Amoxiclav: instructions for use
Amoxiclav belongs to antibacterial drugs of a wide spectrum of action. It is active against most bacteria, which are the causative agents of various infectious diseases. The drug is a representative of the pharmacological group of a combination of semisynthetic antibiotics of the penicillin series and protease inhibitors of the bacterial cell.
Form of issue and composition
The drug is available in the form of tablets of 14 pieces per package. The main active ingredients of the drug are amoxicillin (semisynthetic antibiotic of the penicillin group) and clavulanic acid (inhibitor of the enzyme of bacteria that destroys penicillin and its analogues - β-lactamase). These active substances contribute to the activity of the drug against a wider spectrum of bacteria. There are 2 dosages of Amoxiclav tablets:
- Tablets coated with a coating containing 500 mg of amoxicillin and 125 mg of clavulanic acid - 500/125 mg.
- Tablets coated with 875 mg amoxicillin and 125 mg clavulanic acid - 875/125 mg.
The tablets also contain auxiliary substances:
- Silica dioxide colloidal anhydrous.
- Magnesium stearate.
- Sodium croscarmellose.
- Microcrystalline cellulose.
- Ethyl cellulose.
- Titanium dioxide (E171).
The number of tablets in one Amoxiclav package is calculated for the average course of antibiotic therapy. Various dosages allow to regulate the amount of antibiotic intake when it is used.
Amoxicillin is an antibiotic, a semisynthetic derivative of penicillin, its molecule contains a β-lactam ring. It is active against most bacteria, it has bactericidal action (destroys microbial cells) due to a violation of cell wall synthesis. Some species of bacteria produce an enzyme β-lactamase, which destroys the β-lactam ring of the molecule of amoxicillin, which leads to its inactivation. To maintain the antibiotic activity against such bacteria, the second active ingredient in the tablet is clavulanic acid. This compound irreversibly blocks the enzyme β-lactamase, thereby making such bacteria sensitive to amoxicillin. This combination of active substances still has the name - amoxicillin, protected by clavulanic acid. Clavulanic acid does not compete with amoxicillin and also has a slight antibacterial activity. Therefore, Amoxiclav is active against most bacteria:
- Gram-positive aerobes (bacteria that are colored according to Gram in violet color and can develop only in the presence of oxygen) are strains sensitive to penicillin and its analogues, Enterococcus faecium, Corynebacterium spp., Staphylococcus aureus, Listeria spp., Enterococcus faecalis.
- Gram-positive anaerobes (also colored in violet, but their growth and development are possible only in the absence of oxygen) - Clostridium perfringens, Actinomyces israell, Peptococcus spp., Peptostreptococcus spp.
- Gram-negative aerobes (according to the Gram, they are pink and can exist only in the presence of oxygen) - Salmonella spp., Shigella spp., Vibrio cholerae, Helicobacter pylori, Bordetella pertussis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Haemophillus influenzae, Moraxella catarrhalis, Escherichia coli, Klebsiella spp., Proteus mirabilis, Proteus vulgaris.
- Gram-negative anaerobes (can develop only in anoxic conditions and are stained pink) - Fusobacterium spp., Prevotella spp, Bacteroides spp.
The main active ingredients of the drug are absorbed from the intestine. Their level in the blood reaches a therapeutic concentration within half an hour after taking the pill, the maximum concentration is reached after about 1-2 hours. Both components are well distributed in all tissues of the body, with the exception of the brain, spinal cord and cerebrospinal fluid (cerebrospinal fluid), since they do not penetrate the blood-brain barrier (provided that there are no inflammatory processes in the cerebrospinal cords). Also, amoxicillin and clavulanic acid penetrate the placenta into the fetus during pregnancy and enter the breast milk during lactation. These active substances are mainly excreted by the kidneys (90%) practically unchanged. The half-life (the time of elimination of 50% of the substance from the initial concentration in the body) is 60-70 minutes.
Indications for use
Amoxiclav is an antibacterial drug, it is indicated for the treatment of infectious diseases caused by bacteria sensitive to penicillin and its analogues:
- Infectious pathology of the upper respiratory tract - otitis media (inflammation of the middle ear), tonsillitis (inflammation of the tonsils), pharyngitis (inflammation of the pharynx) and laryngitis (inflammation of the larynx).
- Infectious pathology of the lower respiratory tract - bronchitis (inflammation of the bronchi) and pneumonia (pneumonia).
- Infectious diseases of the urinary system - cystitis (inflammation of the bladder), urethritis (inflammation of the urethra), pyelonephritis (a bacterial process in the calyx-pelvis system of the kidneys).
- Infections of the internal genitalia in a woman - a postpartum abscess (the formation of a limited cavity filled with pus) of the uterus or cellulose of the small pelvis.
- Infectious process in the organs and cellulose of the abdominal cavity - intestines, peritoneum, liver and biliary tract.
- Infectious pathology of the skin and subcutaneous tissue - post-burn infection, furuncle (single purulent inflammation of sweat, sebaceous glands and their ducts), carbuncle (multiple purulent process of the same localization).
- Infections caused by infection of the jaw and teeth structures (odontogenic infections).
- Infectious pathology of the structures of the musculoskeletal system - bones ( osteomyelitis ) and joints (purulent arthritis).
- Preventive antibiotic therapy before or after performing any medical manipulation, accompanied by a violation of the integrity of the skin or mucous membranes.
Amoxicillin can also be used for combination therapy with several antibiotics from different therapeutic groups to increase the coverage of their spectrum of action.
Contraindications for use
The spectrum of contraindications to the use of Amoxiclav is not wide, it includes such states:
- Allergy to penicillins and their analogs is an absolute contraindication, in which Amoxiclav is replaced by an antibiotic from another pharmacological group. Amoxicillin can cause a severe allergic reaction, which is manifested by a rash on the skin, itching, hives (rash on the background of a skin edema resembling a nettle burn), Quincke's edema (angioedema, swelling of the skin and subcutaneous tissue), anaphylactic shock (a severe allergic reaction in which a progressive decrease in systemic arterial pressure with the development of multiple organ failure).
- Severe impairment of the functional activity of the liver and kidneys (insufficiency of these organs).
- Some viral diseases are infectious mononucleosis.
- The tumor process in the lymphocytic sprout of the red bone marrow is lymphocytic leukemia.
In the case of any allergic reactions to antibiotics of the penicillin series (including amoxicillin), Amoxiclave is also not used.
Dosing and Administration
Amoxiclav tablets are taken orally, preferably after a meal. Dosage depends on the severity of the infection process and the age of the patient. Recommended dosage for taking tablets:
- Children from 6 to 12 years - ½ tablets with a concentration of active components 500/125 mg 2 times a day. In severe infectious process ½ tablets are taken 3 times a day.
- Children over 12 years and adults - with an average infection, 1 tablet is given 500/125 mg 2 times a day (the frequency of reception can be increased up to 3 times a day). In case of severe bacterial infection, 875/125 mg tablets are taken, the frequency of their administration is 2 times a day.
The course and dosage of Amoxiclav application is established by the attending physician on the basis of many factors - improvement of the condition, severity of the infectious process, its localization. It is also desirable to conduct a laboratory control of the effectiveness of therapy with the help of bacteriological research.
Taking Amoxiclav tablets can lead to a number of side effects:
- Dyspeptic syndrome - decreased appetite, nausea, periodic vomiting, diarrhea.
- Medicinal effects on the digestive system caused by the use of Amoxiclav - darkening of tooth enamel, inflammation of the gastric mucosa ( gastritis ), inflammation of the thin (enteritis) and thick (colitis) of the intestine.
- Damage to hepatocytes (liver cells) with increasing levels of their enzymes (AST, ALT) and bilirubin in the blood, violation of excretion of bile (cholestatic jaundice).
- Allergic reactions that occur for the first time and can be accompanied by violations of varying severity - from rashes on the skin to the development of anaphylactic shock.
- Disturbances in the system of hematopoiesis - a decrease in the level of leukocytes (leukocytopenia), platelets (thrombocytopenia), a decrease in blood clotting, hemolytic anemia, due to the destruction of a large number of erythrocytes.
- Changes in the functional activity of the central nervous system - dizziness, pain in the head, the development of convulsions.
- Inflammation of the interstitial tissue of the kidneys (interstitial nephritis), the appearance of crystals (crystalluria) or blood (hematuria) in the urine.
- Dysbacteriosis - a violation of the normal microflora of mucous membranes, due to the destruction of bacteria that colonize them. Also, against the background of dysbiosis, a side effect may be the development of a fungal infection.
In case of side effects, taking Amoxiclav tablets is stopped.
The use of Amoxiclav tablets should only be performed as directed by the doctor. It is also advisable to read the instructions to the drug. Special instructions regarding the intake of this medication are necessarily taken into account:
- Before you start taking it, you need to make sure that there are no allergic reactions to taking antibiotics of the penicillin group and its analogues in the past. If necessary, it is desirable to conduct a test for the presence of allergies.
- The drug should be used only with the development of a bacterial infection caused by bacteria sensitive to amoxicillin. Amoxiclav is ineffective against viruses. The optimal before the initiation of antibiotic therapy is the carrying out of a bacteriological study with the isolation of the pathogen culture pathological process and the determination of its sensitivity to Amoxiclav.
- In the absence of effect from the beginning of the use of Amoxiclav tablets for 48-72 hours, it is replaced with another antibiotic or the therapeutic tactic is changed.
- Very carefully Amoxiclav is used in patients with concomitant liver or kidney dysfunction, in parallel, their functional activity is monitored.
- During the administration of the drug (especially when the course of treatment is more than 5 days), periodic clinical examination of the blood is necessary to control the number of its constituent elements (red blood cells, leukocytes and platelets).
- There is no information on the damaging effect of Amoxiclav on the developing fetus. However, its use in the first trimester of pregnancy is undesirable. In late pregnancy and breastfeeding the drug is allowed to use, but the reception should be done only under the supervision of the doctor.
- Amoxiclav in tablets for small children is not used, since it contains a high concentration of active substances, calculated for an age of 6 years.
- Combined use with drugs from other health care groups should be very careful. Do not use in parallel drugs that reduce blood clotting, have a toxic effect on the liver or kidneys.
- Amoxiclav tablets do not have a negative effect on the reaction rate of a person and the concentration of his attention.
All these special instructions regarding the use of Amoxiclav are necessarily taken into account by the attending physician before his appointment.
A significant excess of the therapeutic dose when taking Amoxiclav tablets may be accompanied by changes in the functioning of the organs of the gastrointestinal tract (nausea, vomiting, diarrhea, abdominal pain), the nervous system (headache, drowsiness, convulsions ). Sometimes an overdose of this drug can lead to hemolytic anemia, hepatic or renal insufficiency. In case of symptoms of an overdose, it is necessary to immediately stop taking the drug and seek medical help. The drug is dispensed in pharmacies on prescription.
Terms and conditions of storage
Duration of storage of Amoxiclav tablets is 2 years. They must be stored in a dark place inaccessible to children at a temperature of no higher than 25 ° C.
Analogues of Amoxiclav tablets
The drugs, whose main active components are amoxicillin and clavulanic acid, are - Amoxivan, Augmentin, Bactoklave, Medoklav, Panklave, Renklav, Flemoklav.
Price for Amoxiclav
Amoxiclav tablets 250 mg + 125 mg, 15 pcs. - from 210 rubles.
Amoxiclav tablets 500 mg + 125 mg, 15 pcs. - from 335 rubles.
Amoxiclav tablets 875 mg + 125 mg, 14 pcs. - from 424 rubles.