Clavulanic acid is produced by cultures of streptomyces clavuligerus. Clavulanic acids is not an antibiotic but is an inhibitor of most B-lactamases. it has a betalactam stucture resembling that of the penicillin nucleus.
mechanism of action:
it inhibits the synthesis of bacterial cell wall by binding to one or more of the penicillin binding protein which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall bio-synthesis.
Indication:
- Intra abdominal infections
- Gynecological infection
- Respiratory tract infection,
- Otitis media
- Surgical prophylaxis,
- Dental infection
- Urinary tract infection
Preparation:
It is usually available in the form of tablets, dry syrup and injection such as:
Amoxycillin 500 mg + Clavulanic acid 125 mg tablet
Amoxycilling 200 mg + Clavulanic acid 200 mg vial
Dose:
By mouth: Adult and children over 12 years:250mg tds and doubled in severe infection
Children under 1 years:20mg/ divided doses.
Adverse effect:
GIT: nausea, vomiting, diarrhea,pseudomembranous colitis
Skin: urticaria, angiodema. exfoliative dermatitis, stevens johnsons syndrome
Blood: hemolytic anemia, thrombocytopenia, neutropenia,
Liver: liver dysfuction, elevation in AST, ALT, alkaline phosphates
Miscellaneous: convulsion, vaginal candidiasis, serum sickness, vasculites
Drug interaction
- Probenecid (increases serum Amoxycillin concentration), Allopuriol may incidence of rash
- In patients with renal impairment.
- Epstents-Barr viral infection, acute lymphocytic leukemia, cytomegalovirus infection
Contraindication;
hypersensitivity,, hepatic dysfunction
Note; Regarding the pregnancy safe, it is not know to be harmful and trace amount in milk, safe in usual dose,
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