Augmentin 228.5 instructions for use. Augmentin in the form of a suspension: instructions for use for children. Description of the dosage form

Augmentin: instructions for use and reviews

Latin name: Augmentin

ATX Code: J01CR02

Active substance: amoxicillin + clavulanic acid (Amoxicillin + Clavulanic acid)

Producer: GlaxoSmithKline public company (GlaxoSmithKline PLC) (UK)

Description and photo update: 19.08.2019

Augmentin is a broad-spectrum antibiotic that affects both gram-negative and gram-positive bacteria.

Release form and composition

The antibiotic is produced in the following forms:

film-coated tablets: oval-shaped, white or almost white, on a break - from white-yellowish to almost white [250 mg (250 + 125) each: with an indented inscription on one side of the AUGMENTIN tablet (in blisters of 10 pcs., in a cardboard pack 2 blisters); 500 mg each (500 + 125): with an embossed inscription "AC" and a risk on one side (in blisters of 7 or 10 pcs., in a cardboard bundle 2 blisters); 875 mg each (875 + 125): with the letters "A" and "C" on both sides of the tablet and the risk of breakage on one side (in blisters of 7 pcs., in a carton pack of 2 blisters)];
powder for suspension for oral administration: white or almost white, with a characteristic odor; when diluted, a suspension is obtained (white or almost white), in which a precipitate forms at rest (in glass bottles, 1 bottle with a measuring cap in a cardboard box);
powder for solution for intravenous administration: from white to almost white (10 vials in a carton pack).

As active substances in Augmentin, a combination of clavulanic acid (in the form of potassium salt) and amoxicillin (in the form of sodium salt) is used.

1 tablet contains:

active substances: clavulanic acid - 125 mg, amoxicillin (in the form of trihydrate) - 250, 500 or 875 mg;
excipients: sodium carboxymethyl starch, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose.

The composition of the film shell of the tablets includes: hypromellose, hypromellose (5cP), macrogol 6000, macrogol 4000, dimethicone, titanium dioxide.

5 ml of the prepared oral suspension contains:

active substances [ratio of amoxicillin (as trihydrate) to clavulanic acid (as potassium salt)]: 125 mg/31.25 mg, 200 mg/28.5 mg, 400 mg/57 mg;
excipients: hypromellose, xanthan gum, succinic acid, aspartame, colloidal silicon dioxide, flavors (orange 1, orange 2, raspberry, "Light molasses"), silicon dioxide.

1 vial (1200 mg) of intravenous solution contains active substances:

amoxicillin (in the form of sodium salt) - 1000 mg;
clavulanic acid (in the form of potassium salt) - 200 mg.

Pharmacological properties

Augmentin is characterized by antibacterial and bactericidal action and belongs to penicillins from the group of β-lactams.

Pharmacodynamics

Amoxicillin is a semi-synthetic broad-spectrum antibiotic that is active against many gram-negative and gram-positive microorganisms. However, amoxicillin is susceptible to degradation by β-lactamases, so its spectrum of activity does not extend to bacteria that produce this enzyme.

Clavulanic acid has a structure related to penicillins and is a β-lactamase inhibitor, which explains its ability to inactivate a wide range of β-lactamases that are present in microorganisms that demonstrate resistance to cephalosporins and penicillins. This active component effectively acts on plasmid β-lactamases, which most often provide bacterial resistance, and is ineffective against type 1 chromosomal β-lactamases that are not inhibited by clavulanic acid.

The inclusion of clavulanic acid in Augmentin helps protect amoxicillin from degradation by enzymes - β-lactamases, which ensures the expansion of the antibacterial spectrum of this substance.

In vitro, the following microorganisms are sensitive to the combination of amoxicillin with clavulanic acid:

gram-negative aerobes: Vibrio cholerae, Bordetella pertussis, Pasteurella multocida, Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, Helicobacter pylori;
gram-positive aerobes: coagulase-negative staphylococci (methicillin-sensitive strains), Staphylococcus saprophyticus (methicillin-sensitive), Staphylococcus aureus (methicillin-sensitive), Bacillus anthracis, Streptococcus agalactiae, Streptococcus spp. (other β-hemolytic streptococci), Streptococcus pyogenes, Enterococcus faecalis, Nocardia asteroides, Listeria monocytogenes;
gram-negative anaerobes: Prevotella spp., Bacteroides fragilis, Bacteroides spp., Porphyromonas spp., Fusobacterium spp., Fusobacterium nucleatum, Eikenella corrodens, Capnocytophaga spp.;
gram-positive anaerobes: Peptostreptococcus spp., Peptostreptococcus magnus, Peptostreptococcus micros, Peptostreptococcus niger, Clostridium spp.;
others: Treponema pallidum, Leptospira icterohaemorrhagiae, Borrelia burgdorferi.

The following microorganisms are characterized by acquired resistance to the combination of amoxicillin with clavulanic acid:

gram-positive aerobes: streptococci of the Viridans group, Corynebacterium spp., Streptococcus pneumoniae (strains of this type of bacteria do not produce β-lactamase, and the therapeutic efficacy of the drug was confirmed by the results of clinical studies), Enterococcus faecium;
gram-negative aerobes: Shigella spp., Escherichia coli, Salmonella spp., Klebsiella spp., Klebsiella pneumoniae, Klebsiella oxytoca, Proteus spp., Proteus vulgaris, Proteus mirabilis.

The following bacteria have natural resistance to the drug, which includes amoxicillin and clavulanic acid:

gram-negative aerobes: Yersinia enterocolitica, Acinetobacter spp., Stenotrophomonas maltophilia, Citrobacter freundii, Serratia spp., Enterobacter spp., Pseudomonas spp., Hafnia alvei, Providencia spp., Morganella morganii, Legionella pneumophila;
others: Coxiella burnetii, Chlamydia psittaci, Chlamydia pneumoniae, Chlamydia spp., Mycoplasma spp.

The sensitivity of the pathogen to amoxicillin monotherapy suggests a similar sensitivity to the combination of amoxicillin with clavulanic acid.

Pharmacokinetics

Clavulanic acid and amoxicillin are rapidly and almost 100% absorbed from the gastrointestinal tract (GIT) when taken orally. The absorption of the active components of Augmentin is considered optimal when the drug enters the body at the beginning of a meal.

The oral suspension has been studied in clinical trials in healthy volunteers aged 2 to 12 years. They took Augmentin at a dosage of 125 mg / 31.25 mg 5 ml on an empty stomach in 3 doses, and the daily dose of amoxicillin and clavulanic acid was 40 and 10 mg / kg, respectively. As a result of the experiment, the following values of pharmacokinetic parameters were obtained:

clavulanic acid: maximum concentration 2.7 ± 1.6 mg / ml, time to reach maximum plasma levels 1.6 hours (variation range 1–2 hours), AUC 5.5 ± 3.1 mg h / ml, elimination half-life 0.94±0.05 hours;
amoxicillin: maximum concentration 7.3±1.7 mg/ml, time to reach maximum plasma levels 2.1 hours (variation range 1.2–3 hours), AUC 18.6±2.6 mg×h/ml , half-life 1.0±0.33 hours.

Comparative studies were also conducted on the pharmacokinetics of Augmentin when taken in the form of film-coated tablets (on an empty stomach). The results of determining the pharmacokinetic parameters depending on the intake of Augmentin, clavulanic acid and amoxicillin at various doses were as follows:

one tablet of Augmentin with a dosage of 250 mg / 125 mg: for amoxicillin - the maximum concentration is 3.7 mg / l; time to reach maximum plasma concentration 1.1 hours; AUC (area under the concentration-time curve) 10.9 mg h / ml; elimination half-life (T 1/2) 1 hour. For clavulanic acid, the maximum concentration is 2.2 mg/l; the time to reach the maximum concentration in the blood plasma - 1.2 hours; AUC 6.2 mg h/mL; T 1/2 - 1.2 hours;
two tablets of Augmentin with a dosage of 250 mg / 125 mg: for amoxicillin - the maximum concentration is 5.8 mg / l; the time to reach the maximum concentration in the blood plasma is 1.5 hours; AUC 20.9 mg h/mL; T 1/2 - 1.3 hours. For clavulanic acid, the maximum concentration is 4.1 mg/l; time to reach maximum plasma concentration 1.3 hours; AUC 11.8 mg h/mL; T 1/2 - 1 hour;
one tablet of Augmentin with a dosage of 500 mg / 125 mg: for amoxicillin - the maximum concentration is 6.5 mg / l; the time to reach the maximum concentration in the blood plasma is 1.5 hours; AUC 23.2 mg h/mL; T 1/2 - 1.3 hours. For clavulanic acid, the maximum concentration is 2.8 mg/l; time to reach maximum plasma concentration 1.3 hours; AUC 7.3 mg h/mL; T 1/2 - 0.8 hours;
amoxicillin alone at a dose of 500 mg: maximum concentration 6.5 mg/l; time to reach maximum plasma concentration 1.3 hours; AUC 19.5 mg h / ml; T 1/2 - 1.1 hours;
clavulanic acid alone at a dose of 125 mg: maximum concentration 3.4 mg/l; time to reach maximum plasma concentration 0.9 hours; AUC 7.8 mg h/mL; T 1/2 - 0.7 hours.

The pharmacokinetics of the drug was also studied with intravenous bolus administration of Augmentin to healthy volunteers. As a result, the following values of pharmacokinetic parameters depending on the dose were obtained:

dosage 1000 mg / 200 mg: for amoxicillin - the maximum concentration is 105.4 μg / ml; T 1/2 - 0.9 hours; AUC 76.3 mg h / ml, excreted in the urine during the first 6 hours after administration of 77.4% of the active substance. For clavulanic acid - the maximum concentration is 28.5 μg / ml; T 1/2 - 0.9 hours; AUC 27.9 mg h / ml, excreted in the urine during the first 6 hours after administration of 63.8% of the active substance;
dosage 500 mg / 100 mg: for amoxicillin - the maximum concentration is 32.2 μg / ml; T 1/2 - 1.07 hours; AUC 25.5 mg h / ml, excreted in the urine during the first 6 hours after administration of 66.5% of the active substance. For clavulanic acid - the maximum concentration is 10.5 μg / ml; T 1/2 - 1.12 hours; AUC 9.2 mg h / ml, excreted in the urine during the first 6 hours after administration of 46% of the active substance.

Both with oral administration and with intravenous administration of the drug, clavulanic acid and amoxicillin in therapeutic concentrations are determined in the interstitial fluid and various tissues (in the tissues of the abdominal cavity, adipose and muscle tissues, skin, gallbladder, purulent discharge, bile, peritoneal and synovial liquids).

Both active components of Augmentin bind weakly to plasma proteins. The results of studies indicate that the degree of binding of amoxicillin to blood plasma proteins is approximately 18%, and clavulanic acid - 25%. Animal experiments do not confirm the accumulation of active substances in any organs.

Amoxicillin penetrates into breast milk, in which clavulanic acid is also determined in trace concentrations. Negative effects of these substances on the health of breastfed children, in addition to the development of candidiasis of the mucous membranes of the oral cavity, diarrhea and the risk of sensitization, have not been identified.

The study of reproductive function in animals when using amoxicillin in combination with clavulanic acid showed that the active components of Augmentin penetrate the placental barrier, but do not have a negative effect on the fetus.

From 10 to 25% of the accepted dose of amoxicillin is excreted in the urine in the form of penicillic acid, a metabolite that does not show pharmacological activity. Clavulanic acid is extensively metabolized to form 1-amino-4-hydroxy-butan-2-one and 2,5-dihydro-4-(2-hydroxyethyl)-5-oxo-1H-pyrrole-3-carboxylic acid, and is excreted through the gastrointestinal tract. , with urine, as well as with exhaled air in the form of carbon dioxide.

Amoxicillin is excreted mainly through the kidneys, while clavulanic acid is characterized by both renal and extrarenal mechanism. Approximately 45-65% of clavulanic acid and about 60-70% of amoxicillin are excreted unchanged in the urine during the first 6 hours after taking 1 tablet of 500mg / 125 mg or 250 mg / 125 mg or after a single bolus injection of Augmentin at a dosage of 500 mg / 100 mg or 1000 mg/200 mg. The simultaneous administration of probenecid inhibits the excretion of amoxicillin, but does not affect the excretion of clavulanic acid.

Indications for use

According to the instructions, Augmentin is prescribed for bacterial infections caused by microorganisms that are sensitive to the antibiotic:

infections of the skin, soft tissues;
respiratory tract infections: bronchitis, lobar bronchopneumonia, empyema, lung abscess;
infections of the genitourinary system: cystitis, urethritis, pyelonephritis, abortion sepsis, syphilis, gonorrhea, infections of the organs in the pelvic area;
bone and joint infections: osteomyelitis;
odontogenic infections: periodontitis, odontogenic maxillary sinusitis, severe dental abscesses;
infections that arose as a complication after surgery: peritonitis.

Contraindications

hypersensitivity to clavulanic acid, amoxicillin, other components of the drug and beta-lactam antibiotics (cephalosporins, penicillins) in history;
previous cases of jaundice or abnormal liver function when using a combination of clavulanic acid with amoxicillin in history;
impaired renal function (powder for suspension for oral administration 200 mg / 28.5 mg and 400 mg / 57 mg; tablets 875 mg / 125 mg);
phenylketonuria (powder for oral suspension).

Contraindications to Augmentin for children: tablets - age up to 12 years and body weight less than 40 kg; powder for suspension for oral administration 400 mg / 57 mg and 200 mg / 28.5 mg - age up to 3 months.

In case of impaired liver function, Augmentin should be taken with caution.

During pregnancy and breastfeeding, the decision on the need to use the drug is made by the attending physician.

Instructions for use Augmentin: method and dosage

Before prescribing Augmentin, it is recommended to undergo an examination to identify the sensitivity of the microflora that caused the disease to this antibiotic. Next, the doctor sets the dosage regimen, taking into account the patient's age, weight, kidney function, and the severity of the disease.

The minimum effective course of treatment is 5 days, the maximum duration of therapy without adjusting the clinical situation is 2 weeks. The drug should be taken at the beginning of a meal.

If necessary, the first time the drug is administered parenterally, then oral administration can be prescribed.

in case of infections of mild and moderate severity: 1 tablet (250 mg + 125 mg) 3 times a day;
in severe or chronic infections: 1 tablet (500 mg + 125 mg) 3 times a day or 1 tablet (875 mg + 125 mg) 2 times a day.

Important: 2 tablets 250 mg/125 mg are not equivalent to 1 tablet 500 mg/125 mg.

children over 12 years old and adults: 11 ml suspension 400 mg / 57 mg / 5 ml 2 times a day (corresponding to 1 tablet 875 mg + 125 mg);
children from 3 months to 12 years (weighing up to 40 kg): the daily dose is determined based on body weight and age (in ml - for suspension, or mg / kg / day). The calculated value should be divided into 3 doses with an 8-hour interval (for a suspension of 125 mg / 31.25 mg / 5 ml), or into 2 doses (for a suspension of 400 mg / 57 mg / 5 ml or 200 mg / 28.5 mg /5 ml) at 12-hour intervals. For 125 mg/31.25 mg/5 ml suspension, low* doses are 20 mg/kg/day, high** doses are 40 mg/kg/day. For suspension 400 mg / 57 mg / 5 ml and 200 mg / 28.5 mg / 5 ml low doses - 25 mg / kg / day, high doses - 45 mg / kg / day.

*Low doses are used in the treatment of recurrent tonsillitis and soft tissue and skin infections.

** High doses are required for the treatment of sinusitis, otitis media, joint and bone infections, urinary and respiratory tract infections.

children over 12 years of age and adults: 1000 mg / 200 mg 3 times a day (every 8 hours), in severe infections, the interval between injections can be reduced to 4-6 hours;
children from 3 months to 12 years: 3 times a day at the rate of 50 mg / 5 mg / kg or 25 mg / 5 mg / kg, depending on the severity of the infection, the interval between injections is 8 hours;
children under the age of 3 months: weighing more than 4 kg - 25 mg / 5 mg / kg or 50 mg / 5 mg / kg every 8 hours, weighing less than 4 kg - 25 mg / 5 mg / kg every 12 hours.

Augmentin should be taken strictly in the doses prescribed by the doctor, following the prescribed regimen.

Side effects

The use of Augmentin in rare cases can cause the following (mostly mild and transient) side effects:

hematopoietic system: thrombocytopenia, leukopenia (including neutropenia), hemolytic anemia and agranulocytosis (reversible), increased prothrombin index and bleeding time;
immune system: allergic reactions in the form of anaphylaxis, angioedema, a syndrome similar to serum sickness, Stevens-Johnson syndrome, allergic vasculitis, toxic epidermal necrolysis, bullous exfoliative dermatitis, acute generalized exanthematous pustulosis. The use of Augmentin should be discontinued if any of the forms of allergic dermatitis occurs;
skin manifestations: rash, urticaria, erythema multiforme;
central nervous system: hyperactivity and convulsions (reversible), headache, dizziness;
liver: cholestatic jaundice, hepatitis, moderate increase in AST and/or ALT levels (these side effects occur during or immediately after therapy, most often in elderly patients and in men (with long-term treatment), in children - very rarely, and are reversible);
urinary system: crystalluria, interstitial nephritis.

Very often, the use of Augmentin can cause diarrhea in adults and children, nausea, vomiting, dyspepsia (these digestive disorders can be reduced if the drug is taken with food).

Occasionally, in children taking Augmentin suspension, the color of the integumentary layer of tooth enamel may change.

The microbiological effect of the drug often causes candidiasis of the mucous membranes, in rare cases it can cause hemorrhagic and pseudomembranous colitis.

Overdose

With an overdose of Augmentin, there may be disturbances in the water and electrolyte balance and negative symptoms from the gastrointestinal tract. There are reports of the development of amoxicillin crystalluria, which in some cases provoked the development of renal failure. Patients with kidney dysfunctions, as well as those who take the drug in high doses, may experience seizures.

To stop the negative phenomena associated with the functioning of the gastrointestinal tract, symptomatic therapy is prescribed, in the selection of which special attention should be paid to the normalization of water and electrolyte balance. Clavulanic acid and amoxicillin can be removed from the systemic circulation through a hemodialysis procedure.

A prospective study at a poison control center in 51 children confirms that the administration of amoxicillin at a dose not exceeding 250 mg/kg did not lead to the development of clinically significant symptoms of overdose and did not require gastric lavage.

After intravenous administration of amoxicillin in large doses, it can form a precipitate in urinary catheters, so their patency should be checked regularly.

special instructions

When treating with Augmentin, it is necessary to first collect a detailed history to find out if there were previous hypersensitivity reactions to cephalosporins, penicillins or other allergens.

Serious anaphylactoid reactions, sometimes fatal, have been reported in some cases. The risk of such conditions is especially high in patients with a history of hypersensitivity reactions to penicillins. If an allergic reaction occurs, Augmentin therapy should be stopped immediately, in severe cases, adrenaline should be administered immediately. Oxygen therapy, intravenous glucocorticosteroids, and airway management, including intubation, may be necessary.

With prolonged use of Augmentin, the risk of excessive reproduction of microorganisms insensitive to it increases.

Influence on the ability to drive vehicles and complex mechanisms

Augmentin does not have a negative effect on the ability to drive vehicles and mechanisms.

Use during pregnancy and lactation

The results of studies of reproductive function in animals with parenteral and oral administration of Augmentin confirm the absence of teratogenic effects caused by the drug. A single study in patients with preterm rupture of the membranes suggests that prophylactic therapy with this antibiotic may increase the risk of neonatal necrotizing enterocolitis. Therefore, Augmentin should be used only in cases where the potential benefit of treatment for the mother significantly outweighs the possible adverse effects on the fetus.

Appointment of Augmentin during lactation is allowed. However, if adverse reactions develop in children (candidiasis of the mucous membranes of the oral cavity, diarrhea, increased sensitization), it is recommended to stop breastfeeding.

Application in childhood

It is allowed to prescribe Augmentin for children according to indications in compliance with the dosing regimen:

powder for suspension for oral administration and powder for solution for intravenous administration - from birth;
film-coated tablets - from 12 years.

For impaired renal function

In patients with renal dysfunction, dose adjustments are based on the maximum therapeutic dose of amoxicillin and are based on creatinine clearance (CC) values.

When taken by adult patients whose CC exceeds 30 ml / min, Augmentin tablets with a dosage of 500 mg / 125 mg or 250 mg / 125 mg, as well as a suspension with a dosage of 125 mg / 31.25 mg in 5 ml, there is no need for dose adjustment. If the CC value is from 10 to 30 ml / min, patients are advised to take 1 tablet 500 mg / 125 mg or 1 tablet 250 mg / 125 mg (for mild and moderately severe infections) 2 times a day or 20 ml of a suspension of 125 mg / min. 31.25 mg in 5 ml 2 times a day.

With a CC value of less than 10 ml / min, Augmentin is used at a dosage of 1 tablet 500 mg / 125 mg or 1 tablet 250 mg / 125 mg (for mild and moderately severe infection) 1 time per day or 20 ml of suspension 125 mg / 31.25 mg in 5 ml once a day.

Tablets 875 mg / 125 mg are prescribed only to patients whose CC exceeds 30 ml / min, so dose adjustment is not required. In most cases, it is recommended to give preference to parenteral administration of Augmentin.

When used in adults and children over 12 years of age or weighing more than 40 kg who are on hemodialysis, the recommended dose of Augmentin is 1 tablet 500 mg / 125 mg (2 tablets 250 mg / 125 mg) once every 24 hours or 20 ml suspensions 125 mg / 31.25 mg 1 time per day.

During the dialysis procedure, as well as at its end, the patient receives an additional one tablet (1 dose), which allows compensating for the decrease in the concentrations of clavulanic acid and amoxicillin in the blood serum.

For impaired liver function

In patients with liver dysfunction, treatment is carried out with caution. It is recommended to regularly monitor the condition of the liver. The limited data regarding the use of Augmentin in this category of patients does not allow for correction of the dosing regimen.

Use in the elderly

There is no need to reduce the dose for elderly patients: it is prescribed in the same doses as for adult patients. In elderly patients with renal dysfunction, the dose should be adjusted in the same way as for patients with renal insufficiency.

drug interaction

Probenecid and drugs of similar action (phenylbutazone, diuretics, NSAIDs) reduce the tubular secretion of amoxicillin. Simultaneous administration is not recommended, since it may be accompanied by persistence and an increase in the concentration of amoxicillin in the blood (while the renal excretion of clavulanic acid does not slow down).

Fibell.

Analogues of Augmentin according to the mechanism of action, drugs of the same pharmacological subgroup: Ampiox, Ampisid, Libaktsil, Oksamp, Oxampicin, Oxamsar, Sulbacin, Sultasin, Santaz, etc.

Terms and conditions of storage

Store at temperatures up to 25 ° C in a dry place out of the reach of children.

Best before date:

tablets containing amoxicillin 875 mg and 250 mg - 2 years;
tablets containing amoxicillin 500 mg - 3 years;
powder for solution for intravenous administration - 2 years;
powder for the preparation of a suspension in unopened form - 2 years;
prepared suspension (at a temperature within 2-8 ° C) - 7 days.

In choosing an antibiotic for the treatment of any infection, drugs with a broad spectrum of antimicrobial activity are often preferred. One of them is Augmentin. For children, this medicine is more convenient to give in liquid form. When is it prescribed to young children and how is the suspension prepared? Is the drug taken before or after meals? How long to treat a child? These and other questions are of interest to every mother if her son or daughter is to take an antibiotic.

Release form

Augmentin, from which the suspension is prepared, is represented by a powder placed in a glass vial. Such a powder has a white color and a characteristic odor, and after adding water, a white suspension is obtained from it, which separates during storage with the formation of a white precipitate. The drug is also available in injection form (it is intended for intravenous administration) and in coated tablets with different dosages (they can contain 250, 500 or 875 mg of the antibiotic each).

Compound

Augmentin includes two active ingredients at once, thanks to which it has a wide range of effects on microorganisms:

Amoxicillin. This antibiotic is presented in the form of a trihydrate and is contained in 5 ml of the finished drug at a dosage of 125 mg, 200 mg or 400 mg.
clavulanic acid. Such a compound is a potassium salt and the dosage of this acid is, depending on the dose of amoxicillin, 31.25 mg, 28.5 mg or 57 mg per 5 ml of suspension.

The ratio of these two components is represented by a ratio of 4:1 and 7:1. Additionally, the bottle contains silicon dioxide, xanthan gum, hypromellose and succinic acid. For sweetness, aspartame is added to the preparation, and the smell of the suspension is provided with orange, raspberry and molasses flavors.

Operating principle

Amoxicillin in the composition of Augmentin has an antimicrobial effect on many types of microorganisms. It acts bactericidal, causing the death of bacteria due to inhibition of the synthesis of their cell walls. However, this antibiotic can be destroyed by beta-lactamases, so it cannot kill the bacteria that produce these enzymes.

It is to prevent this destruction that clavulanic acid is present in the preparation. It inactivates beta-lactamase, which makes even amoxicillin-resistant microbes sensitive to the suspension.

The drug is effective against:

Various types of staphylococci, including saprophytic and golden.
Pertussis sticks.
Various types of streptococci, including hemolytic, pyogenic and group B.
Nocardius.
Listeria.
Hemophilic rods.
Enterococci.
Helicobacter pylori.
Gonococcus.
Vibrio cholerae.
Pasteurell.
Peptococcus and Peptostreptococcus.
Moraxell.
Pale treponemas.
Leptospir.
Borrelia.
Bacteroids.
Clostridia.
Fusobacterium.

The suspension may be powerless against Escherichia coli, Proteus, Salmonella, Corynebacterium, Pneumococcus, Klebsiella and Shigella, therefore, when infected with these microorganisms, it is recommended to first do a sensitivity test.

The drug is considered ineffective when infected with Citrobacter, Enterobacter, Morganella, Providence, Legionella, Hafnia, Pseudomonas, Yersinia, Chlamydia, Coxiella, Mycoplasmas and Serrations. In addition, this medicine does not help with influenza, herpetic sore throat, SARS, mononucleosis, chickenpox and other viral infections.

Indications

Augmentin in the form of a suspension is prescribed:

With bacterial lesions of the ENT organs and the upper respiratory system, for example, with otitis media, sinusitis or recurrent tonsillitis.
With whooping cough or scarlet fever.
With exacerbation of chronic bronchitis, acute bronchitis, lobar pneumonia and other bacterial lesions of the lower respiratory tract.
With urinary infections, for example, with urethritis or pyelonephritis.
With gonorrhea.
When infected with streptococci or Staphylococcus aureus of soft tissues or skin.
With bacterial infections of the joints or bones.

At what age is it allowed to take?

Augmentin is prescribed by pediatricians for children of any age, even infants. At the same time, suspensions with a dosage of amoxicillin 200 mg or 400 mg per five milliliters do not give babies the first three months of life. Such drugs are prescribed in childhood only from 3 months.

Contraindications

The drug should not be given to a child with hypersensitivity to any component of the suspension, as well as allergies to other penicillin antibiotics or cephalosporins. Also, treatment is prohibited for phenylketonuria, which is associated with the presence of aspartame in the composition.

Very carefully prescribe the medicine to children who have impaired kidney function or liver disease. If infectious mononucleosis is suspected in a baby, the use of Augmentin can cause a measles-like rash.

Side effects

As a result of treatment with Augmentin, a child may experience:

Allergy in the form of itching, hives or rash.
Loose stools, as well as vomiting or nausea.
Deterioration of the parameters of the general blood test - a decrease in the level of platelets and leukocytes, sometimes agranulocytosis and anemia, as well as a change in the parameters of the coagulation system.
Candida infection that affects the mucous membranes or skin.
Increased activity of liver enzymes.
Headache or dizziness.

Very rare side effects of taking the suspension include Quincke's edema, anaphylaxis, nervous excitement, convulsions, intestinal inflammation, stomatitis, discoloration of tooth enamel, nephritis and other negative phenomena. When they occur, stop treatment and immediately consult a doctor.

Instructions for use

To prepare a suspension, boiled and cooled to room temperature water in a certain amount is added to Augmentin in powder. In a preparation containing amoxicillin at a dose of 125 mg per 5 milliliters, first pour 60 ml of water. Next, the medicine is shaken and left for 5 minutes, after which more water is added so that its total volume is approximately 92 ml.

If a suspension containing 200 or 400 mg of amoxicillin in five milliliters is used in the treatment, then the powder is first mixed with 40 ml of water, and after five minutes a little more water is added to the bottle so that its total amount is approximately 64 ml.

In addition, treatment with the liquid form of Augmentin provides for such nuances:

Before each use, the medicine should be shaken so that the exfoliated syrup becomes homogeneous.
The measuring cap that comes with the antibiotic bottle helps to measure the exact dose of the medication. When the child has drunk the suspension, this cap is thoroughly washed with water.
For a child under two years of age, a single dosage of the drug can be further diluted with water 1: 1.
The mode of application and calculation of a single dosage of the drug is affected by both the age of the child and his weight, and the condition of the kidneys, and the severity of the infection.
In order for the active substances of the drug to be optimally absorbed, and the risk of side effects is less, it is advised to drink the medicine at the beginning of the meal. Suspension is given to infants during feeding.
How many days to drink the drug, in each case is determined individually, but the minimum course of treatment is considered to be a period of 5 days. In addition, it is undesirable to give the suspension longer than 14 days.
To prevent staining of the teeth, it is recommended to brush them thoroughly several times a day.

Dosage

Babies of the first three months of life are given only a suspension, the active substances of which are presented in a ratio of 4: 1 (125 mg / 31.25 mg).

To calculate the daily dose of the drug, you need to know the weight of the baby in kilograms. It is multiplied by 30 and get the number of milligrams of amoxicillin. By dividing the resulting figure by 2, a single amount of ml of suspension is determined, which is given to the child twice a day.

For a child aged 3 months to 12 years who weighs less than 40 kilograms, the suspension is dosed as follows:

Preparation containing active compounds 125mg/31.25mg give three times a day with an interval between doses of 8 hours.
A medicine containing the active ingredients in an amount 200mg/28.5mg or 400mg/57mg, prescribed twice, that is, such suspensions are taken twice a day.

If the child has soft tissue or skin infection then Augmentin is prescribed at a low dose. It is presented at 20 mg per 1 kg of baby's weight per day for a suspension of 125 mg / 31.25 mg / 5 ml or 25 mg per day per kilogram of a child's weight for suspensions with a 7: 1 ratio of active ingredients. The same dosage is used with relapses of tonsillitis.

If Augmentin is being treated otitis, sinusitis, infections of the joints, urinary organs, lower respiratory tract or bones, high doses are used. This is 40 mg per 1 kilogram of the child's body weight per day for a 4:1 suspension. If the baby is given the drug 7:1, then the dosage will be 45 mg per day per 1 kg of the patient's weight. All calculations are performed on amoxicillin.

Children over 12 years old and children weighing more than 40 kg give 11 ml of suspension containing 400 mg of amoxicillin and 57 mg of clavulanic acid. The drug is prescribed twice. It should be noted that such patients are more preferable to use the drug in tablet form.

Overdose

If you exceed the dose of the suspension prescribed by the doctor, this can disrupt the child's digestive system and affect the water and electrolyte balance in his body. It is also possible the formation of crystals in the urine, due to which an overdose can provoke kidney failure. If the child has diseased kidneys, then an excess of the dose can cause convulsions.

Interaction with other drugs

Co-administration with antacids, laxatives or glucosamine impairs the absorption of amoxicillin.
When administered simultaneously with macrolides (for example, with a suspension of Sumamed or Azitrox), the effect of Augmentin will be weaker. The same effect is observed when combined with tetracyclines, sulfonamides, lincosamides and chloramphenicol.
The suspension can be used together with nitrofurans, for example, Enterofuril.
Augmentin should not be given to a child along with allopurinol, as this combination can provoke skin allergies.
When administered with anticoagulants (indirect), the effectiveness of these drugs will increase.
The drug is not prescribed together with methotrexate, since penicillins increase its toxicity.

Terms of sale

To buy powder at a pharmacy, you first need to get a prescription from a doctor. The price of one bottle depends on the dosage and can vary from 130 to 250 rubles.

Storage Features

An unopened bottle of powder can be stored until the end of its shelf life, which is 2 years, in a dry place away from babies, where the temperature does not rise above +25 degrees. The preparation diluted with water should be placed in the refrigerator, but the solution should not be allowed to freeze. The shelf life of the liquid medicine is 7 days.

AUGMENTIN™ (AUGMENTIN™)

GlaxoSmithKline J01C R02

COMPOSITION AND FORM OF RELEASE:

AUGMENTIN™

tab. po 500 mg + 125 mg blister, № 14

Other Ingredients: colloidal anhydrous silica, sodium starch glycolate, magnesium stearate, microcrystalline cellulose, titanium dioxide, hypromellose (5cps), hypromellose (15cps), macrogol 4000, macrogol 6000, dimethicone 500 (silicone oil).

No. UA/0987/02/02 from 07/05/2013 to 07/05/2018

AUGMENTIN™ (BD)

tab. po 875 mg + 125 mg, No. 14

Amoxicillin ............................................... 875 mg
Clavulanic acid .............................. 125 mg