Among the antimicrobial agents in the drug Amoxiclav 625, the reviews of patients and specialists are most indicative. The medicine is considered the most massive antibiotic and therefore has earned widespread recognition. Due to the wide spectrum of action, the safety of use in children and lactating women, Amoxicillin Clavulanate almost completely covers the field of empirical treatment of ambulatory respiratory and genitourinary infections.
Features of release and analogues
The drug Amoxiclav 625 is produced by the Slovenian company Lek and is positioned as a medicine whose active ingredient is aminopenicillin amoxicillin and clavulanic acid. The first plays the role of an antibiotic, and the acid protects against bacterial beta-lactamases. As part of the drug "Amoxiclav 625 mg" tablets contain 500 mg of antibiotic, 125 mg of clavulanate and excipients.
The drug with the active substance amoxicillin is available under many names. The most protected analogues are the following protected aminopenicillins: Amoklav, Augmentin, Flemoklav, Amklav, Farmentin, Amoksikar Plus, Augmenta, Medoklav. There are also unprotected penicillins, which are class analogues of Amoxiclav: Amoxicillin, Amoxicar, Amosin, Hikontsil and others. Their effectiveness is considered approximately the same.
Relevance of the drug
About the drug "Amoxiclav 625" reviews of experts are very unequivocal. This is a quality drug, one of the few oral antimicrobial drugs that have few side effects. For this reason, it is used in all cases in which amoxicillin was appropriate. Moreover, Amoxiclav is a representative of combined preparations. It is protected by clavulanic acid from penicillinase, an enzyme that destroys the antibacterial lactam ring. Thanks to the protection, Amoxiclav has become more active in relation to microbial cells.
Indications
The instruction attached to the Amoxiclav 625 preparation contains indications of infectious diseases in the treatment of which the antibiotic is allowed to be used. These are often developing respiratory, intestinal, and genitourinary infections of mild or moderate severity. In mild forms, monotherapy with the drug is appropriate, while moderate and severe should be treated in a hospital with a combination of antibiotics. In general, the instructions describe the indications for the use of the drug "Amoxiclav 625 mg" as follows:
- infections of the upper organs of the respiratory system (chronic and acute forms of tonsillitis, pharyngitis, sinusitis, otitis media);
- infectious diseases of the lower respiratory tract (acute and chronic forms of bronchitis, pneumonia);
- genitourinary bacterial diseases (pyelonephritis, urethritis, cystitis, salpingoophoritis, pelvioperitonitis, endometritis, gonorrhea and chancroid);
- chronic osteomyelitis;
- skin infections, infected animal bites, seeded with wound bacteria;
- periodontitis.
For the patient, the main source of information about Amoxiclav is the instructions for use. 625 mg of the drug, prescribed three times for an adult, can effectively treat diseases of the respiratory system caused mainly by gram-positive flora. Moreover, with acute respiratory infections, the duration of treatment is usually 5-7 days.
Contraindications
The safety of the drug and the record low toxicity of the penicillin class does not exclude the presence of contraindications.
They have a little medicine. They are associated either with the presence of a concomitant disease, with an allergic reaction, or with the physiological state of the body. Contraindications are as follows:
- the presence of indications of the occurrence of cholestatic jaundice, an increase in the activity of aminotransferases or the development of hepatitis caused by the earlier use of Amoxiclav, its analogues or representatives of the penicillin group;
- liver failure, lymphocytic leukemia, mononucleosis due to the aggravation of the number and severity of side effects;
- allergic sensitization to the drug or its components;
- indications of the appearance of allergic reactions of an immediate type when taking other beta-lactam antimicrobial agents;
- relative temporary contraindications: pregnancy in the 3rd trimester, lactation.
Allergy Risk
If in the patient’s history there is an indication of a local type allergy, then Amoxiclav is not prescribed. If anaphylaxis or Quincke's edema develops in response to taking other beta-lactam antimicrobials, then Amoxicillin Clavulanate should also not be taken. Then the representative of a number of macrolides with a mild course or fluoroquinolone is the drug of choice.
Dosage regimens
The amount of Amoxiclav 625 mg, which is required for treatment, depends on the age and weight of the patient. For respiratory diseases, it is rational to prescribe up to 2 grams for adults and 1.3 grams for adolescents. At the same time, Amoxiclav in a dose of 625 mg is only a teenage and adult drug. For children under 12 years of age, there are drugs with lower doses.
The standard dosage for a person weighing more than 40 kg and over 12 years of age is 625 mg twice a day. Adults over the age of 18 are prescribed 625 mg three times a day. This is enough to treat moderate and lungs, that is, outpatient infections of the skin, respiratory system, and genitourinary system. In severe infections, 1000 mg (875 mg of amoxicillin and 125 clavulanate) are prescribed twice a day. Three times the use of 1000 mg.
Side effect
Despite the sufficient breadth of the therapeutic effect, there are a number of side effects. They are associated with local dysfunctions of the intestines and stomach, and also due to intoxication of the body by the decay products of bacterial cells, since the antibiotic acts bactericidal.
The most common (1-10%) are cases of nausea, vomiting or diarrhea that occurred after the use of an antimicrobial agent. Moreover, they appear after 2-4 days of admission. Significantly increases the likelihood of dyspepsia, an existing violation in the functioning of the intestine and some concomitant diseases: pancreatitis with excretory insufficiency, enteritis, the condition after resection of the stomach or intestines, chronic colitis.
The group of infrequent complications (0.001-0.0001%) includes hepatic impairment: increased activity of aminotransferases and markers of hepatocyte cytolysis, cholestasis and jaundice, leukopenia. In this case, the frequency of Quincke's edema, anaphylaxis and urticaria remains unspecified. The reason for this is a gradual increase in the number of allergic reactions due to early sensitization of children.
Later, this will necessarily lead to a decrease in the therapeutic importance of Amoxiclav. Instructions for use 625 milligram tablets not yet prohibit the use of nursing mothers. However, this could happen soon. Then you will need to look for a new drug from the group of aminopenicillins with similar effectiveness. It is logical that the new chemical substance has already been synthesized and is undergoing testing, however, its introduction is not yet economically viable, because Amoxiclav meets the requirements of clinicians.
Pregnancy and lactation
According to the FDA, Amoxiclav has no teratogenic effect. This conclusion was made after conducting animal studies, because all the analogues of this medicine belong to the FDA category B (USA). However, due to rational fears of exacerbating toxicosis, Amoxiclav 625 is almost not prescribed during pregnancy in the first trimester. In the II and III trimesters, his admission is allowed.
Aminopenicillins in trace amounts penetrate into breast milk, with which they pass into the gastrointestinal tract of the newborn. However, he does not cause important disorders in his body, which is why Amoxiclav 625 can not be canceled during lactation. The only exceptions are cases of a child’s allergic reactions or candidal lesions of the mucous membranes or gastrointestinal tract that occur with the use of Amoxicillin. Then it is necessary either to cancel the mother's intake of the antimicrobial agent, or, for candidiasis of the mucous membranes, to refuse breast-feeding.
Drug safety profile
Amoxiclav 625 tablets have a fairly wide range of therapeutic effects, which avoids poisoning. It also has no central effects, which can be taken by patients driving vehicles or other moving mechanisms. It does not lead to impaired memory, consciousness, attention or thinking.
However, there is a drug overdose syndrome. Such cases are extremely rare and occur in cases of unreasonable single intake of 5 or more grams of the drug. Symptoms are the following symptoms: dyspeptic disorders associated with heaviness in the abdomen, bloating, diarrhea, nausea, and sometimes vomiting.
There are cases of crystalluria associated with the administration of amoxicillin, sometimes leading to the development of renal failure. However, this phenomenon may occur when taking the drug in a therapeutic dosage. The treatment is nephroprotection and dialysis, which eliminates amoxicillin and clavulanic acid from the blood.
Precautionary measures
For patients with lymphocytic leukemia or infectious mononucleosis , Amoxiclav 625, analogues and its generics are not indicated due to the high likelihood of developing a measles-like rash. And due to the decrease in the effectiveness of oral contraceptives during Amoxicillin therapy, it is necessary to supplement the protection against unwanted pregnancy with barrier methods (condom).
With the development of diarrhea during the use of Amoxiclav, antibiotic withdrawal and treatment of colitis (hemorrhagic or pseudomembranous) are required. In this situation, the use of Loperamide is unacceptable. Also, the long-term use of Amoxiclav promotes the development of many colonies of microorganisms that are immune to antimicrobial agents. They can cause complications of the current disease.
Known drug interactions
The uricosostatic drug Allopurinol, when taken together with Amoxiclav, increases the risk of skin rashes. The use of the uricosuric agent Probenecid, Oxyphenbutazone, Phenylbutazone, Sulfinpyrazone or acetylsalicylic acid reduces the release of aminopenicillin (but not clavulanic acid), which slightly increases the concentration of the antibiotic in the blood serum and prolongs its effects.
The combination of the drug Amoxiclav 625 mg with bacteriostatic antimicrobial agents is irrational due to the mutual suppression of their effectiveness. Other preparations containing amoxicillin should also not be combined with bacteriostats: chloramphenicol, macrolides, tetracyclines and sulfonamides. Combination with bactericidal antibiotics leads to a mutual increase in antimicrobial activity.
To use "Amoksiklav" during therapy with oral contraceptives is irrational due to the risk of increasing prothrombin time and the development of thrombosis. In this case, the effectiveness of the contraceptive is significantly reduced. Other broad-spectrum antibiotics also mediate the effect of reducing the effectiveness of oral contraceptives.
The use of Amoxiclav for the treatment of opportunistic infections caused by methotrexate therapy significantly increases the toxicity of the latter. This increases the likelihood of thrombocytopenia, leukopenia, skin ulcers, gastrointestinal ulcers and erosion. Then it is recommended to abandon aminopenicillins and apply macrolides, continuing further treatment with methotrexate.
Like any broad-spectrum antibiotic, Amoxiclav increases the effectiveness of indirect anticoagulants. Therapy with “Warfarin” due to the inhibition of the activity of bacteria synthesizing vitamin K by antimicrobial agents leads to a decrease in the prothrombin index and an increase in INR. The result is a high risk of bleeding.
Aspects of Combined Antimicrobial Therapy
The drug "Amoxiclav 625", analogues and its generics have the property of increasing the likelihood of developing diarrhea, if used with other antimicrobials. Any classes of antibiotics together with amoxicillin are much more likely to cause diarrhea, which cannot be treated with drugs that inhibit peristalsis. Such a drug is Loperamide and its analogues, which are contraindicated in infectious diarrhea. Moreover, diarrhea caused by the use of Amoxiclav should be treated with antibiotics.