"Amoxiclav" is a combined antibiotic agent. Its spectrum of action is quite wide. Is the antiviral drug "Amoxiclav"? He does not have such an impact, so the answer to the question will be negative. The medicine can be used for diseases of viral etiology only in cases where a secondary infectious disease of bacterial origin has occurred against their background.
Composition and release form
What is the composition of the drug "Amoxiclav" in tablets? This antibiotic is produced in the form of pills, coated with a special shell, containing the main substances. This is amoxicillin at a dosage of 875, 500 or 250 mg and clavulanic acid in a volume of 125 mg. In addition, the Amoxiclav preparation contains some additional components: crospovidone, colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, talc, microcrystalline cellulose. Tabletspackaged in blisters and dark glass bottles.
In addition to tablets, the drug is available as a powder for suspension. The latter is intended for oral administration. In 5 ml of the finished drug, the active ingredients are present in the ratios of 125 mg / 31.25 mg, 250 mg / 62.5 mg, 400 mg / 57 mg. Auxiliary substances in the composition of the drug "Amoxiclav" in the form of a suspension are: citric acid, sodium citrate, MCC and carmellose sodium, xanthan gum, colloidal silicon dioxide, wild cherry flavor, lemon flavor, sodium saccharinate, mannitol. The powder is packaged in dark glass bottles.
Another dosage form of this medication is a powder for making an injection solution containing the main components in the ratios of 1000 mg/200 mg, 500 mg/100 mg.
Pharmacological properties
What is the group of the drug "Amoxiclav"? The antibacterial drug is a semi-synthetic penicillin that affects many gram-positive and gram-negative microorganisms. This medication inhibits the biological synthesis of peptidoglycan, a substance that is present in the structure of the bacterial cell membrane. A decrease in the production of peptidoglycan causes a decrease in the strength of cell walls, which subsequently provokes lysis and destruction of pathogenic microorganisms.
At the same time, amoxicillin is sensitive to the effects of beta-lactamases, which destroy it. As a resultthe spectrum of antibacterial activity of this substance does not include pathogens that synthesize this substance. Clavulanic acid is a substance that suppresses the production of beta-lactamase. Its structure is similar to that of penicillic acid.
This component of the drug "Amoxiclav" has the ability to inactivate numerous beta-lactamases, which are highly resistant to penicillins and cephalosporins. The relative effectiveness of the substance in relation to plasmid beta-lactamases, which in most cases determine the resistance of pathogenic bacteria to antibiotics, has also been proven.
Despite this, the substance is not able to act on chromosomal type I beta-lactamases, which means that they are not neutralized by clavulanic acid. The presence of this substance in the composition of the medical product "Amoxiclav" makes it possible to prevent the destruction of amoxicillin and significantly expand the spectrum of functionality of this antibacterial substance.
What infections does the drug destroy?
In vitro clinical studies have proven high sensitivity to the action of the drug "Amoxiclav" of the following pathogens:
- Gram-negative anaerobic organisms: Bacteroides fragilis, Fusobacterium nucleatum, Prevotella, Porphyromonas, Capnocytophaga, Fusobacterium, Eikenella corrodens.
- Gram-positive anaerobic bacteria: Peptostreptococcus magnus, Peptococcus niger, Peptostreptococcus, Peptostreptococcusmicros, Clostridium.
- Gram-negative aerobic bacteria: Moraxella catarrhalis, Vibrio cholerae, Haemophilus influenza, Pasteurella multocida, Neisseria, Helicobacter pylori.
- Gram-positive aerobic bacteria: coagulase-negative staphylococci (showing sensitivity to methicillin), Streptococcus agalactiae, Bacillus anthracis, Streptococcus pyogenes and other streptococci of the beta-hemolytic category, Listeria monocytogenes, Nocardia, Enterococcus faecalis.
- Other pathogens: Treponema pallidum, Borrelia, Leptospira icterohaemorrhagiae. We will talk about the indications of the drug "Amoxiclav" below.
Which bacteria are resistant to the drug?
The following bacteria are characterized by the acquired resistance to the active substances of the drug "Amoxiclav":
- Gram-positive aerobic: Streptococcus pneumoniae, Streptococcus class Viridans, Enterococcus faecium, pathogens of the genus Corynebacterium.
- Aerobic gram-negative: Proteus mirabilis, Shigella, Klebsiella oxytoca, Klebsiella, Escherichia coli and vulgaris.
Naturally resistant to the combination of clavulanic acid and amoxicillin are: Yersinia enterocolitica, Acinetobacter, Stenotrophomonas m altophilia, Citrobacter freundii, Enterobacter, Pseudomonas, Serratia, Hafnia alvei, Providencia, Legionella pneumophila, Chlamydophila psitophila, pneumoniae, Chlamydophila, Coxiella burnetii.
Pharmacokinetic indicators
In accordance with the instructions for use of the drug"Amoxiclav", the main pharmacokinetic values of the active ingredients of this medical product are largely identical. Both active ingredients show high solubility in aqueous solutions having a physiological pH, and after oral administration of the drug are rapidly absorbed from the cavities of the digestive tract.
The degree of absorption of the combination of active substances is considered to be the most optimal after taking the medicine before meals. After oral administration of Amoxiclav, the availability of active substances in the body reaches 70 percent.
The combination "clavulanic acid + amoxicillin" is characterized by a high level of distribution in various organ systems, tissues and body fluids (including lungs, muscle, bone and adipose tissues, abdominal organs, interstitial, peritoneal, synovial and pleural fluids, sputum, bile, pus, urine and skin). Active components moderately bind to plasma proteins: amoxicillin in the amount of 18% and clavulanic acid in the amount of 25% of the accepted dosage. Distribution level is approximately equal to 0.3-0.4 l/kg (amoxicillin) and 0.2 l/kg (clavulanic acid). These substances are not able to pass the blood-brain barrier, except in this case inflammation of the meninges.
Like many penicillins, amoxicillin passes into breast milk during lactation. It contains trace concentrations of clavulanic acid. The active ingredients of the drug also cross the placenta.
What else do we needreports the instructions for use of the drug "Amoxiclav"? About 10-25% of the initial dose of amoxicillin is excreted in the urine as penicillic acid, which is not pharmacologically active. Clavulanic acid undergoes an intensive metabolic process with the formation of substances excreted through the kidneys, gastrointestinal tract, and also when exhaling air (turns into carbon dioxide).
According to the instructions of the drug "Amoxiclav", amoxicillin is excreted from the body mainly through renal filtration, clavulanic acid - through the kidneys and other mechanisms. After oral administration, approximately 60-75% of amoxicillin and 40-70% of clavulanic acid can be excreted in the urine for six hours unchanged. On average, the half-life of the active elements of the drug is one hour, and the total average clearance is approximately 25 l / h. In patients with renal dysfunction, clearance decreases in proportion to the decrease in renal function.
Indications for prescription
According to the information given in the instructions for use, the drug "Amoxiclav" is prescribed for the treatment of infectious inflammatory pathologies provoked by microorganisms sensitive to it. Medication indicated for use:
- for gynecological infections;
- diseases of ENT organs and respiratory canals: sinusitis (acute, chronic type), pharyngitis, otitis media, tonsillitis, retropharyngeal abscess;
- infections of bone and connective tissue;
- infectious pathologies of the lower respiratory organs, including chronicbronchitis, acute bronchial inflammation with bacterial superinfection, pneumonia;
- urinary tract diseases;
- pathologies of soft tissues and skin, including insect and animal bites; biliary tract infections;
- infectious lesions of the structures of the peritoneum;
- sexually transmitted infections - chancre, gonorrhea.
It is also used to prevent the development of infectious diseases after surgical procedures.
List of contraindications
With the indications for the use of the drug "Amoxiclav" figured out. The pharmacological agent is not prescribed for hepatitis and cholestatic jaundice caused by taking antibiotics from the penicillin class. In addition, this medication is contraindicated:
- if you have sensitivity to clavulanic acid, penicillin preparations, amoxicillin, other substances present in its composition;
- lymphatic leukemia;
- infectious mononucleosis.
Use with care
Let's continue the description. The drug "Amoxiclav" is recommended to be used with caution in such pathological phenomena:
- pseudomembranous colitis history;
- liver failure;
- severe renal dysfunction.
The possibility of prescribing this antibiotic during pregnancy and the lactation process should be decided with the doctor on an individual basis.
Instructions for use
Admission rulesmedication and the duration of therapeutic measures are determined depending on the severity of the existing infectious pathology, the age of the patient, kidney function and body weight. In the form of tablets and suspensions, the drug "Amoxiclav" should be drunk with meals. This can significantly reduce the likelihood of developing negative reactions regarding the digestive system. The average course of therapy is 5-14 days. Longer treatment is possible after a second medical examination. This confirms the instructions for use for the drug "Amoxiclav".
Dosing regimen
At the age of less than 12 years, the drug is prescribed at a dosage of 40 mg / kg per day (the dose should be divided into three doses). The drug in this case is prescribed in the form of a suspension. For children weighing over 40 kg, the dosages used for adult patients are indicated.
The following drug regimens are possible for adult patients with moderate and mild disease:
- 1 tablet (250 + 125 mg) every 8 hours.
- 1 tablet every 12 hours (500 + 125 mg).
In case of a severe degree of the pathological process and in diseases of the respiratory tract, it is necessary to take 1 tablet every 8 hours in doses of 500 + 125 mg or 875 + 125 mg every 12 hours. With odontogenic infections for 5 days, the use of 1 tablet in doses of 250 + 125 mg (interval - 8 hours) or 500 + 125 mg (interval - 12 hours) is indicated. So it says in the instructions for the drug "Amoxiclav".
Children up to 3 months of age, the drug is prescribed in the form of a suspension of 30mg/kg of amoxicillin per day (taken every 12 hours). In order to properly comply with the dosage of the drug prescribed to the child, it is necessary to use a special pipette attached to the package.
Daily dose for children after 3 months:
- for mild to moderate disease - from 20 mg/kg per day;
- Severe disease and treatment of pathologies, lower respiratory tract, sinusitis and otitis media - up to 40 mg/kg per day.
It must be borne in mind that when selecting the dosages of the drug in question for a child, one should rely not on age, but on the severity of the course of the disease and on body weight. Very carefully you need to use the drug "Amoxiclav".
An antibiotic in the form of a solution for injection is administered intravenously. For children after 3 months, the dose is calculated as follows:
- with a body weight of less than 4 kg, the drug is administered at a dose of 30 mg/kg (after 12 hours);
- if the weight is over 4 kg - 30 mg/kg (after 8 hours).
For newborns up to 3 months, the injection solution is administered slowly, for at least 40 minutes. For children whose weight is not more than 40 kg, the dosage is selected based on body weight. For children from 3 months to 12 years of age, the drug should be administered at a dose of 30 mg / kg every 8 hours, and in case of severe infection, every 6 hours. Dose adjustments may be required for pediatric patients with diagnosed renal impairment.
Children over 12 years old (weight - more than 40 kg) and adult patients, the drug "Amoxiclav" in the form of an injection solution is administered in a dose1200 mg every 8 hours or every 6 hours for acute infectious disease.
The drug can also be prescribed for surgical interventions in prophylactic doses (1200 mg under anesthesia in cases where the operation lasts less than 2 hours). For longer interventions, the patient should receive medication at the same dose up to 4 times a day.
Side effects of the drug "Amoxiclav"
The use of a drug in the treatment of infectious pathologies can lead to the development of the following adverse reactions:
- Hematopoietic system: eosinophilia, thrombocytopenia, decreased hemoglobin, leukopenia, agranulocytosis.
- Digestive system: flatulence, diarrhea, gastritis, nausea, dyspeptic disorders, stomatitis, glossitis, enterocolitis, anorexia, vomiting.
- CNS: Anxiety, inappropriate behavior, excessive arousal, seizures, confusion, hyperactivity, insomnia, dizziness, headache.
- Skin: puffiness, urticaria, rash, in rare cases - erythema multiforme, exfoliative dermatitis, epidermal necrolysis of the toxic type.
- Urinary system: hematuria, interstitial nephritis.
In addition to the above side effects, superinfection (including candidiasis) may occur. In most cases, such reactions of the body are transient and mild.
Overdose
Information that the drug"Amoxiclav" provokes life-threatening conditions when taken in high doses, is absent. Most often, this condition is manifested by such pathological symptoms as disturbed electrolyte balance and gastrointestinal dysfunction (diarrhea, vomiting, abdominal pain). Sometimes taking the medication can lead to crystalluria, and subsequently to kidney failure.
Patients with renal dysfunction or high concentrations may develop seizures. In case of an overdose, the patient should be under the supervision of a specialist who, if necessary, will recommend symptomatic treatment.
If the drug was taken no more than 4 hours ago, it is desirable to perform gastric lavages and take intestinal sorbents to reduce its absorption into the blood. The active elements of this drug are well excreted by hemodialysis.
Special Recommendations
Taking the original drug "Amoxiclav" with meals reduces the likelihood of negative effects from the digestive system. During the course of treatment, it is necessary to control the functioning of the liver, kidneys and the hematopoietic system. Against the background of impaired renal function, a correction of the dosing regimen or an extension of the interval between doses of the drug is recommended.
If during therapy a patient is diagnosed with adverse effects from the central nervous system, it is recommended to refrain from driving and performing work that requires a high speed of mental and motor reactions.
Use inperiods of pregnancy and lactation
When conducting experiments on animals, the negative effect of this medication on the embryonic development of the fetus has not been confirmed. Nevertheless, it is known that the prophylactic use of the drug increases the risk of developing necrotizing enterocolitis in the neonatal period. During pregnancy, as well as during lactation, the use of Amoxiclav is allowed only if the benefit / risk ratio is assessed by specialists.
The main elements of the drug in small doses are found in breast milk. In infants, this may cause sensitization, diarrhea, candidiasis of the mucous membranes of the oral cavity, so if you need to take the drug, it is advisable to stop breastfeeding.
Compatibility with other drugs
As indicated by the instructions for use for the drug "Amoxiclav", the combined use of the drug with ascorbic acid enhances the absorption of its active ingredients. Simultaneous use with aminoglycosides, antacids, laxatives, glucosamine reduces the level of their absorption.
The use of NSAIDs, phenylbutazone, diuretics, allopurinol and other tubular secretion blockers increases the concentration of amoxicillin in the blood.
Interaction of "Amoxiclav" with other drugs, such as "Probenecid", can contribute to the increase and persistence of the concentrations of active substances, so the one-time use of these funds is prohibited. Combinationclavulanic acid, amoxicillin and methotrexate increases the toxic effects of methotrexate.
The use of the drug "Amoxiclav" with "Allopurinol" can cause the development of allergic reactions on the skin. It is not recommended to use the medication in conjunction with "Disulfiram". The combination of the main substances of the drug reduces the effectiveness of drugs whose metabolism contributes to the formation of para-aminobenzoic acid. Co-administration with ethinylestradiol increases the risk of breakthrough bleeding.
What else can be said about the compatibility of "Amoxiclav" with other drugs? If necessary, combined administration with anticoagulants requires systematic monitoring of prothrombin time or INR. In this case, it may be necessary to adjust the dose of anticoagulants. Joint reception with "Rifampicin" can lead to mutual weakening of the antibacterial effect. It is not recommended to use the drug in combination with tetracyclines, macrolides and sulfonamides due to the likely decrease in its effectiveness. How Amoxiclav interacts with other drugs, you can check with your doctor.
Acceptance of the drug leads to a decrease in the effect of taking oral contraceptives.
Medicine price
The cost of the drug "Amoxiclav" in tablet form (875 mg / 125 mg) is approximately 400-440 rubles. Tablets with a dosage of substances 500 mg / 125 mg cost 330-400 rubles, at a dose of 250 mg / 125 mg - 160-240 rubles. Powder for the manufacture of a suspension (dose - 400 mg / 57 mg) is sold at a price of 160-270 rubles, a dose of 250 mg / 62,5 mg - 210-300 rubles, dose 125 mg / 31, 25 mg - 100-120 rubles. Powder for the manufacture of an injection solution at a dosage of 1000 mg / 200 mg costs about 670-860 rubles, 500 mg / 100 mg - 460-490 rubles.
Analogues for the main substance
Analogues of the drug "Amoxiclav" are:
- "Bactoclav";
- Klamosar;
- "Panklav";
- Arlette;
- "Medoclav";
- Augmentin;
- "Liklav";
- Rapiclav;
- Ecoclave;
- Fibell;
- Amoxivan;
- Amovicomb.
The above analogues have absolutely identical composition and characteristics, therefore they can be used for the same diseases as the remedy we describe.
One of the most popular analogues is "Augmentin". It is an antibiotic with a wide spectrum of action, it also contains amoxicillin and clavulanic acid. It inhibits a large number of gram-positive and gram-negative microorganisms and has a bactericidal effect. Clavulanic acid, which is present in the composition of the tablets, protects amoxicillin from the destructive destruction of beta-lactamase produced by microorganisms, thereby contributing to the expansion of the antibacterial properties of the drug.
It is thanks to this component that "Augmentin" can have a detrimental effect on bacteria that are highly resistant to the penicillin group of drugs and cephalosporins. Dosages should only be determined by the attending physician, especially when it comes to young children.
Minimumthe course of antibiotic therapy with this drug is five days. Therapy should not be continued for more than two weeks without a review of the clinical situation. In order for absorption to be optimal and to reduce the likelihood of side effects from the digestive tract, Augmentin is recommended to be taken at the beginning of a meal.
Analogues by action
Analogues of this medication according to the mechanism of therapeutic action are the following drugs:
- "Libakcil" is an antibiotic, which includes a combination of polysynthetic aminopenicillin - ampicillin and a substance that inhibits beta-lactamase - sulbactam. The bactericidal effect of the main element is due to binding to bacterial transpeptidases involved in the synthesis of glycopeptides, the structural components of pathogen cell walls. Ampicillin destroys beta-lactamases - enzymes produced by microorganisms, which significantly limits the spectrum of action of this substance. Sulbactam from the composition of the drug is a derivative of the core of penicillin. It does not have clinically significant activity, but inhibits beta-lactamase, so its presence in the composition of the drug significantly increases its effectiveness.
- "Timentin" - another analogue of the drug "Amoxiclav". This is a combination drug based on carboxypenicillin - sodium ticarcillin and potassium clavulanate with a wide spectrum of activity for the empirical parenteral treatment of a number of infectious diseases. It can be used in the treatment of sepsis, septicemia, bacteremia, intra-abdominal infections, including peritonitis, postoperativeinfections, gynecological pathologies, including endometritis, infectious diseases of bones and joints, respiratory tract, kidneys, etc.
- Santaz is an antibiotic based on piperacillin and tazobactam. Piperacillin is a semi-synthetic broad-spectrum bactericidal substance that is active against a variety of pathogens of infectious diseases. Piperacillin inhibits the synthesis of cell membranes of the walls of the pathogen. Tazobactam is a derivative of triazolmethylpenicillanic acid of the sulfonic series, a powerful inhibitor of beta-lactamase, provoking resistance to cephalosporins and penicillins. The presence of tazobactam in the composition of this drug enhances the antimicrobial efficacy and expands the range of action of piperacillin due to the inclusion of bacteria that form beta-lactamase.
Reviews about the drug "Amoxiclav"
In most cases, patients and doctors leave positive feedback about this drug. Doctors note that this medication is quite effective in the treatment of pathologies of the respiratory, urinary, reproductive systems, skin infections, etc. According to doctors, Amoxiclav is a modern and high-quality antibiotic that can be prescribed for almost any infection.
Patients who took this remedy characterize it as an inexpensive, affordable drug, very effective. It can be used not only for adult patients, but also for children, and from a very early age.
SomeNegative reviews about the drug are due to side effects from taking it. Among them, the imbalance of the intestinal microflora was most often noted, which led to unpleasant symptoms in the form of nausea, heartburn, and increased gas formation. Some small number of patients experienced short-term nausea. Violations of the functionality of the nervous system are not described in the reviews, so we can conclude that they appear extremely rarely. As a rule, adverse reactions were mild and did not require discontinuation of the drug.
Children tolerate the medicine "Amoxiclav" well, which is also confirmed by the mass of positive reviews. It is often prescribed by pediatricians even for severe infectious diseases in babies.
