Therapeutic action
Penicillin antibacterial, combined with a beta-lactamase inhibitor. The addition of clavulanic acid to amoxicillin extends its spectrum of activity to cover beta-lactamase producing Gram-positive and Gram-negative organisms, including some Gram-negative anaerobes.
Indications
Erysipelas and cellulitis
Necrotizing infections of the skin and soft tissues (necrotizing fasciitis, gas gangrene, etc.), in combination with clindamycin
Severe postpartum upper genital tract infection, in combination with gentamicin
Forms and strengths, route of administration
Powder for injection, in vials containing 1 g amoxicillin/100 mg clavulanic acid and 1 g amoxicillin/200 mg clavulanic acid, to be dissolved in 20 ml water for injection or 0.9% sodium chloride, for slow IV injection (3 minutes) or IV infusion (30 minutes). DO NOT DILUTE IN GLUCOSE.
Dosage
Doses expressed in amoxicillin:

Erysipelas, cellulitis

Child under 3 months: 30 mg/kg every 12 hours
Child 3 months and over: 20 to 30 mg/kg every 8 hours (max. 3 g daily)
Adult: 1 g every 8 hours

Necrotizing infections

Child under 3 months: 50 mg/kg every 12 hours
Child 3 months and over and < 40 kg: 50 mg/kg every 8 hours (max. 6 g daily) Child 40 kg and over and adult: 2 g every 8 hours Upper genital tract infection Adult: 1 g every 8 hours For administration by IV infusion, dilute each dose of amoxicillin/clavulanic acid in 5 ml/kg of 0.9% sodium chloride in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride in children 20 kg and over and in adults. Duration Erysipelas, cellulitis: 7 to 10 days Necrotizing infections: 14 days Upper genital tract infection: depending on clinical response Change to oral treatment as soon as possible. Contra-indications, adverse effects, precautions Do not administer to penicillin-allergic patients, patients with history of hepatic disorders during a previous treatment with co-amoxiclav, patients with infectious mononucleosis. Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur), patients with hepatic impairment or severe renal impairment (reduce dosage and give every 12 to 24 hours). May cause: diarrhoea; hepatic disorders (avoid treatments longer than 14 days); allergic reactions sometimes severe. Do not combine with methotrexate (increased methotrexate toxicity). Pregnancy: no contra-indication Breast-feeding: no contra-indication Remarks Preferably use 1 g amoxicillin/100 mg clavulanic acid, especially in children. Do not mix with other drugs in the same syringe or infusion bag. Storage Below 25 °C Once reconstituted, the solution must be used immediately; discard any unused open vial.