ASAT and / or AlAT, APF and serum bilirubin levels.
skin can respond to amoxiclave rash, urticaria, angioedema, less frequent erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis, Stevens-Johnson syndrome.
Urinary system - occurs the appearance of blood in the urine and interstitial nephritis. With prolonged use of the drug, fever, candidiasis of the oral cavity, and candidal vaginitis may occur.
Amoxiclav during pregnancy
Amoxiclav during pregnancy is not advisable to use. The exception is those cases when the benefit of taking the drug is higher than the harm it causes. Taking this medication during pregnancy increases the risk of necrotizing colitis in newborns.
Amoksiklav for children
For children, powder is used for suspensions, usual and "Amoxiclav Forte".The method of application is described in the Amoxiclav section - the method of application.
Amoxiclav in case of angina
Antibiotics for angina are prescribed only in cases of medium and high severity. Amoxiclav, as an antibiotic of the penicillin series, is often prescribed for sore throats. Its use is shown only when the bacterial form of the infection is confirmed, and the pathogenic microflora is tested for sensitivity to this drug.
In the treatment of angina in children, suspensions are used, adults - tablets. In severe cases, injections of the drug are used.
It should be remembered that antibiotics should not be used for a long time, as this increases the resistance of pathogenic microflora to them.
Compatibility with other medicines
It is undesirable to simultaneously use Amoxiclav and preparations of indirect anticoagulants. This can cause an increase in prothrombin time.
The interaction of Amoxiclav and allopurinol causes the risk of developing exanthema. Amoxiclav enhances the toxicity of methotrexate.
Amoxicillin and rifampicin can not be used at the same time - these antagonist drugs, combined use weakens the antibacterial effect of both.
Amoxiclav should not be administered together with tetracyclines or macrolides( these are bacteriostatic antibiotics), and also with sulfonamides due to a decrease in the effectiveness of this drug.
Amoxiclav intake reduces the effectiveness of contraceptives in tablets.
Comparison with other drugs, which is better than Amoxiclav?
When choosing an antibiotic for the treatment of any infection, it is necessary to be guided by the results of testing the pathogenic microflora for sensitivity to a specific antibiotic. There is no point in using a drug that does not kill bacteria - that is, it does not heal. Therefore, it will be better that the antibiotic to which the pathogenic microflora of the patient is sensitive.
Amoxiclav or amoxicillin?
Amoxiclav is a more effective drug than amoxicillin, since many pathogens have developed immunity to this antibiotic and have learned to destroy it, not allowing to show its bactericidal action. The addition of clavulanic acid to amoxicillin made this antibiotic much more active, expanding its range of action.
Amoxiclav or Augmentin?
Augmentin - an analog of Amoxiclav, contains the same active substances.
Amoxiclav or Flemoxin?
Flemoxin is a drug containing only amoxicillin. Without the use of clavulonic acid, it has a smaller spectrum of action, so it is only used if the bacterial microflora is sensitive to this antibiotic.
Amoxiclav or Sumamed?
Sumamed includes the antibiotic azithromycin, which has a wide spectrum of action. The choice should be made on the basis of testing the sensitivity of pathogenic microflora to these two antibiotics. Side effects are similar.
During treatment with Amoxiclav, it is forbidden to take alcohol. Taking alcoholic beverages significantly reduces the antibacterial effect of the medication.
Synonyms and analogs
Analogues of Amoxiclav: Amovicomb;Arlette;Bactocklave;Clamosar;Verklav;Médoclase;Liklave;Panklav;Ranklav;Rapiklav;Tormentin;Flemoclav;Ecoclave;Amoxicillin + clavulanic acid( Fayser) and others.
Comments of doctors and patients
Anna Leonidovna , therapeutist, Vitebsk. Amoxiclav is much more effective in the treatment of various respiratory diseases than its analogue - amoxicillin. I prescribe a course in 5 days, after which it is mandatory to take drugs that restore the microflora.
Veronika Pavlovna , urologist, Krivoy Rog. This drug works great for bacterial infections of the genital tract. Rarely gives side effects, I prescribe antifungal drugs in parallel, after taking - probiotics to restore normal microflora.
Andrey Evgenevich , ENT doctor, Polotsk. The use of this drug injectively allows you to quickly stop the manifestation of severe and moderate severity of ENT diseases. The drug treats the inflammation of the middle ear well. In addition, patients take a sweet fruit suspension well.
Victoria , patient, city of Dnepropetrovsk. I used the doctor's prescription for the treatment of angina. Saw 5 days. Reception of the antibiotic started on day 3 of the disease. The disease began to decline by a third. My throat stopped hurting. There was diarrhea, passed for two days, after it began taking probiotics to restore the microflora.
of Alexander , patient, Lugansk. This drug was prescribed by a doctor for the treatment of pyelonephritis. The course was 7 days. First 3 days of injection - then pills. The injections are quite painful. However, the improvement began approximately on the fourth day. There were no side effects. Is that the dryness in the mouth.
Tamara , patient, Boyarka. They gave me this medicine to treat a gynecological infection. It is very painful, bruises remained on the site of the injections. However, a week later, the smears from the pathogen left no trace.
Amoxiclav for children Liliya Evgenievna , Saransk. Amoxiclav( suspension) was treated with pneumonia in our baby. He is 3.5 years old. On the third day, a disorder of the intestine began, the doctor prescribed probiotics, which drank after the end of the flow for almost a month. Inflammation of the lungs was won quickly - on the 10th day the baby was already feeling well. As far as I understand, all antibiotics should be washed down with bacterial preparations.
Recommendations for use
If the drug is used for a long time, it is necessary to monitor the liver, hematopoietic organs and kidneys of the patient. In the event that the patient has impaired renal function, it is necessary to adjust the dose or increase the interval between the medications.
It is better to take medicine with food.
In case of superinfection( appearance of microflora, insensitive to this antibiotic), it is necessary to change the medicine. In view of the possibility of cross-allergic reactions with cephalosporins in patients sensitive to penicillins, it is undesirable to use these antibiotics simultaneously.
During the drug intake, it is necessary to drink plenty of liquid to avoid the formation of amoxicillin crystals in the urine.
It should be noted that the presence of high doses of antibiotic in the body can provoke a false positive response to urine glucose( in the case of using Benedict's reagent or Fleming's solution to determine it).Reliable results in this case will result in the use of an enzymatic reaction with glucosidase.
Since the side effects of the nervous system are possible with the use of the drug, it is necessary to drive very carefully the vehicles( car) or engage in activities that require increased concentration, reaction speed and attention.
Available by prescription.
Price in rubles and hryvnia
Suspension forte 280 rub.or 42 UAH.
Tablets 625 370 rub.or 68 UAH.
Ampoules 600 mg 180 rub.or 25 UAH.
Amoksiklav Kviktab 625 404 rub.or 55 UAH.
Tablets 1000 440-480 rub.or 90 UAH.
Storage conditions and shelf life
Store in a dry place inaccessible to children. Storage temperature - no more than 25 degrees. Do not use the drug after the expiration date. Before use, consult a specialist.
Source of publication: editorial of the author's article Pashkova MK from the site