Amoxicillin/Clavulanate

Amoxicillin/Clavulanate: Uses, Dosage and Side Effects

Overview

• Amoxicillin binds to penicillin-binding proteins that are involved in bacterial cell walls.
• This makes the cell walls weaker and less rigid, which affects cell division, growth, and the formation of cell walls.
• Clavulanate and the beta-lactamase inhibitor broaden the antimicrobial spectrum against Staphylococcus and E. coli.

Uses of Co-amoxiclav (Amoxicillin/Clavulanate)

• Active against Gram-positive, Gram-negative aerobic, and many obligate anaerobes.
• Beta-lactamase-producing Escherichia coli and Staphylococcus are sensitive, but difficult Gram-negative organisms like Pseudomonas aeruginosa and Klebsiella are resistant.
• Infection site, severity, and organism determine the dose and its interval.

Dose of Amoxicillin/Clavulanate in Dogs and Cats

Dogs, Cats:

• Parenteral:  8.75–25 mg/kg (combined) i.v. q8h, i.m, s.c. q24h.
• Oral: 12.5–25 mg/kg (combined) p.o. q8–12h.
• For surgical prophylaxis: 22–25 mg/kg i.v. 30 min prior to surgery and then repeated q1.5–2h during surgery.

Side Effects of Amoxicillin/Clavulanate in Dogs and Cats

• Most side effects are nausea, diarrhea, and skin irritation.
• Soluble intravenous preparations can cause adverse responses, especially under general anesthesia for surgical prophylaxis.
• Allergic edema, pruritis, hives, and hypotension have occurred.
• The 2nd-generation antibiotic cefuroxime may have fewer side effects.

Contraindications of Amoxicillin/Clavulanate in Dogs and Cats

• The critically ill patients may need i.v. antibiotics due to poor GI absorption.
• Beta-lactam-hypersensitivity.

Some Notes:

• Avoid the concurrent use of amoxicillin with bacteriostatic antibiotics (e.g. tetracycline, erythromycin).
• Do not mix in the same syringe as aminoglycosides.
• Synergism may occur between the beta-lactam and aminoglycoside antimicrobials in vivo.