Amoxicillin/clavulanic acid

Amoxicillin/clavulanic acid
Amoxicillin/clavulanic acid
Combination of
Amoxicillin Penicillin antibiotic
Clavulanic acid Beta-lactamase inhibitor
Clinical data
Pregnancy cat. B(US)
Legal status POM (UK) -only (US)
Routes oral, iv
CAS number 74469-00-4 N
ATC code J01CR02
PubChem CID 6435923
ChemSpider 4940608 YesY
 N(what is this?)  acid (verify)

Amoxicillin/clavulanic acid (INN) or co-amoxiclav (BAN) is a combination antibiotic consisting of amoxicillin trihydrate, a β-lactam antibiotic, and potassium clavulanate, a β-lactamase inhibitor. This combination results in an antibiotic with an increased spectrum of action and restored efficacy against amoxicillin-resistant bacteria that produce β-lactamase.

Unlike co-trimoxazole, the BAN has not been widely adopted internationally. Trade names include Augmentin (by GlaxoSmithKline),[1]Clavamox (by Pfizer), and CLAMP (by Dr. Reddy's Laboratories).[2]



The combination was invented around 1977/78 by British scientists working at Beecham (now part of GlaxoSmithKline), which filed for US patent protection for the drug combination in 1979. A patent was granted in 1984.[3] Augmentin is the original name used by its inventor.


Many branded products indicate their strengths as the quantity of amoxicillin. Augmentin 250 for example contains 250 mg of amoxicillin and 125 mg of clavulanic acid.[1][4]

An intravenous preparation has been available in the UK since 1985,[5] but there is no parenteral preparation available in the US; the nearest equivalent is ampicillin/sulbactam.

Suspensions of amoxicillin/clavulanic acid are available for use in children. They must be refrigerated to maintain effectiveness.

Side effects

Amongst the possible side-effects of this medication are diarrhea, vomiting, nausea, thrush, and a few other conditions. These do not usually require medical attention. However, if the patient experiences an allergic reaction to the medication, jaundice, fever, or severe diarrhea, it is necessary to contact a doctor immediately. As with all antimicrobial agents, pseudomembranous colitis has been associated with the use of amoxicillin/clavulanic acid. Amoxicillin is known to have caused liver failure in some patients. Amoxicillin is a member of the penicillin family of antibiotics, and therefore should not be taken by patients allergic to penicillin.

Veterinary use

The amoxicillin/clavulanic acid combination is also used in the treatment of, among other infections, periodontitis and kennel cough[6][7] in dogs; urinary tract infections, skin and soft tissue infections in cats; enteritis and navel ill in calves; respiratory tract infections, soft tissue infections, metritis and mastitis in cattle; respiratory tract infections, colibacillosis, mastitis, metritis and agalactia in pigs. In combination with prednisolone it is used for intra-mammary infusion for the treatment of mastitis in lactating cows. Trade names include Clavaseptin, Clavamox and Synulox.

Amoxicillin/clavulanic acid is banned from use in domestic-food animals (cattle, swine, etc.) in both the US and Europe, in the UK synulox can be used in "domestic-food animals" as long as a specified withdrawal period is adhered to.

Bacterial resistance

Bacterial antibiotic resistance is a growing problem in veterinary medicine. Amoxicillin/clavulanic acid is reported to be effective against clinical Klebsiella infections, but is not efficacious against Pseudomonas infections.[8]

Trade names

  • Amoksiklav (Romania, Serbia)
  • AMOX/K CLAV (875mg, Sandoz; US)
  • Amoxicilina-Clavulánico (Spain)
  • Amoxycillin-clavulanate (US)
  • Amoxicillin-clavulanate (rINN)
  • Amoxicilline-clavulanique (France)
  • Amoxiclav (Belgium)
  • Amoxi Clav (Canada)
  • Augmentin (GlaxoSmithKline; originally Beecham, 1981)
  • Augmex (Singapore)
  • Augpen (Zuventus; India)
  • Clamoxyl Duo Oral Suspension (Australia)
  • Co-amoxiclav (UK, KSA, Ireland, South Africa)
  • Moxiclav Duo (Australia)
  • Xcilan (Ovia Pharma Pvt. Ltd.; India)
  • polyclav625 (India)
  • Аугментин (Russia)

  1. ^ a b British National Formulary (54 ed.). September 2007. 
  2. ^ "India Product List". Dr. Reddy's. Retrieved 2011-07-24. 
  3. ^ US 4441609 
  4. ^ "Augmentin -- Prescribing Information" (PDF). GlaxoSmithKline. December 2006. Retrieved 2008-01-28. 
  5. ^ Davies BE, Boon R, Horton R, Reubi FC, Descoeudres CE (1988). "Pharmacokinetics of amoxycillin and clavulanic acid in haemodialysis patients following intravenous administration of Augmentin" (PDF & scanned). Br J Clin Pharmacol 26 (4): 385–90. PMC 1386558. PMID 3190988. 
  6. ^ , 
  7. ^ , 
  8. ^ Federation of Veterinarians in Europe Position Paper: Antibiotic Resistance & Prudent Use of Antibiotics in Veterinary Medicine

External links

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