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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › BETA-LACTAM ANTIBACTERIALS, PENICILLINS › Combinations of penicillins, incl. beta-lactamase inhibitors
combinations of penicillins
J01CR50
Forms & Strengths
- Amoxicillin 500mg + Clavulanic acid 125mg tablets
- Amoxicillin 875mg + Clavulanic acid 125mg tablets
- Amoxicillin 250mg + Clavulanic acid 62.5mg/5mL oral suspension
- Ticarcillin 3g + Clavulanic acid 100mg vials for injection
- Ampicillin 1g + Sulbactam 500mg vials for injection
Adult Dosing
- Typical dosing: 500mg/125mg to 875mg/125mg every 12 hours for 7-10 days
- Severe infections: up to 2.2g/0.2g intravenously every 6-8 hours
- Renal impairment: dose adjustment may be required
Pediatric Dosing
- Children >40kg: same as adult dosing
- Children 3 months to 12 years: 22.5mg/3.75mg/kg to 45mg/6.4mg/kg every 12 hours
- Neonates: amoxicillin 10-20mg/kg every 8-12 hours, adjust based on post-conceptual age
Indications
- Bacterial infections: skin/skin structure, respiratory tract, urinary tract, intra-abdominal
- Severe dental infections
- Animal bites
- Community-acquired pneumonia
Mechanism of Action
- Amoxicillin: inhibits cell wall synthesis by binding to penicillin-binding proteins
- Clavulanic acid: irreversible inhibition of beta-lactamases, extends spectrum of amoxicillin
- Ticarcillin: inhibits cell wall synthesis by binding to penicillin-binding proteins
- Sulbactam: irreversible inhibition of beta-lactamases, extends spectrum of ampicillin
Contraindications
- Hypersensitivity to penicillins or beta-lactamase inhibitors
- Cholestatic jaundice or hepatic dysfunction with previous use
- Mononucleosis: potential for rash
Adverse Reactions
- Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain
- Hypersensitivity reactions: rash, urticaria, anaphylaxis
- Central nervous system: headache, dizziness
- Hematologic: eosinophilia, thrombocytopenia
Drug Interactions
- Allopurinol: increased risk of rash
- Oral contraceptives: reduced efficacy
- Warfarin: increased international normalized ratio
- Methotrexate: reduced clearance of methotrexate
Curated Content: Needs Vetting Before Put to Clinical Use