Augmentin (co-amoxiclav)

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How does it work?

Augmentin injection, tablets, dispersible tablets, suspension and Augmentin-duo suspension all contain the active ingredients amoxicillin and clavulanic acid, which together are known as co-amoxiclav. (NB. Co-amoxiclav is also available without a brand name, ie as the generic medicine.) Amoxicillin is a penicillin-type antibiotic, and clavulanic acid is a medicine that prevents bacteria from inactivating the amoxicillin. Co-amoxiclav is used to treat infections caused by bacteria.

Amoxicillin works by interfering with the ability of bacteria to form cell walls. The cell walls of bacteria are vital for their survival. They keep unwanted substances from entering their cells and stop the contents of their cells from leaking out. Amoxicillin impairs the bonds that hold the bacterial cell wall together. This allows holes to appear in the cell walls and kills the bacteria.

Certain bacteria are resistant to penicillin-type antibiotics, because they have developed the ability to produce defensive chemicals called beta-lactamases. These interfere with the structure of penicillin-type antibiotics and stop them from working.

Clavulanic acid is a type of medicine known as a beta-lactamase inhibitor. It is included in this medicine because it inhibits the action of the beta-lactamases produced by certain bacteria. It prevents these bacteria from inactivating the amoxicillin, and leaves the bacteria susceptible to attack. Clavulanic acid therefore increases the range of bacteria that amoxicillin can kill.

Co-amoxiclav is a broad-spectrum antibiotic that kills a wide variety of bacteria that cause a wide variety of commonly-occuring infections. Co-amoxiclav may be used to treat infections of the upper or lower airways, skin or soft tissue, or ears. It may also be used to treat urine infections, certain sexually-transmitted infections, dental infections, and infections affecting the blood or internal organs.

To make sure the bacteria causing an infection are susceptible to co-amoxiclav, your doctor may take a tissue sample, for example a swab from the throat or skin, or a urine or blood sample.

Co-amoxiclav injection is used to treat more serious infections, or in cases where the medicine can't be taken by mouth. It may also given to prevent infection following surgery, particularly gastrointestinal, pelvic, major head and neck surgery and after limb amputation. The injection is given by injection or infusion (drip) into a vein.

What is it used for?

- Bacterial infections of the upper respiratory tract (nasal passages, sinuses etc) eg sinusitis.
- Bacterial infections of the lower respiratory tract (lungs, airways) eg bronchitis, pneumonia.
- Bacterial infections of the ears, nose or throat, eg otitis media, tonsillitis.
- Bacterial infections of the urinary tract, in particular recurrent cystitis.
- Bacterial infections of the genital organs, including those following childbirth or abortion.
- Bacterial infections inside the abdomen, eg peritonitis.
- Bacterial infections of the skin and soft tissue, eg cellulitis, animal bites.
- Dental abscesses.
- Preventing infections following surgery (by injection).

Warning!

- Augmentin tablets, dispersible tablets and suspensions are absorbed into the bloodstream better if taken at the start of a meal. This may also minimise any side effects on the gut. Dispersible tablets should be stirred into a glass of water before taking. Follow the instructions given by your doctor or pharmacist.
- People receving high doses of this medicine, particularly by injection, should make sure they drink plenty of fluid to reduce the risk of crystals forming in the urine. If in hospital, this fluid may be given via a drip.
- Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this antibiotic medicine, even if you feel better or it seems the infection has cleared up. Stopping the course early increases the chance that the infection will come back and that the bacteria will grow resistant to the antibiotic.
- Broad-spectrum antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea either during or after taking this medicine, particularly if it becomes severe or persistent, or contains blood or mucus, you should consult your doctor immediately.
- Co-amoxiclav can rarely cause cholestatic jaundice either during or following treatment. For this reason, the duration of treatment should not exceed 14 days without review by your doctor. Consult your doctor if you experience any yellowing of the eyes or skin while taking this medicine, or in the few weeks after finishing treatment. This side effect is more common in people above the age of 65 years and in men.
- People with impaired liver function should have their liver function monitored while receiving treatment with this medicine.

Use with caution in

- Decreased kidney function.
- Decreased liver function.
- History of allergies.
- Sodium restriction (injection only).
- Augmentin suspensions and Augmentin Duo suspensions contain aspartame, which is a source of phenylalanine. As a result, these suspensions may not be suitable for people with an inherited disorder of protein metabolism called phenylketonuria.

Not to be used in

- Allergy to penicillin or cephalosporin-type antibiotics.
- History of liver problems or jaundice caused by previous use of this medicine or other penicillin antibiotics.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine is not expected to be harmful when used during pregnancy. However, the manufacturer states that as with all medicines, use should be avoided during pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
- The medicine passes into the breast milk, but at normal doses it is unlikely to harm the baby. Discuss with your doctor.

Label warnings

- Take at regular intervals. Complete the prescribed course unless otherwise directed.

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