Amoxicillin & Clavulanic Acid

What are some common indications for amoxicillin and clavulanic acid?

• Hospital-acquired pneumonia

• Pelvic inflammatory disease

• Urinary tract infection

• Bites and clenched fist injuries

• Acute otitis media

• Acute sinusitis

• Acute cholecystitis

• Melioidosis

How would you explain the mechanism of action of amoxicillin and clavulanic acid to a patient?

This medicine contains two ingredients that work together to fight certain bacterial infections. Amoxicillin attacks the bacteria by stopping them from building and maintaining their protective cell walls. Clavulanic acid helps protect amoxicillin from enzymes that some bacteria produce to break the antibiotic down. Together, they allow the antibiotic to work against a wider range of bacteria.

What is the usual dose of amoxicillin and clavulanic acid for adults?

500-875mg amoxicillin every 12 hours for 5-10 days, or longer, depending on the condition.

What is the usual dose of amoxicillin and clavulanic acid for a child?

• 25mg/mL oral liquid: 7.5-15mg/kg amoxicillin (maximum 500mg) every 8 hours

• 80mg/mL oral liquid: 22.5mg/kg amoxicillin (maximum 875mg) every 12 hours

What is the usual age cutoff for amoxicillin and clavulanic acid oral liquid?

• 25mg/mL oral liquid: Children >1 month old

• 80mg/mL oral liquid: Children >2 months old

What are some important side effects associated with amoxicillin and clavulanic acid?

• Rash: Widespread maculopapular rash that occurs >7 days after treatment. It is not necessarily an allergic response, but caution is still required if penicillins are used again in the future.

• Cholestatic hepatitis (rare): Generally reversible and less severe than flucloxacillin hepatitis. May cause jaundice, dark urine, pale stools, fatigue and loss of appetite.

What are some important referral points associated with amoxicillin and clavulanic acid?

• Widespread rash

• Symptoms of anaphylaxis: Difficulty breathing, wheeze, fainting, tachycardia, nausea and vomiting

• Symptoms of cholestatic hepatitis: Jaundice, dark urine, pale stools, fatigue, loss of appetite

What are some important counselling points for amoxicillin and clavulanic acid?

• Take this medication with food to increase absorption

• Take this medication for the full course prescribed by your doctor, even if you start to feel better

What are some important lifestyle points for patients using amoxicillin and clavulanic acid for UTI?

• Aim to drink at least 1.5-2 litres of water per day

• Always wipe from front to back

• Urinate after sexual intercourse

• Wear breathable cotton underwear

• Avoid irritating products such as fragranced soaps, feminine hygiene products, douches and powders

• Use a pH-balanced, fragrance-free soap substitute when washing genitalia

What are some lifestyle points for patients using amoxicillin and clavulanic acid for acute otitis media?

• Vaccinations: Flu, pneumococcal, COVID and others as recommended

• Avoid pacifiers: Associated with AOM, especially in children >6 months

• Breastfeed: Breastfeeding for at least 6 months reduces the incidence of AOM

• Avoid smoke exposure: Avoid second-hand tobacco smoke, fires, etc.